Areas for guidance
4.2 Capitalising on informal opportunities
Throughout the course of the person’s journey with dementia relationships develop between staff members, the person with dementia and their families as a natural component of care. As discussed in section 4.1, it is within the context of these relationships that discussions regarding a person’s feelings, wishes and preferences for future will take place. Opportunities to address concerns and queries relating to a person’s health and future care will often arise as part of an informal chat or during casual conversations with health care staff (42). At such moments it is vital that staff recognise this as an opportunity to give clear information, explore people’s wishes, thoughts and fears and respond to this in an appropriate way. In order to do this, staff need to ensure they are informed and prepared for the changes that come about during the course of a person’s dementia (9,15,17). See section 5.1 for additional information on understanding the progression of dementia. Informal conversations can be guided by the AFIRM approach (69). AFIRM is an acronym which gives staff a suggested framework to deal with informal conversations. AFIRM has been devised to support staff to be ready to use these occasions as opportunities to pick up on underlying apprehensions or queries that the person with dementia or their family has.The AFIRM acronym is described below and the subsequent case studies (adapted from (69)) illustrate how the AFIRM approach can be used to structure spontaneous and informal conversations.
CKNOWLEDGE the person’s concern or questions.
A
IND out what the person knows about the condition.
F
I
MMEDIATE concern addressed by providing adequate information within the scope of your work.
R
ESPOND to subsequent questions by providing accurate information within the scope of your work role.
M
EETING suggested to discuss their concerns with a senior clinician.
When casual or unplanned conversations about end-of-life care occur, it is important that staff are aware of the steps to take and who they can inform, so that the information shared can inform formal care planning process (69).
Facilitating discussions on future and end-of-life care with a person with dementia
17
Made with FlippingBook flipbook maker