Background End of Life Conversations, facilitated by doctors and other health care practitioners are an essential part of preparing patients and their families for death. They are often held in challenging circumstances, under pressure of time, when emotions are running high, and sometimes conflicting. There are cultural, religious, gender and professional tensions at play.
Aim Introducing a new perspective for health care professionals, empowering ongoing communication that enables patient centred care. A realistic and empathetic approach, combined with a strategic process helping bring certainty and comfort around dying.
Methods Applying the tools used by mediators, understand the interests that underpin stated positions, identify and work with the emotions that drive these interests.
Results Drawing on the principles of Interest Based Negotiation (Harvard):
Differentiate between positions and interests
Identify interests from language used
The 7 key elements of interest based negotiation
Working with emotions, promote understanding, build rapport and trust:
4. Five Key Concerns that drive most emotions
5. Using these as a lens to understand the emotions at play
6. Leverage understanding to stimulate positive emotion and agreement
Use a Five Key Concerns preparation chart.
Discussion Hear initial feedback from health care professionals in Australia introduced to this process across a variety of contexts including Accident and Emergency, General Practice in rural health and Chronic Disease Management at home.
Conclusion This practical approach adapted from an established method supports facilitating effective ACP. Application across a variety of medical contexts to date supports its versatility and potential.
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