Although often associated with life-saving actions, emergency ambulance care is also required by people with known life-limiting illness and those who are nearing the end of their life. Access to specialist palliative care may be limited at night, on weekends or in remote and rural areas. Family members play an essential role caring for those living their last days of life in the community, but their experiences of emergency ambulance care have received very little research attention, to-date. Our qualitative study explores 38 bereaved family members’ experiences of emergency ambulance care at the end of life.
We found that emergency ambulance care was highly valued. Bereaved family members in caregiving roles appreciated compassionate, caring ambulance responses to a range of challenging issues including falls, bleeding, confusion, pain, infection, breathlessness, collapse and death itself.
‘They took every, every minute that they needed. They didn’t rush him. They helped and they told mum and I to just let them do it and they checked him over and they just said, you know, if you ever need to call us, don’t feel bad about it’.Participant #6
However, several participants also felt reluctant to call an ambulance, expressing concerns about unwanted hospital admission and being a low priority in a very busy emergency care system.
‘.. . . you know there’s triaging and they have to prioritise, and we understand that. And I thought, you know he can’t sit up in a chair and wait for hours and hours . . . he’s better lying in our bed you know, in bed at home.’Participant #16
Our findings have implications for practice and policy. After hours and urgent services need to be resourced to meet the growing needs of people living and dying at home with complex comorbidities, and the family members that care for them. Palliative care services in policy and practice need to include emergency ambulance providers and education should prepare and support paramedics to provide support to caregivers and bereaved family members. More research is needed in this area (watch this space!)
This work was made possible through funding from New Zealand’s Heart Foundation, Cancer Research Trust and A+ Trust. Project funders did not have a role in the design of the study or collection, analysis and interpretation of data, or in writing the manuscript.