‘Difficult’ conversations: the bedrock of person-centred care

Thanks in part to the work of organisations like National Voices and its members, recent years have seen a significant shift away from a culture of medical paternalism, towards approaches which explore what makes each person unique; and how treatment and care can be delivered in individual, compassionate ways.

‘Person-centred care’ is now a buzzword, written into countless policy reports and mission statements. But making it a reality often boils down to the interactions between individuals on the ground: between patients, their family, friends and their healthcare team. Without honest communication about someone’s wishes, person-centred care simply cannot be achieved.

Recent polling found that an overwhelming majority (87%) of people feel it is important for healthcare professionals to know their wishes around future medical treatment and care, yet only 58% would feel comfortable discussing these wishes with them. Just one in ten (10%) said they would want a doctor to make final decisions regarding their treatment and care if they were to become unable to make these choices for themselves.

These results reveal a significant gap between what people say they would want the healthcare professionals delivering their care to know about them, and the ‘on the ground’ experience of having these ‘difficult’ conversations. They reveal that, for many, the care they are likely to receive is a world away from the vision of person-centred care described by National Voices’ Every Moment Counts narrative:

“I can make the last stage of my life as good as possible because everyone works together confidently, honestly and consistently to help me and the people who are important to me, including my carer(s).”

To help encourage and facilitate the conversations which enable people to experience a life which is meaningful to them, Compassion in Dying has developed Planning Ahead: My treatment and care. This new resource was produced in close collaboration with members of the public as well as health, social care and legal professionals. It explains in simple language the information people need to understand how treatment and care decisions are made, how they can plan ahead to ensure they stay in control of these decisions, and who to talk to and share their wishes with. The importance of communication is emphasised throughout, and the easy-to-follow layout provides an ideal template to prompt and guide people through the conversations they need to have in order to help ensure they get the care and treatment that’s right for them.

People tell us that having these conversations is incredibly worthwhile. They tell us that these conversations bring peace of mind, and enable people to live as fully as possible, reassured that those around them know what a good life means to them. These conversations help make people’s families and friends feel more involved and confident that they can act to ensure these wishes are respected. And they help to ensure that healthcare professionals won’t be left guessing what matters most to the person in front of them.

“Now that I’ve written these things down, people caring for me will understand what matters to me, and can make the right decisions for me”

– Ana, whose personal experience is shared in Planning Ahead.

We hope Planning Ahead will be a valuable resource for individuals, their loved ones and healthcare professionals alike. All can play a part in encouraging and guiding these all-important conversations – they form the bedrock of person-centred care, particularly at the end of life.