Overview of Objectives

• Overview of end-of-life care and ethical considerations
• The role of communication in maintaining patient safety and emotional health
• Aligning conversations with patient safety goals and minimising distress
• Legal and regulatory frameworks surrounding end-of-life conversations (e.g., DNACPR)

Activities:

• Group discussion on the challenges of end-of-life conversations
• Review of patient safety incidents linked to poor communication

• Recognising clinical signs and symptoms associated with end-of-life (e.g., frequent hospital admissions, frailty, disease progression)
• Tools for identifying patients approaching the end of life (e.g., SPICT™, Gold Standards Framework)
• Proactive approaches to initiating end-of-life conversations early in the patient’s trajectory
• Multidisciplinary team involvement in patient identification

Activities:

• Case-based scenario discussion to identify patients at end-of-life
• Role-playing patient identification meetings

• Preparing for end-of-life conversations: setting, timing, and approach
• Strategies for initiating discussions without overwhelming the patient
• Listening and empathy: understanding patients’ values, fears, and concerns
• Framework for discussing end-of-life goals and priorities beyond DNACPR
• Handling emotional responses from patients and families

Activities:

• Live role-playing exercises to initiate end-of-life conversations
• Group reflection on effective communication techniques used during role-play
• Use of the “Ask, Tell, Ask” model for compassionate dialogue

• Exploring patients’ values and priorities (e.g., quality of life, preferred place of care, symptom control)
• Beyond DNACPR: discussing advance care plans (ACP), lasting power of attorney (LPA), and preferred care pathways
• Ensuring preferences are documented clearly in the patient’s record
• Collaborative decision-making with patients, families, and healthcare teams

Activities:

• Small group work on creating advance care plans for simulated patients
• Review and critique of existing documentation practices for end-of-life choices
• Discussion of case studies where patient preferences were successfully honoured

• Managing family dynamics and disagreements regarding patient choices
• Addressing cultural, religious, and personal beliefs in end-of-life care
• Supporting patients and families through grief, denial, and difficult emotions
• Using de-escalation techniques in emotionally charged situations
• Ensuring personal resilience: self-care strategies for healthcare professionals

Activities:

• Group discussion of challenging scenarios (e.g., conflicting family views, emotional outbursts)
• Role-playing conversations involving family conflict or cultural differences
• Reflection on managing emotional stress and avoiding burnout