Conversations about End of Life

Sue Willis
Sheffield Hallam University
 Aims
• To discuss some of the wider issues about
conversations about end of life
• To give an example of one educational tool to
promote conversation
• To sum up some of the themes discussed
today
Attitudes to death
and dying

• Historical context
• Fear of death in society
• Medical model and modern
lifestyle
• Cultural differences
Current Drivers

• DOH End of Life Care (2008)

• NHS England’s Actions for
End of Life (2014)
• Health Foundation Person
Centred Care (2014)
• HNA for all
• Dying Matters Awareness
and rising Death Café
movement
 SHOOC Conversations about End of Life
• Aimed to provide an educational opportunity
to engage in conversations about death and
dying and preparing for end of life.
• Participants learned about the perspectives
and experiences of patients, family members,
carers and health care professionals engaging
in difficult or challenging conversations.
 Key themes

• Talking about death and

dying
• Spiritual and cultural
issues
• Preparing for end of life
• Bereavement
 Outcomes

• An emotional and rewarding experience with an

opportunity for participants to reflect on personal
experiences of, and engage in conversations
about death and dying and preparing for end of
life.
• Contributions to the discussions were extremely
moving, enlightening and supportive -
highlighting the willingness of participants to
share their learning and experiences.
• ‘You would not believe how quickly the course
material has impacted my day to day practice,
with an increase in my palliative advanced
prostate cancer patients in the last two
months. Thank you for the opportunity to
attend this online education’
 Barriers

• Personal feelings (fear?)

• Experiences
• Beliefs and values
• Ability to portray empathy – ‘walking with the
patient’
• All impact on our ability to talk about it
personally and professionally.
What’s so important about empathy?

• Step back
• Stop doing
• Look and listen
• Be open
• Be aware
• Empathy is only helpful if it is communicated
and acted upon
 Summary
• Engaging in conversations about death and
dying or end of life is difficult
• It is not about having the answers
• Listening and empathy are important
• Communications skills training
• Support for self!
References
• Cancer Action Team (2007) Holistic Common Assessment of Supportive and Palliative Care Needs for Adults
with Cancer: Assessment Guidance. London, Cancer Action Team.
• DOH, (2008) End of Life Care Strategy - Promoting high quality care for all adults at the end of life. DOH
• Health Foundation, (2014). Person-centred care made simple. Health Foundation. ISBN 978-1-906461-56-0
• National Cancer Action Team (2013) Holistic Needs Assessment for people with cancer- A practical guide for
healthcare professionals. London, National Cancer Action Team
• National Institute for Clinical Excellence (2004). Guidance on cancer services: improving supportive and
palliative care for adults with cancer. The manual. London: National Institute for Clinical Excellence.
• NHS England, (2014) Actions for End of Life Care. NHS England, Leeds