Important questions to ask with patients

What is it you understand about your illness? What do you want? What are your goals? Now that we know this bad news, what are your goals?

What do you do when you have an incurable problem, pain, sx management, transitions,

Introduce the topic of consultation

“To best meet some of the goals we’ve been discussing…I would like to have some consultants from the Palliative Care Team visit with you”

Introduce the topic of consultation

“They can help with the symptom you have been experiencing…They are also good at helping your family deal with all of the changes brought on by your illness…”

Before meeting the family, consider

review hx, tx options, prognosis, who should be there? Ask the nurse, chaplain about the family situation. who is going to lead? the meeting before the meeting

chairs in a circle or round table, cell phones and pagers off, sit down, door closed, if in the patient room: position yourself closer to the patient and further from the door.

Establish the goal of the meeting

“Today, I’d like to make sure that everyone understands how (the patient) is doing and answer questions you may have” Ask family what their goal for the meeting is

Establish ground rules

Is there a time limit? Everyone will have a chance to ask questions Acknowledge that this is a difficult time/situation

Questions to open the meeting with

what do you understand about your condition? Whta have the doctors told you? How do feel things are going?

respond to emotion first!!! Then later come back if anything needs to be clarified, "this is what I understand". Acknowledge, "I can see how hard this is for you."

Name the emotion, Understand, Respect, Support, Explore

I can see how distressing this is

I can imagine that this must be very difficult

You are asking a lot of really good questions. I can see that you want to respect your dad's wishes

we will continue to talk and answer your questions. I will check in with you tomorrow. Or, this is my shift, and this is who will be taking over when I am not here

tell me more about what you are thinking

Has anyone in your family ever used hospice and what was there experience? Also, if you're grandfather could speak for himself about ____ (condition or tx) what would he say?

Be conscious of whether faith is important to the person and if it is,

invite their minister, or pastor or whomever they are getting spiritual counsel from

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Ger. End of Life

Geriatrics End of Life and Family Meetings

Question	Answer
Important questions to ask with patients	What is it you understand about your illness? What do you want? What are your goals? Now that we know this bad news, what are your goals?
Palliative care	What do you do when you have an incurable problem, pain, sx management, transitions,
Introduce the topic of consultation	“To best meet some of the goals we’ve been discussing…I would like to have some consultants from the Palliative Care Team visit with you”
Introduce the topic of consultation	“They can help with the symptom you have been experiencing…They are also good at helping your family deal with all of the changes brought on by your illness…”
Before meeting the family, consider	review hx, tx options, prognosis, who should be there? Ask the nurse, chaplain about the family situation. who is going to lead? the meeting before the meeting
The setting	chairs in a circle or round table, cell phones and pagers off, sit down, door closed, if in the patient room: position yourself closer to the patient and further from the door.
Establish the goal of the meeting	“Today, I’d like to make sure that everyone understands how (the patient) is doing and answer questions you may have” Ask family what their goal for the meeting is
Establish ground rules	Is there a time limit? Everyone will have a chance to ask questions Acknowledge that this is a difficult time/situation
Questions to open the meeting with	what do you understand about your condition? Whta have the doctors told you? How do feel things are going?
In conflict	respond to emotion first!!! Then later come back if anything needs to be clarified, "this is what I understand". Acknowledge, "I can see how hard this is for you."
NURSE acronym	Name the emotion, Understand, Respect, Support, Explore
Name ex:	I can see how distressing this is
Understand ex:	I can imagine that this must be very difficult
Respect ex:	You are asking a lot of really good questions. I can see that you want to respect your dad's wishes
Support ex:	we will continue to talk and answer your questions. I will check in with you tomorrow. Or, this is my shift, and this is who will be taking over when I am not here
Explore ex:	tell me more about what you are thinking
Good Q	Has anyone in your family ever used hospice and what was there experience? Also, if you're grandfather could speak for himself about ____ (condition or tx) what would he say?
Be conscious of whether faith is important to the person and if it is,	invite their minister, or pastor or whomever they are getting spiritual counsel from

Created by: ltm12

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