Article Text
Abstract
Background The Royal College of Physicians’ ‘Talking about dying’ report (2018), demonstrated that doctors find end of life conversations difficult. Terminally ill people spend only 10% of their time with doctors and other clinicians in the final 12 months. The other 90% is spent with family, friends and neighbours. There has been no report of the difficulties lay people have talking about death and dying, and no communication training offered to the public. The Omega Course offers a safe space for discussion about death and dying during 14 hours of public health education, including six hours of communication training by role play. Participants also explore death experiences, their bucket list, advance care planning and bereavement.
Aims and method To investigate the lay experience of talking about death and dying, using thematic analysis, and test the acceptability of communication training by role play in this setting. Facilitators collected challenging scenarios, taught and modelled communication skills and after boundary setting volunteers were invited to role play the scenarios with suggestions and opening lines from the observing group. Positive feedback and learning points then given (Maguire).
Results Eight themes map onto professional themes (in capitals): CULTURE: Crossing cultural chasms; Starting the conversation; CONFIDENCE: Confidence in my competence; Taking responsibility; How will others respond to my bad news? PRACTICALITIES: Resilience for the hearers of bad news; Dealing with distress on the Phone; CONFRONTING OWN MORTALITY: Bereavement issues. Participants rated this the most valuable part of the course.
Conclusion The similarity between professional communication challenges and those of the ‘helpful friend’; and the acceptability of communication skills training in a lay setting means The Omega Course contributes to Ambition 6: ‘People are ready, willing and confident to have conversations about living and dying well, and to support each other in emotional and practical ways’ (National Palliative and End of Life Care Partnership, 2015).