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3 The acceptability of having conversations about poor prognosis with the patient with frailty or dementia and their relatives
  1. Kate Davies,
  2. Charlie Beard and
  3. Colette M Reid
  1. University Hospitals Bristol


Objective In an attempt to address the findings of the CQC report ‘A different ending – addressing inequalities in end of life care’, we interviewed family members of patients on Care of the Elderly wards in our trust. Our aim was to ascertain their views about hearing prognostic information.

Method We interviewed family members who had told ward staff they were happy to speak to us. We used vignettes to aid discussion and explained we did not know the details of any ward patients. We wrote copious notes which were then analysed to produce a summary of participants’ views, supported by verbatim quotes.

Results We spoke to 9 relatives (three wives, three siblings, two sons and one son-in-law) and one patient. Key themes identified were: families welcome prognostic information since it allows them to feel prepared and prioritise their time – some would feel relieved to hear that time could be short; relatives have strong feelings about the appropriateness of medical treatments and do not always hope for active treatment, but are mostly guided by medical staff; given the choice relatives would wish the patient to be given the opportunity to receive end of life care at home.

Conclusions Relatives (and one patient) told us they would welcome a pro active approach to the recognition of a patient approaching the end of life. They would also wish information regarding prognosis to be shared with the GP, even if it was not information the patients themselves wished to have. No funding was obtained for this study.

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