Geriatrics End of Life and Family Meetings
Help!
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| 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?
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| Palliative care | What do you do when you have an incurable problem, pain, sx management, transitions,
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| 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”
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| 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…”
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| 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
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| 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.
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| 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
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| Establish ground rules | Is there a time limit? Everyone will have a chance to ask questions Acknowledge that this is a difficult time/situation
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| 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?
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| 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."
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| NURSE acronym | Name the emotion, Understand, Respect, Support, Explore
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| Name ex: | I can see how distressing this is
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| Understand ex: | I can imagine that this must be very difficult
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| Respect ex: | You are asking a lot of really good questions. I can see that you want to respect your dad's wishes
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| 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
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| Explore ex: | tell me more about what you are thinking
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| 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?
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| 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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Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
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To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
ltm12