Early conversations are very important and can build a good relationship and increase the family’s confidence in the multidisciplinary team. If communication breaks down early, families may lose trust and confidence in the team. Before your meeting consider:
Information gathering
- Find out as much as you can before the meeting
- What key points should be discussed? Is the information needed available to you?
- Think about using computed tomography (CT) scans or simple diagrams to explain the extent of the stroke if this is appropriate
- Talk to other members of the team before the meeting, they may have information that has been gathered by more informal discussions with the family and patient
- Have test results to hand
- Check in the medical records whether the patient has any other conditions (such as dementia, cardiac problems or cancer) which could affect outcome after stroke
- Consider whether there are urgent decisions which need to be made
Who needs to take part in the discussion?
- If family or friends have power of attorney they are significant in decision making. There may be family members who can only be contacted by telephone. In large families, check if it is acceptable to ask for a family representative to relay information to others. It is helpful to be aware of any conflicts between families members that might make communication and decision making more difficult
- Does the patient have capacity? It should be remembered that capacity is decision specific and healthcare professionals should make every effort to include the patient in decision making if at all possible
- How aware of their deteriorating health and prognosis is this person or their family? Are there clues in the medical notes or would a phone call to their GP help to clarify this before the meeting?
The right environment and timing
- Try to get a private space away from distractions
- What is a good place and time? How long does the meeting need to be? (remember to leave time for questions)
- Leave your bleeper or pager with someone else while you are having this conversation
- Would a series of conversations be better? This is very helpful when the outcome is uncertain. Check when you are available for the next meeting, families are often reassured to know that they will have further opportunities to ask questions
Page last reviewed: 16 Jan 2023
