September 2020 Communication Tip

September 2020 Communication Tip

Serious Illness Conversation Guide Step 4: Exploring Key Topics

This month’s communication tip continues the review of Atul Gawande’s Serious Illness Conversation Guide (SICG), a proven aid for busy clinicians to discuss Goals of Care with patients facing serious illness. 

Checklists work and we are starting into the second half of the guide!

In previous months, I reviewed

Step 1:  Getting Permission to talk about goals of care

Step 2:  Assessing Understanding

Step 3:  Sharing a Prognosis

 

This month: Step 4 Exploring key topics.

The key topics (and question scripts) are below:

 

  • Goals

“What are your most important goals if your health situation worsens?”

 

  • Fears & Worries

“What are your biggest fears and worries about the future with your health?”

 

  • Sources of strength

“What gives you strength as you think about the future with your illness?”

 

  • Tradeoffs

“What abilities are so critical to your life that you can’t imagine living without them?”

And

“If you become sicker, how much are you willing to go through for the possibility of gaining more time?”

 

  • Family

“How much does your family know about your priorities and wishes?”

 

I feel like the most important question is about goals-- what matters most to patients.

If your patient is interested in exploring this further in an online 2-session workshop, please consider recommending them to the “What Matters Most” Advance Care Planning Workshop.  It is free and offered monthly.  Patients can sign up here: 

Register for What Matters Most

All My Best,

mike