Time of discussion • In conjunction with routine checks, and other similar situationsa • When the patient becomes noticeably more frail (anticipating the issue of life-extending treatment in the near future)a • In conjunction with hospital admission • When the patient becomes acutely ill Form and content of discussions • Primarily information about regular routines, or if decisions have already been made a) Discussion in advance: “this is how things are usually done here” b) Discussion in an acute situation: inform of the decisions that have been made • Focus on dialogue • Allow family members to influence whether or not the patient should have treatment Doctors’ reasons for discussions • Considered routine practice • Family members have requested it • The doctor assesses the need for discussion or information • The nurses assess the need for discussion or information |