Areas for guidance
EIGHT STAGE APPROACH TO FACILITATE A FORMAL DISCUSSION ON FUTURE & END-OF-LIFE CARE Adapted from Derksen et al (2006) (81) .
1. Prepare for discussion (meeting) • Introduce the need for the meeting with the person. • Explain the aim. • Ask the person with dementia what relatives and staff they would like to attend. • Invite relatives and other staff members as appropriate. • Ask family to write down their questions for the meeting. • Allocate adequate and suitable time for the discussion. • Arrange suitable private space with no interruptions. • Read medical records to learn their history and liaise with staff to familiarise yourself with the person’s situation. • Decide who should chair the meeting (taking account of familiarity with the person and experience in conducting formal discussions of this nature (10,15,33,35,44,69,82–84). 2. Introductions • Introduce yourself and everyone present. • Put people at ease. • Outline the purpose of the meeting. • Ask the person/relative what they would like from the meeting. • Ask the person/relatives what questions they have (69). 3. Determine their knowledge of dementia Establish the person’s: • knowledge of dementia. • understanding of their symptoms. • understanding of the prognosis and treatment options (33,82,85).
As part of our normal care planning, we would like to invite you to meet with us to discuss your mother’s condition and care plans. The doctor and your mother will also be attending the meeting.
If you have any questions that you would like to discuss, you may want to write them down as this meeting will be an ideal opportunity to discuss them.
Thanks for coming in today. From my point of view, for the next 20 minutes or so we want to talk about how you are doing and what we think might happen in the next 12 months, so that we can plan together to ensure you receive the best care possible.
Did you have any things that you wanted to talk about at this meeting? I will jot them down and make sure that we answer them before we finish.
Tell us about how the last few months have been? What symptoms are you experiencing? Do you have any queries about the treatment available or how the disease will progress?
Facilitating discussions on future and end-of-life care with a person with dementia
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