Discussing current and future care – example

We’re now going to hear from a group of care workers and professionals in Switzerland about their experiences of implementing Step 1 in their care home. A lady who entered the nursing home last year, she is 76 years old and has obstructive pulmonary disease and uses oxygen permanently. And she doesn’t want to talk about end of life.

Then we tried to introduce the documents, ‘Thinking and looking ahead’, and it worked quite well. Then we applied the Go Wish, which is a game, and we succeeded with her. We introduced the Go Wish game after the ‘Thinking and looking ahead’ documents. This game consist of cards, and on these cards are written – life values. And then we ask the residents how they perceive the end of their life. We are still trying to collect information, for example, when we are doing the hygienic care.

Even when we are not the specific carer of this lady, we collect information and we filled in the documents.

Sometimes there are moments when they are more open to talk about it. For example, when she is drinking her coffee she talks to us. And then we collect information and we filled in the document.

[SPEAKING FRENCH] That we are not so bad in the practice. It reinforces their practice, it improved it, it evolved.

We have introduced life values indicators analysis with the help of a card game called Go Wish.

We can do more personalised interviews with the residents.

The presence, the repetition of the steps, and also a collaboration with the palliative care nurse and my support. I have to be there.

I do not let go, I must not let go. And when things happen, the way we wish it. And also the support of the direction and the managers, and also my assistants, and the palliative care nurse. [SPEAKING FRENCH] I would say the best case scenario is when everyone agrees, the resident and the family of the resident. A majority decision is very helpful because it clarifies everyone’s expectations of both the resident and the family of the resident, and that we’re not caught off guard with an end of life emergency or the sudden deterioration of the resident’s health. The ‘Looking and thinking ahead’ document should be applied much earlier in the decision making process, even before the resident enters the nursing home.

You may face some challenges in starting to implement Step 1. This slide helps you to understand what the barriers and solutions might be.

You’ve now completed Step 1 and are ready to implement it in your care home. We’re now going to move on to Step 2.