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Das Unfassbare verstehen: Kommunikation mit Angehörigen von sterbenden Patienten auf der Intensivstation

Comprehend the incomprehensible: death on the intensive care unit and communication strategies with the next of kin

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Intensivmedizin und Notfallmedizin

Abstract

In Germany, approximately half of all death occurs in hospitals with the majority of patients being cared for in intensive care units (ICUs) at the time they pass away. Thus, exposure to dying patients and subsequent death is an integral part of the daily work in ICUs. In addition, patients’ relatives often are defencelessly confronted with agony, the process of dying and death, thus requiring considerable attention from the ICU staff. The importance of empathic support of the next of kin is rarely considered and premises, time, and training of soft-skills to accompany the afflicted next of kin are often missing.

Owing to the demographic development the number of dying patients and thus the confrontation with death in the ICU will further increase. Lately, important work has been published impressively demonstrating the benefit of a deliberate and open-minded communication strategy, thereby facilitating the mourning process and preventing post-traumatic stress disorders of the next of kin.

Zusammenfassung

Gegenwärtig verstirbt etwa die Hälfte aller Menschen in Deutschland im Krankenhaus und ein großer Teil dieser Patienten verbringt die letzte Lebens- bzw. Sterbensphase auf der Intensivstation. Für das intensivmedizinische Team stellt der Umgang mit Sterben und Tod somit einen wesentlichen Teil des beruflichen Alltags dar. Neben dem Patienten gilt es aber auch, sich intensiv den Angehörigen dieser Patienten zu widmen, die häufig dem Erleben von Leid, Sterben und Tod hilflos gegenüber stehen. Zu selten werden im professionell-medizinischen Umfeld der Intensivstation diese wichtigen Aspekte der Angehörigenbegleitung berücksichtigt: es fehlen Räumlichkeiten, Zeit und Ausbildung im Umgang mit emotional schwer belasteten Angehörigen.

Aufgrund der demographischen Gesellschaftsentwicklung wird die Konfrontation mit Sterben und Tod im Krankenhaus und auf der Intensivstation in den nächsten Jahren weiter zunehmen. Eine Reihe bedeutender Arbeiten hat in den letzten Jahren eindrucksvoll dargelegt, dass ein bewusster und offener Umgang und eine pro-aktive Gesprächsführung die betroffenen Angehörigen erheblich entlasten, die Trauerarbeit aktiv unterstützen und die Entstehung von posttraumatischen Störungen verhindern kann.

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Authors and Affiliations

  1. Medizinische Klinik, St.-Antonius-Hospital, Dechant-Deckers-Str. 8, 52249, Eschweiler, Germany

    Uwe Janssens

  2. Facharzt für Innere Medizin, Klinik für Anästhesie und Intensivtherapie, Philipps-Universität Marburg, Universitätsklinikum Gießen und Marburg GmbH Standort Marburg, Baldingerstraße, 35043, Marburg, Germany

    Jürgen Graf

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Correspondence to Uwe Janssens.

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Janssens, U., Graf, J. Das Unfassbare verstehen: Kommunikation mit Angehörigen von sterbenden Patienten auf der Intensivstation. Intensivmed 44, 325–331 (2007). https://doi.org/10.1007/s00390-007-0795-5

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