What are the most important considerations when discussing end-of-life care with patients and providers?

when my gp suggested I have pallitative care, I was totally apprehensive because I thought she meant Hospice. someone called and made an appointment to come to my home. I made a list of questions I had. They refused to answer them because they had a multi page questionnaire to fill out. I asked them to leave. No one ever called to ask me why.

My working life was mainly in sales and dealing with someone you have not met, relies on establishing a rapport with the individual. That is not regarding their current position but exploring the reactions to conversation by making questions open ended so that the response may give a better understanding of the person or their needs. It takes a little time with anyone who is in need of a resolution to a problem but, when you can find a point of recognition or familiarity, then the connection can work to manage a persons expectations whilst addressing the main problem. I.n our visits to Veterans with issues or problems, we have an advantage in that we too are Veterans so, the connection is easier to establish. Mutual trust is key to success

It is important to approach palliative care discussions from a place of education and not persuasion. As case managers, social workers, or other professionals, we have the responsibility of honoring the client's perspective while also providing all the information necessary to make an informed decision. I've also had the best outcomes when I provided facts, personalized the discussion to the client's specific situation, and allowed them to understand the options available. In this role, we are bridging gaps and helping clients connect to resources that are often difficult to access or understand.

Emphasize the importance of shared decision-making, where the patient, family, and providers collaboratively decide on the best course of action, ensuring that medical expertise is combined with the patient's values and preferences. Recognize and respect the cultural, religious, and personal beliefs of the patient and their family. Providers should be made aware of any specific wishes or rituals that need to be accommodated.

History and research tell us that end-of-life decision-making and funeral planning are not one-size-fits-all scenarios. It is up to us as case managers to be knowledgeable about the beliefs of different cultures so we can address them with respect and understanding. Doing the work of assessing your community demographics and their preferences allows you to be prepared to have these discussions. We should also always be willing to listen and learn from our clients. They are their own advocates and will tell us what they value. Our job is to provide support and facilitate their wishes.