Summary

  • timely, honest/open communication that is patient/carer led is essential
  • communication between teams is crucial to ensure seamless care
  • assessment of needs in physical, psychological, social and spiritual domains
  • diagnosing dying is highly complex
  • have knowledge of the patient’s condition
  • have an awareness of family dynamics
  • people can change their minds so decisions need to be revisited
  • adopt a goal setting approach to shared decision making
  • look after yourself!

What is helpful:

  • using a model such as SPIKES
  • patient led interactions
  • anticipation of needs and planning accordingly
  • open and honest communication about what is happening and what to expect - advance care planning
  • good documented summary/synopsis of conversations
  • knowing what and who is important to the patient
  • understanding the potential for complexity around communication – try to identify a key person to share information with
  • ask patient if they want to bring someone to the clinics/appointments
  • timely referral to other services
  • facilitate shared decision making
  • assessment and care planning
  • using a structured framework for assessment and care planning – use of tools such as GSF, SPICT, Palliative Performance Scale
  • adopting a consistent approach when communicating between teams
  • be honest if you don’t know the answer but let the person know you will find out the information for them
  • checking how the family are when sitting with the dying patient – providing drinks/place for quiet time/comfortable chair
  • checking out previous experience of death/bereavement
  • explain the process of dying

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