For all questions the informant was reminded to focus on the decedent’s last 30 days while he/she was at the location identified earlier through a series of questions, as to where the majority of care was provided.
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Physical comfort and emotional support
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[Asked of informant’s if the decedent had experienced pain and were provided medications or treatment for their pain] …
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Did [DECEDENT] receive too much, too little, or just the right amount of medication for (his/her) pain?
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[ ] Too much
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[ ] Too little
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[ ] Right amount
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Similar questions were asked about help to treat dyspnea and support for feeling of anxiety and/or sadness (emotional support).
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Promotion of shared decision making (among informants who had contact with the decedent’s doctor or nurse…)
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Was there ever a problem understanding what any doctor or nurse was saying to you about what to expect from treatment?
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[ ] Yes
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[ ] No
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[ ] No treatment
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Was there ever a decision made about (his/her) care without enough input from (him/her) or (his/her) family?
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[ ] Yes
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[ ] No
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How much information did the doctors or nurses provide you about [DECEDENT’S] medical condition - would you say less information than was needed, just the right amount, or more than was needed?
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[ ] Less than was needed
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[ ] Just the right amount
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[ ] More than was needed
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Treating the dying patient with respect
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During those last 30 days how often was (he/she) treated with respect by those who were taking care of (him/her) - always, usually, sometimes, or never?
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[ ] Always
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[ ] Usually
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[ ] Sometimes
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[ ] Never
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Attend to the needs of the family
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a) Information needs
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At any time did you or your family receive any information about what to expect while (he/she) was dying? (e.g. symptom relief (pain, breathing), emotions)
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[ ] Yes
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[ ] No
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Would you have wanted some or more information about that?
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[ ] Yes
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[ ] No
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At any time did you or your family receive any information about what to do at the time of (his/her) death? (process of who to call, contact …)
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[ ] Yes
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[ ] No
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Would you have wanted some or more information about that?
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[ ] Yes
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[ ] No
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At any time during the time around [DECEDENT’S NAME] death, did you or your family receive any information about the medicines that would be used to manage (his/her) pain, shortness of breath, or other symptoms?
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[ ] Yes
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[ ] No
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Would you have wanted some or more information about the medicines?
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[ ] Yes
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[ ] No
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b) Caregiver skills – knowing what to expect as death approached
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How confident were you that you knew what to expect while [DECEDENT] was dying? Were you:
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[ ] Very confident
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[ ] Fairly confident
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[ ] Not confident
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How confident were you that you knew what to do at the time of death. Were you:
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[ ] Very confident
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[ ] Fairly confident
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[ ] Not confident
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How confident were you that you understood about the medicines that would be used to manage [his/her] pain, shortness of breath, or other symptoms. Were you:
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[ ] Very confident
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[ ] Fairly confident
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[ ] Not confident
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Attend to emotional and spiritual needs of the family
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During this time did someone talk with you about your religious or spiritual beliefs?
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[ ] Yes
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[ ] No
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If yes, was it done in a sensitive manner?
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[ ] Yes
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[ ] No
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Did you have as much contact of that kind as you wanted?
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[ ] Yes
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[ ] No
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How much support in dealing with your feelings about [DECEDENT’S] death did the doctors, nurses or other professional staff taking care of [him/her] provide you?
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[ ] Less support than was needed
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[ ] Right amount
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Did a doctor, nurse or other professional staff taking care of [DECEDENT] talk about how you might feel after [his/her] death?
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[ ] Yes
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[ ] No
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Would you have wanted them to?
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[ ] Yes
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[ ] No
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Was it done in a sensitive manner?
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[ ] Yes
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[ ] No
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Provide coordination of care
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During those last 30 days, was there any problem with doctors or nurses not knowing enough about [his/her] medical history to provide the best possible care?
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[ ] Yes
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[ ] No
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Overall satisfaction with care
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On a scale of 0 to 10, where 0 means the worst care possible and 10 means the best care possible, what number would you give the overall care that [DECEDENT] received during those last 30 days of life while being cared for at [LOCATION OF CARE]?
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0 = worst care possible
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10 = best care possible |