Communication at End of Life
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Communication at End of Life

What we know

Communication between a person receiving palliative care, their family, and health professionals is at the core of a positive end-of-life experience. Older adults would like the opportunity to discuss their end-of-life needs and often value frank conversations with health care professionals. The timing, content, pace and setting of conversations are important in helping people deal with difficult issues at or near end-of-life. Many older adults may wait for health professionals to raise the topic of end-of-life discussion and often it is not clear which health professional should lead end-of-life discussions.

What can I do?

Communicating about end-of-life issues can be difficult. You may like to ask how you can help. Remember that listening and acknowledging concerns may be of great comfort.

Patient and families appreciate being listened to, being invited to ask questions. You may not know the answer to every question, but you can be of help by sharing information. 'Here is a brochure, maybe you could talk to …. about ….'

Familiarise yourself with types of questions people may ask Asking questions can help: An aid for people seeing the palliative care team (614kb pdf).

Checking a person’s understanding of the current situation is a good way to start a discussion. You can use ask-tell-ask technique to structure these discussions.

Use Communication Cards to communicate with people in their preferred language. (From The Centre for Cultural Diversity in Ageing)

Use education modules and resources in End-of-Life Essentials. Perhaps start with:

  • Module 2 - Patient-Centred Communication and Shared Decision-Making
  • Module 5 - Teams and Continuity for the Patient.

 

What can I learn?

Read:  Check out these videos: 
  • Palliative Care and the Human Connection: Ten steps for what to say and do when talking about palliative care. It is principally for doctors but can be of interest to many people.
Use the PCC4U online learning modules to learn about:

 

What can my organisation do?

Have readily available to families the Asking questions can help: An aid for people seeing the palliative care team (613kb pdf) resource.

Develop a list of flags to clearly identify the triggers for palliative care or end-of life care discussions or review discussions.

Providing comfortable non-clinical meeting rooms for end-of-life discussions may offer a more nurturing environment for discussion, putting everyone at ease.

Have a member of staff or key health professional provide a telephone follow up after initial discussions to check how information has been received and understood. Offering the opportunity to clarify information may reduce stress and anxiety experienced by the person and his/her family.

Provide a qualified medical interpreter if practical and not costly. 

  • Department of Home Affairs provides a Free Translating Service to approved community organisations and individual service providers. 
  • National Accreditation Authority for Translators and Interpreters (NAATI) provides an Online Directory to assist in finding an accredited interpreter. 

Conducting a family meeting can be useful to provide information, to address the family's questions and concerns, and to establish goals of care. Information on how to conduct a family meeting in palliative care is available from the Therapeutic Guidelines (Palliative Care)  (with subscription) in the section: Supporting families in palliative care.

Family meetings often require a skilled facilitator, consider that skill set in a recruitment process.

Page updated 24 June 2020