Bereavment support in the form of conversations in palliative care – a blind spot in acute care at stroke units

Stroke units could improve support for bereaved family members by adopting a more systematic and intentional approach to bereavement support in the form of conversations following the death of patients from acute stroke. Offering such conversations routinely, rather than selectively based on perceived need, would be a valuable first step. While many stroke units in Sweden use the Swedish Palliative Care Registry, it appears to be an underutilized resource for enhancing the quality of end-of-life care for patients with acute stroke. A more consistent and comprehensive use of the registry would be beneficial. Background and Aims: Despite advances in primary prevention and acute treatments, stroke remains a leading cause of death. However, few patients who die from acute stroke receive care in dedicated palliative care units, highlighting the need for stroke unit staff to be well-versed in palliative care. Bereavement support for family members is also an important aspect of care. This study aimed to describe the provision of bereavement support, particularly in the form of conversations, to relatives of patients who die from acute stroke in stroke units, as well as the registration of this support in the palliative care registry. Methods: A quantitative descriptive study with a cross-sectional design was conducted using a study-specific survey. All 72 stroke units in Sweden were contacted by email or telephone, with 71 responding. Data were analysed using descriptive statistics, including frequencies and percentages. Results: Bereavement support through conversations was offered to family members of patients who died from acute stroke in 34 (48%) of the 71 stroke units. Of these, 21 units provided support to all family members, while 13 offered it only to those identified as needing it. Sixty of the 71 units (84%) were registered in the Swedish palliative care registry, but only 25 units systematically used the data, meaning 58% did not utilise the collected data. Conclusion: Bereavement support in the form of conversations and palliative care registry use in stroke units require improvement to ensure comprehensive end-of-life care for patients and their families.