Table 3 Behaviours identified from all three sources
From: Appropriate disclosure of a diagnosis of dementia: identifying the key behaviours of 'best practice'
• Organise a private, quiet, comfortable location |
• Schedule ample time |
• Establish a trusting & supportive relationship with the patient |
• Identify the most appropriate approach to disclosure based on knowledge of the patient and family |
• Identify informal support available for the patient after disclosure |
• Identify formal support available for the patient after disclosure |
• Prepare the patient in earlier consultations |
• Break the news over a series of contacts |
• Discuss ahead of time how much information the patient would like about diagnosis and prognosis |
• Respect the patient's right (not) to know |
• Negotiate the presence of a relative with the patient |
• Establish the patient's perceptions about their symptoms |
• Give information step by step according to the patient's ability to cope with it |
• Use terminology carefully as a way of getting information across without telling patients what they don't want to hear |
• Check understanding frequently |
• Be direct in disclosing the diagnosis |
• Explicitly name the illness |
• Avoid the use of technical terminology or medical jargon |
• Discuss how the person's current problems may progress in the light of the probable diagnosis |
• Provide an opportunity for the patient to absorb and emotionally process the information |
• Create time and space for the individual to explore what the diagnosis means to them |
• Provide an opportunity to discuss the diagnosis again, answer questions & clarify matters |
• Repeat or reinforce information as required |
• Document the information given and to whom |
• Identify further medical and social care pathways |
• Ensure information is consistent across professionals |
• Provide (written) information on practical & emotional support available from health & social care services |
• Provide (written) information on practical & emotional support available from voluntary organisations |
• Identify the (practical) implications of the diagnosis |
• Disclose all the treatment options (including no treatment) |
• Do not impart too much information in one session |