The Arc of Conversation

A How-to Guide for Goals of Care Conversations
2024
ISBN: 978-3-031-70494-9
Verlag: Springer

Buch, Englisch, 355 Seiten, Format (B × H): 155 mm x 235 mm

Intending to fill an important gap in medical training, this book presents an easy-to-learn, standardized approach to having compassionate and collaborative goals of care
conversations with patients and families, a skill that can be difficult for clinicians to learn and that is not part of standard medical education curricula.

Developed by a Palliative Care provider, this is the first book to teach everything clinicians need to know to gently guide patients and families through what can often be
difficult discussions about illness, disease, end-of-life wishes, and hospice care. This technique can be used to discuss any medical diagnosis or treatment, be employed at
any age or stage of an illness, and can be used by health care professionals at any level.

Readers will be introduced to the patterns of decline patients follow toward the end of life, criteria for recognizing when a patient’s time is limited, hospice care, ground
rules for compassionate communication, and a step-wise method of leading patients and families through difficult goals of care conversations in a collaborative way. The
book includes specific questions to ask and starter language clinicians can use for developing their own patient-friendly talking points about disease progression, the end
of life, concerns that a patient’s time is limited, advanced directives, code status, and hospice care. An Arc of Conversation Guide, for use when learning this technique, is also included. 

While modern medicine is terrific at acute stabilization of illness or injury, it often ignores the elephant in the room—disease progression and death. By doing so, the healthcare system frequently misses opportunities to align patient wishes with the care they receive. Furthermore, physicians often avoid difficult conversations with patients due to a lack of training or the assumption that hospice care represents medical or personal failure. Incorporating the material and technique taught in The Arc of Conversation into everyday practice will enable clinicians to acknowledge and discuss patient decline and to confidently include hospice care as a viable option for treatment that can support patient values, wishes, and priorities. Moving toward a continually collaborative approach with patients—a shift away from physician-directed care to patient-centered care—will enable clinicians to develop treatment plans that prioritize outcomes that matter most to patients and families, improving patient and family experience of health care across their lives and providing patients with the ‘soft landing’ they want at the end.

Zielgruppe

Popular/general

Autoren/Hrsg.

Shaw, PA, Amy

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete AINS Schmerzmedizin & Schmerztherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Palliativmedizin

Inhaltsverzeichnis

Introduction.- The Forest for the Trees–Patient Decline and Acute Illness.- The Elephant in the Room–Disease Progression and Death.- Approaches to the End of Life–Disease Trajectories.- Hospice Criteria Determining that Time is Limited.-Illness, Disease, and Sickness–Three Dimensions of a Diagnosis.- Holding Space–Creating a Compassionate and Collaborative Environment.- The Arc of Conversation–Foundations of the Technique.- The Illness Arc–Exploring Personal Experience and Understanding of Illness with Patients and Families.- The Disease Arc–Exploring Disease, Disease Progression, and the End of a Journey with Patients and Families.- The End-of-Life Wishes Arc Exploring End-of-Life, Advance Directive, and Code Status Wishes with Patients and Families.- The Hospice Care Arc– Exploring Hospice Care with Patients and Families.- Aligning Patient Wishes with Care–The Goal of Patient-Centered Care.

Über Autor(innen)

Amy Shaw, PA-C, is a leader in palliative and dementia care. She established Wyoming's first comprehensive dementia care program, positively impacting over 450 families. Her work has been featured in the Wyoming PBS special “A State of Mind: The Caregivers.” Additionally, she is the author of “The Arc of Conversation: A How-To Guide for Goals of Care Conversations.” Amy provides family dementia consulting services nationwide and serves as the Medical Director at Cottonwood and Aspen Creeks memory care facilities, where she delivers specialized care to residents and their families. To learn more about her work, visit AmyShaw.net.