Trauma-Informed Care, Advance Care Planning and grief – integrating approaches to enhance care

Purpose - Application of a Trauma-Informed Care (TIC) approach in palliative and end-of-life care is recent and under-researched. This study aimed to describe the experience of people bereaved following a death in a Local Health District. This included exploring the relationship between ACP and bereavement and whether care provided was consistent with TIC principles. Methods – Invitations for an online survey were sent to bereaved Next of Kin of adult patients who had died in a metropolitan health district in Australia between September 2021 and November 2022. Data were analysed using descriptive statistics and a Z test. Results – Response rate was 15.7% (n=293). Of participants involved in ACP discussions, 38% reported a positive impact on their post-death grief. Analysis against all variables showed the strongest association for positive impacts of ACP on grief where discussions were held in line with principles of TIC. Associations were also shown between care provision in line with TIC and family being involved in decisions at the level they wanted to be, in the last 3 months of life. Conclusion - A trauma-informed approach to ACP has significant positive impacts on family being involved in decisions at the level they wanted to be, and on their later grief. These results contribute a new perspective from bereaved family members reporting on the impact ACP discussions had on subsequent grief experiences, demonstrating the benefits of a Trauma-Informed approach in ACP. The principles of TIC should be used to underpin ACP practice, and education for healthcare professionals on ACP.