Tool to initiate tough conversations

Region launches renal scenario video on advance care planning

By Andrea Bodie
Wednesday, July 31, 2013

Asking people to think about their wishes for medical care if illness or injury strikes or if a chronic health condition worsens isn’t the easiest conversation to start.

But it’s a necessary one. One that many Canadians haven’t had.

In 2004, an Ipso-Reid poll revealed that 80 per cent of respondents agreed people need to start planning for end of life when they are healthy. Despite that, 70 percent of them had not prepared a plan. Forty-seven per cent had not designated someone to speak for them if they were unable to do so.

What happens if you don’t speak English? And what role does culture play in having a conversation about end of life health care issues?

That’s something the recently launched video called ACP Discussion in Renal Health hopes to get people thinking about. Aboriginal Health Services – including Brenda Roland, Martha Baker and Amie Lesyk – were key supports in making this video happen. Betty Ross, Dr. Paul Komenda and Gordon Dumas offered their talents in front of the camera and Julie Lorenz acted as a clinical lead for the video shoot.

The resource is the latest resource added to the advance care planning tools and resources web page. Along with the new Goals of Care form, there are communication tips, a patient workbook (which explains terms in user-friendly language and poses thought-provoking questions to help a person better understand and choose their goals of care), frequently asked questions, videos and other resources to help guide individuals through these sensitive discussions.

“We’ve been looking at producing this resource for quite some time now, and I’m so proud of the end result,” says Lori Lamont, Vice President of Interprofessional Practice and Chief Nursing Officer for the Region and Adjunct Professor (External) for the University of Manitoba. “The video offers but one example of how the Region is offering support and resources for the people we care for and the people who care for them in having these tough conversations. It’s really powerful to see the impact that can have in a medium like video. I know this tool is one people will find very helpful.”

Everyone can benefit from having these tough conversations but it’s particularly important for people living with chronic health conditions. For health care providers, languaging important questions in a culturally sensitive way is part of compassionate service delivery.

“When we were shooting the video, we were informed that using the word ‘die’ is offensive to Aboriginal people. Because the video shoot was a collaborative process, when someone identified red flags around this, we were able to tinker the language to be more culturally appropriate and sensitive while still communicating the important things that needed to be communicated,” says Tracy Thiele, Project Manager, Nursing Initiatives. “We all learned during the process of shooting the video and as a result had the chance to make the video even better. In some cases the language choices may be subtle but slight changes create different nuances to be mindful of.”

From a patient perspective, having an end of life conversation with the use of an interpreter is important to see. The video depicts the interpreter speaking Cree but interpreter services for 34 different languages are available at no cost in the Region.