Thinking ahead and making plans for the future – what’s important

Dr Sally Boa, Strathcarron Hospice Head of Palliative Care Education, Research and Practice Development has been thinking ahead and making plans for the future – what’s important.

All too often, conversations about priorities and preferences for end-of-life care are put off. Talking Mats is a visual communication tool that can support these important conversations.

We have received funding from the Scottish Government’s Neurological Framework fund to train 18 people who work with people with neurological conditions to use the “Thinking Ahead’ Talking Mats resource. This project aims to help people think about and talk about their priorities and plans, should their health deteriorate.

Over the last few months, we have been working with people with neurological conditions to find out what would be important to them if we were offering training to professionals to help them start conversations about the future. Initially we set up a focus group, but participating in this was not always possible for people with neurological conditions so we adapted and either had additional calls or even in one case visited someone in a nursing home to get their views. Information we gained from these conversations has helped to shape the scenarios that we are developing with colleagues from the Scottish Simulation Centre. Priorities for those living with neurological conditions are:

If starting these conversations, professionals need to think about who else is in the room and discuss this with the person – what are their preferences?

• Any information that comes out of the conversation is personal – it should be up to the person what they do next and who they share it with.

• These conversations are potentially very emotive. Professionals need to be prepared to create a safe space and be ready to hold that space so any emotional responses can be acknowledged and supported.

• The conversation should be led by the person – professionals need to be sensitive to cues and be ready to stop/pause as appropriate.

• Decisions made shouldn’t be set in stone. These conversations need to be reviewed and revisited over time.

As a result of our discussions, we have been able to devise 4 scenarios to provide practice in a safe space for professionals learning to use the Thinking Ahead resource. Once we have delivered the training, they will start using Talking Mats to support people living with neurological conditions to think about and plan for the future.

We are looking forward to finding out about the experiences of those who use the Mats and making changes to the resource as well as informing future training for professionals