Background Current models for breaking bad news are inadequate in meeting the needs of people with learning disabilities (LD). People with LD are often not told of a life-limiting diagnosis. The task of breaking bad news is often left to carers who are poorly prepared and supported to cope with this. Healthcare professionals don't know how to communicate adequately with people with LD.

A new model for breaking bad news The model was developed following a focus group/interview study involving 109 participants, including people with LD, family carers, LD professionals and healthcare professionals (see related abstract for oral presentation). The findings were combined with the literature. A preliminary model was developed; 60 stakeholders gave feedback on this, including a wide range of family carers, professionals and academics. The preliminary model was modified following this feedback. The poster will present the model in a visual format. The model has four components.

1. Building a Foundation of Knowledge is central to the model. Gradually and over time, the person with learning disabilities builds his/her understanding of the way his/her situation is changing because of the bad news. The people around him/her help with this, by giving small, singular chunks of information that make sense to the person. This does not have to done by talking much of the information will be understood through experience. The other three components must be considered throughout.

2. Capacity and understanding, taking account of the Mental Capacity Act

3. The people involved, including family, partners, friends, paid carers and professionals

4. The support needed by everyone involved, including information, emotional, social, practical and spiritual support The model now needs to be tested in practice.