Information gathering
- Make use of other information that has been gleaned by other members of the team through informal bedside discussions with family.
- Check with colleagues medical notes and nursing staff before you meet the family for an update on the patient’s condition.
Giving information
- Introduce yourself and check which family members are present.
- Offer family follow up meetings and/or details on others who would be able to provide information in your absence.
- Be aware of what has happened initially and what the family have been told.
- Remember that your manner/attitude and body language are all very important in helping you to have good conversations. Avoid talking too much or interrupting families as they speak. Simply listening is incredibly important in gaining trust from families.
- Explain the uncertainty of prognosis and acknowledge that uncertainty makes accurate prediction very difficult.
- Avoid information ‘overload’.
- The family are never responsible for decisions although they are included in discussions if the patient with capacity wants that. If the patient lacks capacity, then those close to them must be involved and asked about what they think the patient might want to help the team make the best decision about giving a treatment.
- When a welfare power of attorney is in place they can be asked to consent to a treatment on the patient’s behalf if that treatment is an option of benefit to the patient. Attorney’s cannot make advance treatment decisions e.g. about CPR unless that is specified as a power granted by the patient to the Power Of Attorney.
- Start to prepare families for the possibility of death or survival with significant disability and try to explore what the patient would want.
- Ensure that you accurately document discussions in the notes. Also ensure that at team meetings, the team is updated about discussions with families. (see section on tips for documentation and communication within teams later in this module)
Page last reviewed: 16 Jan 2023
