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Dealing with a difficult discussion – Senior Planet



It's not always easy to talk about end-of-life care – and that's partly because people tend to look back at them a little bit. We focus too much on the first word: End and not nearly enough on the most important word: Life. This shift in perspective may seem small, but it can make all the difference when it comes to a productive and proactive discussion about end-of-life care.

In part due to a lack of ease-accessible resources for patients and their families, there are a variety of misunderstandings regarding hospice and care at the end of life. The tendency to fix on the word end in elderly care is one of them, which in and of itself can have disastrous consequences. Viewed through the narrow lens of the end, one can assume that end-of-life care is a point where nothing meaningful can be done for the patient ̵

1; though this could not really be further from the truth. ]

No one wants their relatives to spend their last moments in distress and discomfort – and hospice and palliative care can actually help alleviate unnecessary suffering for patients and their families. In addition, it has been shown that the early utilization of hospice and palliative care services produces a notable difference in patient outcomes, particularly in terms of quality of life. And that is the true heart of the problem.

In my view, patients do not go to the hospice to die – but to live and enjoy their remaining lives while the hospice team looks after them for medical problems. And although the individual care plan is tailored to each hospice patient, the overriding goal of this care is always the same: to improve the quality of life of the patient and his family.

Focusing on quality of life makes it easier for you to consider all your options, open a discussion, and make proactive decisions about end-of-life care. Still, it can still be uncomfortable when the time comes to sit down and have a conversation. To help get you started with this discussion, I've reviewed some tips from my own work as Head of Palliative & End of Life Care from Michigan Health Professionals and Head of Inpatient Clinical Operations at Karmanos-McLaren Oakland Cancer Center: [19659006] Choose a Quiet, Comfortable Environment: This is not a conversation you should make immediately. Plan on meeting your loved one at a time when you know none of you will be distracted – in a quiet and comfortable place where privacy is assured.

  • Please ask for permission before opening the discussion: Give courtesy to your loved one and show that you respect their wishes by first asking them if it is okay to discuss the subject. Even something as simple as "It's important to me to know how you want to be treated if you're really getting sick, would you agree to talk about it?" Can set up the stage gently and thoughtfully.
  • Show Empathy with Physical Indications: Carefully give your loved one full attention in a compassionate way, meaning being sensitive to their body language and using physical cues such as direct eye contact, and if they find it pleasurable, you can also take their hand
  • Listening Actively: There is a big difference between waiting for your turn and actual listening. It's important to listen carefully and really understand where your beloved person comes from and what he says, let them set the pace You can have your own thoughts on the best course of action – but think d aran, that you initiated the conversation from the beginning to understand what is best for .
  • Author: DR. Adil Akhtar is associate professor at the Department of Medical Oncology and Hematology at Oakland University at the William Beaumont School of Medicine. Director of Inpatient Clinical Operations at Karmanos-McLaren Oakland Cancer Center, Michigan; and Head of Palliative & End of Life Care for health professionals in Michigan.


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