Bereavement survey

We are interested in the quality of care provided to patients, their families, close friends and carers at Russells Hall Hospital at the end of life. This information will help us to improve the care and support we provide to people at this difficult time. All information is confidential and you do not need to include your name unless you wish us to contact you.

The following errors occurred:

1. Bereavement survey

The period of time this survey relates to
Please tell us the last ward that was involved in your relative's/friend's care
Were you given the opportunity to talk with any of the doctors involved in your relative's care?
If you spoke to a doctor, was there ever a problem understanding what the doctor was saying to you about what was happening and what to expect? If yes, please tell us more
While your relative was in hospital was the possibility that they may not recover ever discussed with you?
Did a member of staff tell you that your relative may die?
Did you feel you had enough privacy when you were told your relative may die? If yes, please tell us more
Was there ever a discussion about where your relative wanted to be cared for in their last days?
Were you given a chance to talk to someone about any concerns you had?
Did you feel the environment (e.g. room/ward) in which they spent their last days was appropriate? If no, please tell us more
If you wished to stay with your loved one during their last few hours/days, were you given the opportunity to do so?
If you chose to stay with your loved one during their last few hours/days, how well supported by staff did you feel?
Were you given the opportunity to see them after they died?
Did you feel there was ever a decision made about their care without enough involvement from yourself? If yes, please tell us more
Did you feel that their personal wishes were respected by those caring for them?
Did you feel that their religious/cultural/spiritual beliefs were taken into consideration by those caring for them?
When you visited the bereavement office was there anything that could have been improved? If yes, please tell us more
Since your relative died, have you been able to talk to anyone from the hospital about your feelings regarding their illness or death? If no, was this because
On balance, did you feel the hospital was the right place for your relative to spend their last days? If no, please specify preferred place
Do you have any additional comments that you want to tell us about?
What was your relationship with the person you have completed this questionnaire about?

2. About you

Important information

If you would like someone to contact you regarding anything you have included on this questionnaire, please write your name and contact number below.
Your full name (optional)
Your contact number (optional)

3. About your relative/friend

Which sex was your relative/friend?
What was their age when they died?
To which of these ethnic groups would you say they belonged?
Did they consider themselves to have a disability?