What you're trying to do, so, you've had the discussion.
What you're trying to do at the end when you're,
you know, thinking about concluding the meeting
is make sure that there's a common understanding
of the disease and the treatment options.
If it's a particular treatment that has, you know,
uncertainty or, you know, significant challenges
in regard to burdens and how it compares
to the benefits of that treatment,
it's also good to think about framing it as a best case, worst case,
and most likely outcome of what the options are.
So, you might provide a recommendation
as to what the treatment might be.
You suggest that the alternatives might be,
you know, one or two other things.
And then, you walk through with them what
the best case would be for option one.
What the worst case would be for option one.
Option two, what the best case and worst case would be
and what you think is most likely to happen
in each of those options so they have a better
understanding of how to you know, weigh one
versus the other when they're considering what your recommendation is
and how they should make their decision.
And the recommendation you provide should
really be based on the patient's values.
So, hopefully, over the course of the meeting
or the course of your relationship with the patient,
you've learned about their values,
what's important to them in their life,
all the things that we've talked about
in terms of, like, goals of care?
You're basing your recommendation
on those wishes, those values.
And then, before you, you know, finish the
meeting, before you conclude completely,
you want to just check in again with
the patient and/or the family,
see if there are any lingering questions,
you know, wait for, you know, pause to see
if they have any, you know, additional things
that they want to ask about or talk about
and also to make sure you address
those before stopping the meeting.
Once that's done, maybe they reach
the decision during the meeting.
You've come to some consensus
about what the plan is going to be.
Maybe they're going to need more time to think about it,
so, you're going to set a, you know,
another meeting time to have them talk as a family,
and then, come back to you.
But you want to have a clear idea of what the
goals of care are, you know, how they view the situation,
what their treatment priorities would be.
You want to show that you are going to
support them in the process.
So, each team member, you know, might have a different
role in helping to support the patient or family.
So, having them explicitly say how
they can support the family.
You want to have a basic plan as to follow up,
you know, so, if decisions are made now,
if those are implemented, what's going to
be the follow up to see how that plan is playing out?
If it's, "Well, we haven't made a decision yet
but we're going to need to make a decision in the future."
What needs to be decided?
What's the timeframe for making that decision?
I'm sure, at least, everyone has a clear
understanding of a follow up plan.
And then, making sure that they, the family
and/or the patient have a way of reaching you.
So, what's going to be the contract
information for the team to reach them?
For them to reach you in case
there needs to be more discussion.