Communication Regarding Prognosis and End of Life Issues

Being prepared to discuss prognosis and end of life issues is important to ensure that families are able to participate in decisions in a fully informed way. It is important to be prepared for the discussion by reviewing the resident’s current clinical condition or involve someone in the case conference who can provide this information. Based on the Clinical practice guidelines for communicating prognosis and end of life issues. (1)
  • Determine what understanding families have regarding the resident’s current conditions
  • Determine how much information the family and or the individual want to know and tailor information to their needs
  • Information should be jargon free and provided in a sensitive manner 
  • Explain the difficulties in determining prognosis with dementia. Discuss the expected progression of dementia and the signs that the condition is deteriorating, but avoid being specific about timeframes stressing individual variability
  • Be sensitive and provide reassurance where appropriate, while being realistic and avoiding creating false hope. Whilst the progression of dementia cannot be changed, a lot can be done to ensure quality of life for the resident, and the family have an active role to play
  • Acknowledge that difficult conversations can be emotionally challenging and provide comfort and support if people become distressed 
  • Encourage questions throughout and offer the opportunity to continue the discussion at a later stage.

Further information

How to discuss prognosis and end of life issues 
Information booklet for families on advanced dementia (2.24mb pdf)

References
  1. Clayton, J. M., Hancock, K. M., Butow, P. N., Tattersall, M. H., & Currow, D. C. (2007). Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. The Medical Journal of Australia, 186(12 Suppl), S77-S79.

Last updated 29 September 2015