Assisting with Difficult Conversations

Posted on June 16, 2020 by Terri Foley

Families and older adults may be confronting end-of-life questions that they have not prepared for before the COVID-19 pandemic. Advance Care Planning and POLST (Physician Order for Life-Sustaining Treatment) are commonly talked about in our field, yet people may still be surprised when the situation arises when they may need to be used to make decisions. Or, the COVID-19 pandemic may be the trigger for them to complete the documents.  

LeadingAge Minnesota has a created an Advance Care Planning Resources Overview that provides guidance from the National Hospice & Palliative Care Organization, Honoring Choices Guide to Health Care Directives, and Five Wishes Guide about the five most important things to talk about in advance care planning conversations. These sites might also be helpful to share with families and residents who request assistance.

The COVID-19 virus, combined with people who may have pre-existing conditions, serious illnesses or otherwise, presents many unknowns for seniors and their families. Senior care providers may find themselves in the position to facilitate these conversations about residents’ existing health issues and their end-of-life care wishes before situations become emergencies.

To assist with these conversations, a Seattle-based nonprofit organization has collected tips (Vital Talk) for communicating with family and residents during difficult situations. The Vital Talk playbook is available in several languages including Spanish, Russian, Chinese and Korean.

Here is an example of the quick review talking points:

“When coping need a boost or emotions are running high”

WHAT THEY SAY	WHAT YOU SAY
“I’m scared.”	This is such a tough situation. I think anyone would be scared. Could you share more?
“I need some hope.”	Tell me about the things you are hoping? I want to understand more.