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What critical thinking skills can you use to help patients make end-of-life care decisions?

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End-of-life care decisions are often complex and emotional for patients and their families. As a patient advocate, you can use critical thinking skills to help them navigate the options and consequences of their choices. In this article, we will discuss some of the critical thinking skills that can enhance your patient advocacy practice and how to apply them in different scenarios.

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1 Clarify the goals

One of the first steps in helping patients make end-of-life care decisions is to clarify their goals and preferences. What matters most to them? What are their values and beliefs? How do they define quality of life? How do they cope with uncertainty and risk? By asking open-ended questions, listening actively, and summarizing their responses, you can help them articulate their goals and align them with their treatment options.

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Rebecca Harmston

Patient Representative and Lay Member in Health Research
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Talk to patients, families, and carers about end-of-life care. Death still seems to be a hidden topic. I'd want to know why a healthcare professional thinks that a relation needs end-of-life care and how this can help them to die with dignity and as pain-free as possible. I know patients who have refused treatment to avoid serious side effects that have a massive impact on their quality of life. Other patients prefer and have the support to try everything that might help even though the extension to life might be short. This is something that needs to be talked about together alongside making sure that the patient and their family have support.

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2 Evaluate the evidence

Another critical thinking skill that can help patients make informed decisions is to evaluate the evidence behind the different options. How reliable and relevant is the information that you and the patient have access to? What are the benefits and harms of each option? How do they compare with each other? How confident are you and the patient about the outcomes? By critically appraising the evidence, you can help the patient weigh the pros and cons of each option and avoid biased or misleading information.

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Sarah Millard

CT Supervisor | RT (R) (CT) ARRT @ The University of Vermont Medical Center
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Some patients need input and support from their spouse or from friends and family. It is best to ask the patient what their preference is.

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NDYAMUHAKI PHILIMON

VETERINARY DOCTOR AND SURGEON(BVM) |ONE HEALTH ADVOCATE | ANIMAL WELFARE ADVOCATE
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it is important to talk about the patient's life such as what they have achieved in life what they feel they need to achieve. get to know them and in there you bring in the concept of end of life care. generally the communication skills must be excellent along side interpersonal skills

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3 Consider the alternatives

Sometimes, patients may face situations where there is no clear or optimal option, or where they have to choose between competing values or interests. In these cases, you can use critical thinking skills to help them consider the alternatives and their implications. What are the possible scenarios and consequences of each option? How likely are they to occur? How would they affect the patient's goals and quality of life? How would they affect the patient's family and caregivers? By exploring the alternatives, you can help the patient anticipate and prepare for different outcomes and cope with uncertainty.

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Michelle Swenson

Risk
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Since the fear of the unknown is an issue for all of us, it is especially important to help them uncover as many options or opinions as we can. This helps reduce the fear and give options instead giving them more control in a situation that usually has little control overall.

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4 Communicate effectively

Communication is a key aspect of patient advocacy, especially when it comes to end-of-life care decisions. You can use critical thinking skills to communicate effectively with the patient, their family, and the health care team. How can you convey the information in a clear, accurate, and respectful way? How can you address the patient's emotions, concerns, and questions? How can you facilitate a dialogue and collaboration among the different stakeholders? How can you advocate for the patient's wishes and rights? By communicating effectively, you can help the patient express their preferences and needs and ensure that they are respected and honored.

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Sandra Washington

Independent Professional Patient Advocate, Credible Messenger, Kidney Health Coach, Author, AI Distributor
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I agree, but the communication should start with asking the patient what they knew about the end of life process. The answer to this question should then be used to guide the remaining conversation.

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Matt Toresco

CEO & Chief Patient Officer Devoted To Driving Patient Outcomes & Education Through Advocacy
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It’s not about communicating as much as it’s about a dialog. Understand the patient’s thoughts and desires. Help clarify any outstanding questions. Engage with caregivers separately to prepare them for the tough discussions that may come and provide the answers they need as well. Once you have calm and confident patients and caregivers, you can move towards a treatment plan developed in concert with then clinicians - true shared decision making.

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Sarah Millard

CT Supervisor | RT (R) (CT) ARRT @ The University of Vermont Medical Center
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Cultural awareness is key to effective communication. Communication is not just talk but also body language and facial expressions. Be observant and try to keep you face and body neutral to keep the trust.

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5 Reflect and learn

Finally, you can use critical thinking skills to reflect and learn from your patient advocacy experiences. How did you apply your critical thinking skills in different situations? What worked well and what did not? What challenges or barriers did you face? How did you overcome them? What feedback did you receive? How can you improve your skills and practice? By reflecting and learning, you can enhance your professional development and competence as a patient advocate.

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Sarah Millard

CT Supervisor | RT (R) (CT) ARRT @ The University of Vermont Medical Center
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Consider the patients religion, ethnicity, gender identification, sexual orientation and background when communicating with the patient and their family to be a sincere patient advocate. There may be challenges and or barriers if they speak a foreign language or are from a culture you may not be familiar with.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Pamela Bartee ND, NP-CRNA, CFMP

Nurse Disruptor| Life Coach for High Performing Women| Patient Experience Advocate| Keynote Speaker | Author
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I’m not trained in end of life decisions but I have been apart of this process many times. Usually when it’s at the very end of life and it seems to be a hopeless situation . One reason I’ve become apart of these decisions is, they simply thought they could trust me. Establish trust with your patients who you know need to make these decisions. Then as you go through options, present information, etc. they know they can focus less on ulterior motives and more on what is best for them and their family.

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What critical thinking skills can you use to help patients make end-of-life care decisions?

1

2

3

4

5

6

1 Clarify the goals

2 Evaluate the evidence

3 Consider the alternatives

4 Communicate effectively

5 Reflect and learn

6 Here’s what else to consider

Patient Advocacy

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What critical thinking skills can you use to help patients make end-of-life care decisions?

1

2

3

4

5

6

1 Clarify the goals

2 Evaluate the evidence

3 Consider the alternatives

4 Communicate effectively

5 Reflect and learn

6 Here’s what else to consider

Patient Advocacy

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感谢您的反馈

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