Hola a todos, mis queridos amigos.

From 41 French ICU (network FAMIREA) a new tool is proposed to assess relatives’ experience of dying and death in the ICU. The hypothesis: to know their experience will allow us to implement preventive actions for the management of family grief.

The article has just been published on Intensive Care. The authors designed and validated the questionnaire CAESAR (with 15 questions) which was answered 21 days by the relatives of deceased patients, and also completed the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and the Inventory of Complicated Grief (ICG) after 3, 6, and 12 months.

The 15-item questionnaire, named CAESAR, covered the patient’s preferences and values, interactions with/around the patient and family satisfaction. The experience is evaluated from 1 to 5: 1 traumatic, 2 painful, 3 difficult, 4 acceptable, 5 comforting).

1. Was your loved one’s pain well controlled throughout the ICU stay?

2. Do you feel that your loved one’s dignity was maintained?

3. Do you feel the ICU team was attentive to your loved one?

4. Are you satisfied with the quality of medical care received by your loved one?

5. During the days before the death, were you clearly informed that your loved one was dying?

6. Are you satisfied with the quality of the communication between you and the physicians?

7. Are you satisfied with the quality of the communication between you and the nurses?

8. Were you in conflict with the ICU team?

9. Were you given the opportunity to discuss your loved one’s wishes, as well as your own preferences, with the ICU team?

10. Did your loved one refuse any of the suggested treatments?

11. Do you believe the ICU team went too far in the treatment given to your loved one? Do you believe the ICU team used unnecessary treatments?

12. Were you able to say goodbye and express important feelings to your loved one?

13. Were you present when your loved one died?

14. Are you satisfied with the support you received while your loved one was dying?

15. During your loved one’s stay in the ICU, did you receive counselling, for instance from a psychologist?
CAESAR score 21 day was correlated with the presence of symptoms of anxiety, depression, post-traumatic stress and complicated grief. Therefore, it can serve to identify areas for improvement and implement strategies of communication, training, palliative care in the ICU and the recognition of the vulnerability of the family.

Associated to this article, Dr. Randall Curtis has written the following editorial about the importance and challenge of measuring family experience with end-of-life care in the ICU, where attention is often so varied according to the Unit, the Hospital or the professionals .

From the IC-HU Project, we want to congratulate the authors. Why not trying in Spain?

Give back to Caesar what is Caesar’s.

Happy Tuesday,