Conversations about End of Life

Sue Willis Sheffield Hallam University

Aims

• To discuss some of the wider issues about conversations about end of life

• To give an example of one educational tool to promote conversation

• To sum up some of the themes discussed today

Attitudes to death and dying

• Historical context• Fear of death in society• Medical model and modern

lifestyle• Cultural differences

Current Drivers

• DOH End of Life Care (2008)• NHS England’s Actions for

End of Life (2014)• Health Foundation Person

Centred Care (2014)• HNA for all• Dying Matters Awareness

and rising Death Café movement

SHOOC Conversations about End of Life • Aimed to provide an educational opportunity

to engage in conversations about death and dying and preparing for end of life.

• Participants learned about the perspectives and experiences of patients, family members, carers and health care professionals engaging in difficult or challenging conversations.

Key themes

• Talking about death and dying

• Spiritual and cultural issues

• Preparing for end of life• Bereavement

Outcomes

• An emotional and rewarding experience with an opportunity for participants to reflect on personal experiences of, and engage in conversations about death and dying and preparing for end of life.

• Contributions to the discussions were extremely moving, enlightening and supportive - highlighting the willingness of participants to share their learning and experiences.

• ‘You would not believe how quickly the course material has impacted my day to day practice, with an increase in my palliative advanced prostate cancer patients in the last two months. Thank you for the opportunity to attend this online education’

Barriers

• Personal feelings (fear?)• Experiences • Beliefs and values• Ability to portray empathy – ‘walking with the

patient’• All impact on our ability to talk about it

personally and professionally.

What’s so important about empathy?

• Step back• Stop doing• Look and listen• Be open • Be aware• Empathy is only helpful if it is communicated

and acted upon

Summary • Engaging in conversations about death and

dying or end of life is difficult • It is not about having the answers• Listening and empathy are important• Communications skills training• Support for self!

References

• Cancer Action Team (2007) Holistic Common Assessment of Supportive and Palliative Care Needs for Adults with Cancer: Assessment Guidance. London, Cancer Action Team.

• DOH, (2008) End of Life Care Strategy - Promoting high quality care for all adults at the end of life. DOH • Health Foundation, (2014). Person-centred care made simple. Health Foundation. ISBN 978-1-906461-56-0• National Cancer Action Team (2013) Holistic Needs Assessment for people with cancer- A practical guide for

healthcare professionals. London, National Cancer Action Team• National Institute for Clinical Excellence (2004). Guidance on cancer services: improving supportive and

palliative care for adults with cancer. The manual. London: National Institute for Clinical Excellence.• NHS England, (2014) Actions for End of Life Care. NHS England, Leeds