End-of-life care promotes compassion by granting wishes of dying patients, families

The 3 Wishes Project (3WP), a “transferable, affordable and sustainable” palliative intervention, has been successfully implemented, providing value to dying patients, their families, clinicians and institutions, a recent study has shown.

“The 3WP is an end-of-life programme that aims to honour the dignity of dying patients by creating meaningful patient- and family-centred memories while promoting humanistic interprofessional care,” the authors said.

In total, 730 patients were included, eliciting 3,407 wishes. Qualitative data were obtained from 75 family members, 72 clinicians and 20 managers or hospital administrators.

One value created by the 3WP was the intentional comforting of families as they honoured the lives and legacies of their loved ones while inspiring compassionate clinical care. Factors that encouraged transferability of the programme included family appreciation and a collaborative intensive care unit (ICU) culture committed to dignity-conserving end-of-life care.

Moreover, participation of the staff evolved from passive support to professional agency.

Initiating the 3WP required minimal investment for reusable materials. Subsequently, the mean cost was $5.19 per wish. The continuation of 3WP at each site after study completion demonstrated the programme’s sustainability.

This mixed-methods formative programme evaluation included dying patients, their families, clinicians, hospital managers and administrators from four North American ICUs. The intervention elicited and implemented wishes from dying patients, family members and clinicians.

Measurements included patient characteristics and care processes; number, type and cost of each wish; and semistructured interviews and focus groups with family members, clinicians and managers.

“This descriptive formative evaluation describes tertiary care centre–specific experiences rather than aiming for generalizability to all jurisdictions,” the authors noted.