Having Difficult Conversations
Where healthcare resources come under so much pressure that difficult decision-making is required to facilitate the management of patients not expected to survive then decision-making can be complex both to undertake, but also to communicate to patients and those close to them.
Where travel and/or visiting restrictions are in place, conversations regarding decision-making and supporting families may have to be carried out remotely, on the phone or via video links.
The following resources may be helpful for professionals who are not accustomed to having difficult conversations about end of life care conversations:
The Northern Ireland Social Care Council have developed a resource ‘Hope and Hints; Responding to living and dying issues during Covid-19’ which includes a section on ‘Facilitating Difficult Conversations’
Advance Care Planning
One of the key priorities of the Palliative Care in Partnership Programme is the promotion of Advance Care Planning. Ideally, people should have discussions with those important to them and their healthcare professionals prior to a crisis situation arising however it is recognised where a person has recently contracted Covid -19 this may not have been possible.
Where possible, health and social care professionals should be encouraging people in vulnerable groups to discuss and document their care preferences.
GPs who are aware of a patient’s end of life care preferences should ensure that the patients Key Information Summary (KIS) is up to date and has been shared as part of their Electronic Care Record (ECR) so that their preferences are known in the event they are admitted to hospital.