The death of a loved one in the intensive care unit may cause prolonged grief, social distress, and even symptoms of posttraumatic stress in family members. End-of-life interventions, such as grief education materials, telephone follow-up, and cards, are an important part of bereavement care for families. However, use of these interventions varies across institutions, and research findings on their effectiveness are conflicting.

Takaoka and colleagues examined the use of multiauthored, customized handwritten sympathy cards mailed to families 2 to 8 weeks post mortem. They interviewed family members and clinicians and identified 3 themes:

  • Reminder of shared humanity—both families and clinicians felt that the cards offered a shared connection with the other.

  • Personalized, authentic messages—an individualized message was deemed more authentic than cards that used generic phrases.

  • Extension of compassionate patient- and family-centered care—this care beyond the hospital setting was appreciated by both the...

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