Section 4
The eight step approach devised by Derksen et al (81) can help facilitate clear and open conversations between healthcare staff and the person, their relatives or friends, and this has been adapted with prompts to facilitate formal discussion on future and end of life – this is shown in detail overleaf. The steps they recommend are as follows: 1. Prepare for the discussion 2. Introductions 3. Determine their knowledge 4. Explain about dementia 5. Allow space for emotions 6. Discuss care options 7. Clarify understanding 8. Self-care.
GUIDANCE ON HOSTING FORMAL FAMILY MEETINGS 1. Staff need to recognise prompts which signal the need for a formal family meeting that address matters relating to end-of-life care. 2. Services would benefit from having step by step guide for staff to prepare for formal family meetings. 3. Services should prepare an information leaflet for persons with dementia and their family on the purpose of family meetings. It may be of benefit if this was in an easy to read format and included visual aids in order to support the person with dementia to understand it.
The resources section which follows will demonstrate the eight step approach with prompts and show an example of a form used in Marymount University Hospice and Hospital and Milford Care Centre to record family meetings.
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Facilitating discussions on future and end-of-life care with a person with dementia
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