There are many things you can do to support patient centered communication and support shared decision making. Think about some of these ideas.
- Have you had an end-of-life care talk within your own family? If there a family member approaching the end of life, are you the best placed person to start this discussion? What are the barriers to starting a dialogue about your family member’s end-of-life care preferences? How might they be overcome? How to discuss prognosis and end-of-life issues and Patient Centred Interviewing are handy resources.
- Have you discussed your own wishes for end-of-life care or appointed someone to make decisions in the event that you are no longer able to communicate them? Take some time to think about what would be important to you personally and who you think is best placed to communicate those preferences.
- Remember to introduce yourself to each new patient and any family members. Find out about the Hello, my name is…Campaign
- Tell a colleague or student about the Hello My Name Is Project to promote awareness of the importance of patient-centred care.
- Think of one question from a patient approaching the end of life that you found difficult to respond to. Imagine you are being asked this question again now. How would you answer that question now based on what you have learnt from the End-of-life Essentials Modules? Ask a colleague what they would have said in that situation. Talk about their suggested response.
- Think of one question from a family member of a patient at the end of life that you found difficult to respond to. Imagine you are being asked this questions again now. How would you answer that question now based on what you have learnt from the End-of-life Essentials Modules? Ask a colleague what they would have said in that situation. Talk about their suggested response.
- Request training on communicating with patients and their families. A training program with role plays will allow you to practice your communication skills in a safe environment.
- Practice active listening, and feedback to check your understanding. You can do this with a patient, a patient’s family member or a colleague.
- Ask your patient: What is the most important thing I should know about you?
- When relaying new information to a patient, give them time to think and respond. Talk to the patient about whether the new information impacts on their wishes or preferences.
- When a patient is non-verbal or has limited capacity for speech, check if they have any communication aids. Ensure that your team knows that they need to make sure these are in place before they communicate with the patient.
- Reflect on what conditions are needed to ensure that your patient has the best opportunity for engaging with you and other members of the treating team. Have they got their hearing aid in? Do they need glasses if you are going to provide them with some written information? Is this the time of day when they are most alert? Are they adequately hydrated and fed? Is a family member or carer there?
- Asking an open question: Use “other people” framing so that patients or family members know it is OK to be scared, concerned, or confused. For example, “Other people with conditions like yours sometimes worry about things that may or may not happen in the future, so I just wanted to check in with you. What is it that you are most concerned about at the moment?”
- When talking to a patient by the bedside sit down so that your face is as much on the same level as the patient as possible. Standing over someone can be intimidating and signals having power over the person who is positioned lower. Sitting down signals both that you are taking time to address their concerns and that you are approachable. Be aware of the cultural appropriateness of eye contact and proximity.
My Toolkit contains ideas, suggestions and other resources to help you maintain your knowledge about end-of-life care and facilitate discussion and engagement in your practice setting. Please find below a checklist with ideas for action and an associated sheet of resources. You can download these resources for use in your workplace.
Download Checklist (263kb pdf)
Download Resources (159kb pdf)
Download Module 2: Patient-centred Communication and Shared decision-making
Download Complete Set
Complete Set of Checklists (825kb pdf)
Complete Set of Resources (1MB pdf)
Last updated 4 April 2018