Communication is at the heart of better outcomes in the last stage of life. I'm often asked 'What does it take to open these conversations? My view: the most important considerations are timing & tone. If you get these things right, the words tend to find their own way. 1/7
I've been so inspired by our @Violet_org_au Guides, @drkathrynmannix & @CACEnotes. Building on their wonderful work, I often use the analogy of 'how to open the door' to improve communication in the last stage of life. 2/7
In some cases, it might be OK to just open the door and step right into the conversation. Depth of relationship, measures of trust, people & personality are the clues to guide you here. If this feels right, take a deep breath, summon your courage & gently step in.3/7
Sometimes you need to nudge the door gently, to see if it will open. You may need to nudge several times in fact. Try gentle, open, well-spaced questions. Sensitively raising different options to explore what might lie ahead can help open the door in different ways. 4/7
Sometimes you might sense that there is already a chink of light: the door might already be a little open. You may sense the opportunity or hear questions, or comments that suggest this. If so, gently seize the moment.
'Are there things on your mind you'd like to talk about?'5/7
Breathe deep. Be brave. Step through.
The door, when closed, might seem frightening & foreboding - but there is often real relief on the other side. So much more can be made possible. 6/7
And please don't forget that whatever your situation, @Violet_org_au is here to help you. 7/7
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I'm so saddened by a story shared with me today.
Just this week, a paramedic was called to administer CPR to a 100yr old woman, as requested by the RN in the aged care home, on the family's instructions. There was no advance care plan in place. (1/7)
Fortunately, the paramedic that attended the aged care home was a courageous young woman who managed to get the resident's family on the phone, explain the trauma that CPR would cause, and with their consent, the lady was allowed to die in peace. (2/7)
There are so many things deeply wrong with this scenario.
First - the family. Unaware that this woman was in the last stages of her life. Unsupported & unprepared for the decisions they needed to make on her behalf.
Family dynamics = key drivers of non-beneficial treatment (3/7)