Managing difficult conversations during end-of-life care Managing difficult conversations is a core part of any social work practice. But when you're working with a family who is facing a bereavement, what considerations are needed? We speak exclusively with JJ Nadicksbernd, the National Lead Facilitator for Difficult Conversations, who gives us some insight into how social workers can improve their communication skills when faced with an end-of-life situation.
The ability to manage difficult conversations is a core skill for all social workers, but why is it so important when faced with an end-of-life situation? We know these conversations are imperative to one having a good death. This is for the person dying but it is also for those close to the dying and their bereavement.
Should social workers alter their communication style when speaking to patients and their families? Everyone has their own style and that is okay. The approach may be different, but not always. It is best to treat each person individually as there is no one right way of communicating. It’s what works for that person at that time.
You've recently worked in partnership with Kings College London to look into how communication can be improved, and it was noted that discussions around the end of life, before the person passes away do not always take place, or if they do, they are poorly conducted. Why is this? Fear. I think fear is the number one reason, but also this feeling of helplessness. We are afraid of the emotions we anticipate the person may have, but often we are afraid of our own emotions. Dying is not something we talk about as a society, but also, in my experience, social workers go into the profession to help others. When someone is dying, they often feel like there is nothing they can do. That
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helplessness doesn't feel good. I challenge them to look at it differently, as one can still help the dying in a lot of ways, including communicating with care and compassion. The research with Kings found when professionals engaged in experiential learning, ‘Difficult Conversations', there was increased knowledge, skills, and maybe most importantly to combat that fear, confidence to have these conversations. It found multi-professionals valued an interactive group learning, in a safe environment, and appreciated receiving a communication framework to use. It is not just social workers struggling with these conversations and professionals do value coming together to learn from each other.
Do you think this is because on a societal level, as a Nation, we are not comfortable talking about death or bereavement?
