20% of U.S. deaths now occur during or soon after an ICU stay — but the families live on, often with upsetting memories, depression, and anxiety. Kross et al re-heat data from the IPACC palliative care study in Washington, surveying family members of ICU decedents, showing they had a 14% prevalence of PTSD symptoms and 18% of depression. (However, only 13% of eligible patients had a family member who responded to the survey, increasing the likelihood of response bias.) Younger age of the deceased patient and family presence at the time of death were associated with higher rates of symptoms. Comfort-care extubation was linked to lower family symptoms. Authors suggest that families should be offered the option of not being present at the time of a family member’s death in the ICU. CHEST 2011;139:795-801.