Bereavement questionnaire
1.
Please tell us the name of the ward that your friend or relative died on.
2.
In your opinion, was hospital the right place for your friend / relative to receive care at the end of their life?
Yes, definitely
Yes, to some extent
No, not really
No, not at all
N/A
3.
Please tell us why
4.
Do you feel your friend / relative's care needs were met during the last few days of their life?
Yes, definitely
Yes, to some extent
No, not really
No, not at all
N/A
5.
Please tell us more about this
6.
Were you involved in discussions with staff about your friend / relative's care during the last few days of their life?
Yes, definitely
Yes, to some extent
No, not really
No, not at all
N/A
7.
Please tell us more about this
8.
Did you feel supported by staff at the RUH in the days before your friend / relative died?
Yes, definitely
Yes, to some extent
No, not really
No, not at all
N/A
9.
Please tell us more about this
10.
Did you feel supported by the staff in the Bereavement and Medical Examiner office in the days after your friend / relative died?
Yes, definitely
Yes, to some extent
No, not really
No, not at all
N/A
11.
Please tell us more about this
12.
If you think that there was anything that was done well at the RUH, or that made a difference to you or your friend or relative, please tell us more here.
13.
If you think the RUH could have done more to support you and your relative / friend, please tell us more here.
If you have any concerns about the care and support provided, please contact our Patient Support and Complaints Team on 01225 825656 / ruh-tr.psct@nhs.net