5. Open and respectful communication

Communication that is open, respectful, culturally safe and agreeable enables effective conversations regarding expectations with the person, their family and carers. This ensures coordination of care is maintained with both internal and external care providers who commonly collaborate on End of life and palliative care. This type of communication centres around empowering the patient, their family and carers.

Action

Processes are in place to provide the person, their family and carers with clear, health literate and appropriate information regarding available care, and how it may be provided. This includes setting expectations of the roles of care providers, the individual, families and carers. Considerations of cultural and linguistic needs is also recommended.

Evidence

Open and respectful communication is important to improve the experience of the person with life-limiting illness, their family and carers.

Considerations and resources

Communication training tools, such as eLearning module SHAPE End of Life Conversations and Teach-back, can be used for end of life and palliative care discussions and planning, including discussing advance care directives and NSW Ambulance Authorised Palliative Care Plans.

Using virtual care

Referrers should consider the questions and use the tools and information below when providing virtual palliative and end-of-life care.

Inform the patient, their family or carer of the virtual care modalities available, and document their preferences. Based on availability and mutual agreement, this could include their ability and willingness to travel due to wellbeing, ease and cost of travel, personal and family commitments, spiritual needs, and available technology. More on consumer support.

Who else needs to attend the appointment? Any person who can support the patient can be included in a virtual consultation with their consent. Where the patient does not have decision-making capacity, is the person responsible attending the appointment? Is a support person needed? Has the patient identified a family member or carer to be included in their care discussions? Has the clinician considered the multidisciplinary advantages of having the GP, family, specialist, other health professionals and other relevant people to attend the appointment?

Do all people attending the VC appointment understand virtual care processes and etiquette? Consider factors such as lighting, framing, background, background noise levels, position of the camera and screens. Clinicians may need to provide information, model good etiquette and provide direction to patients, family and carers attending.

Does the patient, family or carer need support to navigate the virtual care platform? Consider the need for additional clinician, family or carer to be available to support the patient. Provide virtual care education resources as required.

What happens if the patient, family or carer deteriorates, or the technology fails while I’m providing care virtually? Each team should have their own protocols for escalating care or managing technology failures during an appointment. Measures could include:

• Confirming the patient’s address and contact number at the start of any consult
• Being able to call an ambulance or other emergency service
• Organising an urgent visit
• Contacting a family member
• Enacting the backup process if the connectivity is poor or the technology fails

More about consumer support

For more virtual care resources, see:

• Virtual care in practice guide
  Information to support healthcare providers to deliver virtual care.
• Virtual care palliative care resources for clinicians and consumers
  Resources supporting health professionals, patients, families and carers to access and use virtual care as part of palliative care.

Video resources