August 19, 2015

managing difficult conversations for healthcare professionals

These resources are available for loan to members of AANSW - if you would like to reserve them please email the Library on

Talking about dementia and dying : a discussion tool for residential aged care facility staff
This discussion tool deals with the issue of dying from dementia in a residential aged care facility. It
is a resource to help people working in facilities to openly communicate with people with dementia
and their families and friends about death and dying. Talking about dying is often difficult and this tool
provides guidance for those who would like to improve their skills.
In the following guide you will find:
Part 1: Why it is important to talk with families and friends about dying
Part 2: When to talk with families and friends about dying
Part 3: What to do when talking with families and friends about dying and How to talk about dying
Part 4: AFIRM provides suggestions for more spontaneous conversations about dying
Part 5: Some additional tools that might be useful prompts in your facility

Dementia information for carers, families and friends of people with severe and end stage dementia (3rd ed.)
Blue Mountains Division of General Practice, University of Western Sydney and the Sydney West Area Health Service (N.S.W.)
The involvement of relatives and friends in the care of people living with dementia is invaluable, and helps to maintain the best possible quality of life of the person with dementia.
By reading this booklet and discussing the issues raised you will be better able to understand what is happening to a person with severe or end state dementia, and you will feel more informed if you need to make decisions about future care.

Live well, die well : information for carers, families and friends of people with end stage dementia
The aim of this handbook is to enhance the quality of life for people with dementia and their carers, through their lives living with dementia, to the end of life stage using a Palliative Care Approach.  The ultimate goal of palliative care is to relieve any emotional, physical, psychological, spiritual, cultural and social suffering promoting quality of life until death.

Letting go without giving up : continuing to care for the person with dementia
The idea for Letting go without giving up grew from concerns expressed by carers who felt they were no longer allowed to have a role in caring for the person they had looked after at home after the person entered long-stay care. This booklet is aimed at carers who want to continue their involvement in the lives of the people they have cared for, even if they are no longer responsible for their day-to-day physical care needs.

DVD - Innovation versus compliance
Nick Ryan, CEO of the Australian Aged Care Quality Agency and Allison Patchett, General Manager of Innovation and Development at Uniting AgeWell, discuss how managers can balance innovation, risk and compliance without compromising standards in a changing aged care environment.
DVD The discomfort zone : a guide to managing difficult consultations

Difficult consultations are not just the result of particular types of patient behaviour.  They result from factors such as conflicting agendas, blurred boundaries, stereotyping and poor communication.  Often there is a marked difference between the patient’s beliefs and perspectives and those of the doctor.  Also, there may often be a gap between the doctor’s proposed intervention and the patient’s level of readiness or preparedness.

This program covers a range of difficult consultations and the factors that contribute to them.  It examines cues and effective communication skills as well as strategies for dealing with issues such as drug seeking, somatisation and anger.

This program includes five case study role plays, detailed below.  The first two role plays are both in two parts, the first demonstrating a “difficult” consultation, and the second illustrating an alternative approach to the situation.  The final three role plays take place with program panelists and highlight some typical difficulties encountered in the doctor-patient situation. These include the angry patient, the issue of patient confidentiality, the patient with a “list”, and the problem of maintaining appropriate professional boundaries.

Role Play 2 - Mary .. repeatedly consults her doctor with anxieties ..Role Play 3 - The Angry Patient

A patient comes to see a different doctor in the practice as her usual doctor is on holidays.  She asks for a script for tamazepan because of her sleeping difficulties.  When the doctor demurs, the patient becomes increasingly angry and distressed; eventually she begins to talk more about the considerable difficulties in her family.  The scenario illustrates an attempt to deal with a patient’s anger, rather than to capitulate in the face of it.  Role Play 4 - The Mother The patient requesting information regarding her daughter.  A  concerned mother asks the family doctor to provide information about the doctor’s contact with her daughter (who is over 18).  The doctor attempts to explain the nature of professional confidentiality, but the mother, who is very concerned about her daughter’s mental health, puts increasing pressure on the doctor to be helpful.  The scenario illustrates the difficulty of maintaining confidentiality when confronted by a patient who is well-known to the doctor and desperate for information.

Role Play 5 - The Doctor’s Professional Boundaries  A grateful female patient invites the doctor, who is new to a small rural town, to a barbeque on her property, in order to introduce him to some of the local people.  The doctor, who is initially pleased at the invitation, gradually finds himself in increasing difficulty as he tries to draw the line between appropriate professional involvement and a social situation which threatens to blur the boundaries.

Resilient individuals : sexual orientation, gender identity & intersex rights : national consultation report, 2015
This report explores the lived experience of human rights and discrimination among lesbian, gay, bisexual, trans and intersex (LGBTI) people in Australia. It presents findings from one of two consultations held in parallel to inform the Human Rights Commissioner's work around sexual orientation, gender identity and intersex (SOGII) issues. LGBTI people and allied individuals, groups, service providers, and organisations were asked about how well SOGII rights are respected and protected in Australia, specific legislation and policies that unduly restrict SOGII rights, and what more should be done to promote a culture of respect. Issues raised include structural discrimination, religious freedom, participation in employment and sport, equal relationship recognition, reproduction and the interests of children, young people in primary and secondary school, the 'gendered' nature of healthcare, conversion therapy, surgery and classification of intersex infants and children, Aboriginal and Torres Strait Islander peoples, expungement of criminal records, the 'homosexual advance' defence, and age of consent. The report also states what law reform is needed to address this inequality, and the role of the Australian Human Rights Commission in this work.

No comments: