Philip J Larkin

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Philip J Larkin Communication in Palliative Care
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Overview

• Communication a stony path
• Why multi-disciplinary communication?
• The scope of technology
• Leadership
• What challenges remain?
• A vision for the future?

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On communicating

What is the evidence? Do we do this well?
Research limited, mostly on physicians Training
people to break bad news rather than on
effectiveness.
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Communication why the gaps exist

• Dance of Denial
• Failure to realise the complexity of need facing
  families
• Suboptimal communication
• Avoiding the conflict
• Weiner JS, Roth J. J Palliat Med 2006, 9451-463.

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Communication a house of cards


I didnt know what it was palliative care..no
one told me anything.. its very, very difficult
you cant imagine what its like...Because when I
arrived here I was (silence) how can I lost? I
felt really lost.(CH 3)
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Communication Typologies

Patient - centred wants, needs, preferences Cue
centred control with the patient Focused -
Resuscitation
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Multi-disciplinary communication
An opportunity for something different Organic I
nterdependent Stimulating Civilised Contextual Con
tinual review Confident

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Communication Public advocacy and Outreach
Death is not just a medical diagnosis. It is a
social construction

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Technology
Extending, enabling, equity Telemedicine and
e-health Currell R. et al. Telemedicine versus
face-to-face patient care. Cochrane Database
Systematic Review 2006 (4), CDOO2098. Saysell E,
Routley T. Telemedicine in community based
palliative care Evaluation of a videolink
teleconference project. Int J Palliat Nurs 2003,
9 489-495.
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Leadership
Leadership and learning are indispensible to
each other John F Kennedy The price of
greatness is responsibility Winston
Churchill Good leaders must first become good
servants Robert Greenleaf
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Lessons learnt

• Do I listen to the other?
• Do I respect what differs?
• Am I prepared to trust?

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Key Challenges

"The road to success is always under
construction. Lily Tomlin
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Key Challenges

• To inform succinctly
• To create a voice for social justice
• To foster meaningful and compassionate dialogue

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A vision for the future...
Narrative therapy in communication Understanding
the stories by which people express the lives
they live. Lester J. Life review with the
terminally Ill in Firth P, Luff G, Oliviere D
(Eds) Loss, Change and Bereavement in Palliative
Care. London OUP 2005