Section 6
Themes: All of the findings from the above literature reviews were analysed using a thematic framework by Carmel Collins (IHF) with oversight from the Expert Advisory Group. Further details on these literature reviews are available from the IHF on request from sarah.cronin@hospicefoundation.ie The themes which emerged from the literature reviews in facilitating conversations when planning future and end-of-life care were as follows:
• Client centred care • Communication techniques • A tailored approach to communication • All healthcare professionals should be involved in facilitating discussions • Knowledge of dementia and end-of-life is crucial • Staff barriers to engaging in discussion around end-of-life care.
Collation of Themes/Consensus Building : These key themes were presented to the Expert Advisory Group who, over a six month period, considered and reorientated the scope of the themes based on their clinical practice and experience. Finally, the document was circulated for feedback to the Project Advisory Group of workstream 2 and subsequently to specialists, frontline service providers and service users. Handsearches of additional Information : In order to enrich and further inform the guidance document, further searches of; bibliographies of papers used, key Irish and international reports were undertaken, in addition to a hand search of national and international healthcare policies and best practice guidelines. Limitations Literature was examined for relevance. Strength of evidence was not explicitly graded due to the nature of the subject matter being discussed. Therefore, it was difficult to explicitly link recommendations or guidance to the supporting evidence at all times, as recommended in NCEC guidelines (89). Evidence on effectiveness and cost effectiveness was not explored due to time and resource constraints. In order to facilitate stakeholder involvement and participation in the development of the document, a consultation took place with external stakeholders. Thirty-five submissions were received from a range of organisation, allied health professionals, carers and a person with dementia. This process further enhanced and refined the content of the guidance document. Appendix 3 has a list of submissions received.
42
Facilitating discussions on future and end-of-life care with a person with dementia
Made with FlippingBook flipbook maker