Högskolan i Skövde

Background: Globally, stroke is the second leading cause of death. About 20% of patients with acute stroke die within 30 days of onset, yet fewer than 10% receive palliative care, and only a small fraction of these receive it in specialized palliative units. Rather, they are treated in stroke units, where both knowledge of palliative care and support for bereaved family members may be inconsistent and limited.

Objectives: To describe the occurrence and design of bereavement support in the form of conversations offered to family members of patients who die from acute stroke in a stroke unit, as well as the registration in the Swedish Register of Palliative Care.

Design: This study employed a quantitative descriptive design with a cross-sectional approach.Methods:A study-specific survey consisting of three main questions and several follow-up questions was used. All 72 stroke units in Sweden were contacted in person, by phone, or by email; 71 units ultimately participated.

Results: Bereavement support in the form of conversations was provided to the family members of patients who had died from an acute stroke in 34 (48%) of the 71 stroke units. Among these, 21 units offered bereavement support to family members in all deaths, while 13 provided it when the need for support was identified. In total, 60 of the 71 stroke units (84%) register in the Swedish Register of Palliative Care, and of these, 25 units systematically use the registered data.

Conclusion: Neither bereavement support in the form of conversations nor the systematic use of the palliative care registry are fully established part of care at stroke units. To ensure good and equitable end-of-life care, support for bereaved family members needs to be strengthened. Palliative registry data from stroke units represent an underutilized resource with the potential to improve both palliative care and bereavement support.