Difficult Conversations Starting the conversation if someone close is seriously ill Presented by Martha Flann

What is cancer?

Main treatments for cancer Surgery Radiotherapy Chemotherapy Hormonal therapy Targeted therapies

What is dementia?

Main treatments for dementia Non-drug treatment: talking therapies, counselling and support at home Drug treatments: help with memory problems for a while; hallucinations and depression and anxiety

Treating cancer in someone with dementia Benefits and disadvantages Giving consent Capacity: Understand the information and able to make an informed decision

What we are going to cover Why it is important to talk about death What you might need to talk about What to bear in mind Starting the conversation Talking vs helping

What situation might you find yourself in Someone very close is very ill Some one you love is dying

Some myths It is important to put on a brave/happy face when people are very ill or dying Don’t waste time talking about things, it will only upset them. They probably don’t want to talk about it, otherwise they would have already. And there are more ……….

Why might you not want to talk ? Relatives and Friends Fear of saying the wrong thing or making it worse Cure collusion - Refusing to face the truth. Fear of what others might say Not wanting to upset professionals Fear of own mortality Guilt shame of the past Denial The people who are ill or dying Fear of being a burden Lack of privacy or opportunity Inner conflict /unfinished business Fractured families Secrets never shared Denial – not facing the truth Fear of upsetting relatives Never liked to talk Trusting the right person

Why we need to talk? They may not have left a will or expressed wishes about funerals, arrangements, dependants They may not have said something they wanted to say You may have to tie up loose ends without any direction You may have sadness and regret about not sharing your feelings with them It helps to accept things are coming to an end, and helps to acknowledge strong emotions It can bring you closer It brings a sense of relief once things are brought into the open.

Principles to Bear in Mind In general, in the long run, you hurt people more by the conversations you don’t have than by the ones you do Its quite likely that the other person has been thinking about these things to but not said anything Talking about the important subjects can’t be done in one cover all conversation but by lots of small ones If you are worried about getting it wrong, you can always discuss it with someone else beforehand

Subjects to talk about The type of care someone would like towards the end Where they’d like to die Funeral arrangements Care of dependants Organ donation How they would like to be remembered What worries they would like to discuss What they would like people to know before they die

Starting and Having THAT Conversation Right time and place Focus on them Reassure but don’t try to solve Let them lead

How to Listen Be respectful. Be honest Engage and watch Stay grounded and calm Think of some questions Offer options or alternatives Don’t be scared of emotions …………..Be quiet

During the conversation “What would you like to talk about” “I know these things are difficult to talk about” “ is there anything you want us to know” “how do you feel you are progressing” “what are your hopes for the next few weeks”

Keeping the Conversation Going Words aren’t always necessary Encourage by asking and listening Add your own recollections Allow for negatives

Summary It’s hard – but living with regret is too You are probably not the only one wanting to talk Being there and listening can be enough Emotions are part of life – they don’t hurt us as much as avoiding them does