Dr Matthew Grant, a palliative care specialist, has published this article in The Conversation describing normal conversations in the course of his daily work.
I love the way he sensitively maneuvers through difficult conversations, allowing the patient to control the content of prognostic information given.
“Not everyone will feel comfortable talking about their future treatment plans like Keith. It’s important I allow Sharon to decide whether or not she wants to talk about a future where she dies, just as I shouldn’t necessarily dissuade Christos from smoking if it gives him pleasure.”
An important message is the working in palliative care involves little immediate dying. This differs according to the setting, of course: a palliative care unit on site with a hospital with an emergency department will have a relatively high proportion of dying patients and a shorter than usual length of stay.
But community teams, consultation teams in acute hospitals and outpatient teams see fewer deaths than the public might expect. It’s more about symptom management, goal of care decisions, treatment decisions.
“hope for the best but plan for the worst” and set up plans for patients and families to follow if things go wrong, trying hard to keep people out of the emergency department unless necessary.
Do you think that the community has a realistic idea of what a referral to palliative care means?