Family meetings at end of life

Structured family meetings are ideally conducted based on a collaboration between the patient, family members, informal caregivers, and an interdisciplinary team of health care professionals to facilitate communication and end-of-life planning, thereby creating opportunities for shared decision making. Little evidence currently exists to guide the health care professional in conducting the meeting. The purpose of this systematic review is to examine and synthesize the evidence available to inform our understanding of family meetings at the end of life. We conducted a systematic review of the literature and screened 1113 articles; 59 were assessed for eligibility with a full-text screening, and 24 were included in the final synthesis. Structured family meetings can be an effective means of communicating when preparing for the end of life and can potentially reduce suffering for patients and family members. Patients and family outcomes included satisfaction, enhanced psychological well-being, and well-planned decisions regarding life-sustaining medical interventions. Some evidence indicates that structured interventions transcend cultural and geographic boundaries; however, sociological aspects in some countries may restrict end-of-life planning. Future research needs to focus on the development of structured communication interventions, including assessment of emotional state, readiness to face the end of life, and explication of effective strategies for the provision of meaningful information and emotional support.