Resource

Serious illness conversation guide

Definition

<aside>

Conversations between a provider and a capable patient (or incapable patient's SDM) that focus on patient's illness understanding and exploring their values and goals for their medical care.

• The discussions are focused on the current clinical context and help the patient prepare to make treatment decisions.
• Often they are prompted by a specific event or clinical change.
• SDM or POA </aside>

Examples of GOC

• Curing the disease
• Prolongation of life
• Alleviate suffering
• Adverse to specific symptoms (granular level → what are the symptoms that patient care more about)
• Optimizing quality of life
• Maintaining control
• Achieving a good death
• Not being a burden to the loved ones
• Getting support for the loved ones

Preparation

• Prior to any discussions, become a medical expert for your patient. This would include knowing their current clinical status, available treatments (the benefits and burdens of each) and their estimated prognosis
• Prepare the physical space - for example consider whether you are in a private space, and whether there should be any other people in attendance (e.g. other consulting physicians, allied health professionals, family and friends)