Authors (including presenting author) :
Li CY(1), Ng HY(2), Ip WY(1), Leung ST(1), Kwok HL(1), Wong MS(1), Ma SY(1), Tsang WY(1), Lam PT(1), Lo KP(2)
Affiliation :
(1)Medical and Geriatrics Department, (2)Nursing Services Division, United Christian Hospital
Keyword 1: :
Palliative care
Keyword 2: :
End of life care
Keyword 3: :
Imminent dying care
Introduction :
Saying goodbye is a crucial aspect of the end-of-life process. Families reported greater satisfaction with their caregiving experience when they believe they have fulfilled their duty and expressed love through care (Lowers et al., 2020). Low levels of preparation for death are also associated with abnormal grief responses (Nielsen et al., 2016). This quality improvement project was implemented in a mixed-specialty (rehabilitation and palliative) ward to provide more standardized end-of-life support.
Objectives :
1. To enhance the family experience during a patient’s final days 2. To improve nursing staff competence and confidence in delivering compassionate end-of-life care 3. To standardize family support through structured materials and instructions.
Methodology :
The “Goodbye Kit” was developed, comprising comfort care supplies (mouthwash, bed bath pack, moisture cream); an information leaflet on signs of impending death; a “Last Words Board” utilizing the “Four Themes of Life” framework to facilitate meaningful communication; and a speaker for ambient comfort music. All ward nurses received a 30-minute training session on the end-of-life care principles and the use of the “Goodbye Kit”. The kit was offered to families when doctor documented that a patient was imminently dying. Nurses’ attitudes were assessed using the Frommelt Attitude Toward Care of the Dying Scale (FATCOD, Form B) before and after training. Family members and staff satisfaction surveys were conducted. Data were analyzed using descriptive and inferential statistics.
Result & Outcome :
From November 2024 to August 2025, the “Goodbye Kit” was provided to 16 patients. All participating family members (100%) reported that the kit “reduced their anxiety through providing information on impending death and helped maintain patient dignity and personal hygiene. 75% of participating family members reported the “Goodbye Kit” facilitated the process of saying goodbye and expressing their love. 69% reported that it created a more peaceful environment. All ward nurses (n=23) were satisfied with the training workshop and reported an increased understanding of how to apply psychosocial-spiritual frameworks such as the “Four Themes of Life” in end-of-life care family support. The FATCOD score had no significant difference (p=0.166) before and after the training. However, they showed a positive attitude toward caring for terminally ill persons and their families. In conclusion, “Goodbye Kit” enhanced the family experience during the dying process and supported nursing staff in delivering standardized, compassionate end-of-life care. Incorporating the "Goodbye Kit" into routine practice is recommended to facilitate family expression of love and support during the patient's final journey.
