End-of-life decision-making is an important area of research, and few sociological studies have considered family grief in light of end-of-life decision-making in the hospital. Drawing on in-depth interviews with family members in the intensive care unit (ICU) during an end-of-life hospitalization and into their bereavement period up to six months after the death of the patient, this article examines bereaved family members’ experiences of grief by examining three aspects from the end-of-life hospitalization and decision-making in the ICU that informed their subsequent bereavement experiences. First, this article explores how the process of advance care planning (ACP) shaped family experiences of grief, by demonstrating that even prior informal conversations around end-of-life care outside of having an advance directive in the hospital was beneficial for family members both during the hospitalization and afterwards in bereavement. Second, clinicians’ compassionate caring for both patients and families through the “little things” or small gestures were important to families during the end-of-life hospitalization and afterwards in bereavement. Third, the transition time in the hospital before the patient’s death facilitated family experiences of grief by providing a sense of support and meaning in bereavement. The findings have implications for clinicians who provide end-of-life care by highlighting salient aspects from the hospitalization that may shape family grief following the patient’s death. Most importantly, the notion that ACP as a social process may be a “gift” to families during end-of-life decision-making and carry through into bereavement can serve as a motivator to engage patients in ACP.

临终决策是一个重要的研究领域，鉴于医院临终决策，很少有社会学研究考虑过家庭悲痛。本文根据临终住院期间对重症监护室（ICU）家庭成员的深入访谈，以及在患者死亡后长达六个月的丧亲期，本文考察了失去亲人的家庭成员的经历。通过检查重症监护病房临终住院和决策中的三个方面了解他们的丧亲经历，从而悲痛。首先，本文探讨了预先护理计划（ACP）的过程如何影响家庭的悲痛经历，通过证明即使在医院中有预先医疗指示之外，即使是关于临终关怀的事先非正式对话对住院期间和之后的丧亲家庭成员也都是有益的。其次，在临终住院期间和丧亲之后，临床医生通过“小事”或小手势对病人和家人的同情关怀对于家庭很重要。第三，患者死亡前在医院的过渡时间，通过提供对丧亲的支持和意义，促进了家庭的悲痛经历。这一发现对于强调临终关怀的临床医生具有重要意义，因为他们强调了住院期间的重要方面，这些方面可能会在患者死亡后造成家庭的悲痛。最重要的是，