Patient centred care

Question:Who’s the expert here?

Answer:The patient is the expert about what’s important to them.

Authentic engagement with the patient requires:

compassion, knowledge, experience, sensitivity and skill
responsiveness to sexual, cultural and linguistic diversity
one, two or a series of conversations to elicit the patient’s goals, values and wishes
inclusion of substitute decision-makers, families and carers, according to the patient’s wishes
education, training and exposure to good practice.

Events indicating the need for a conversation about care in the last 12 months of life include:

a life-limiting illness is diagnosed
a patient who is likely to die in the short to medium term is admitted, or deteriorates during the admission
a patient living with a life-limiting illness has recurrent, unplanned or recent admissions
a previously well person who has suffered an acute life-threatening event or illness is admitted
unexpected, significant physical deterioration occurs
the patient decides to withdraw life-prolonging interventions¹
any patient (or medical treatment decision maker, carer or family member, if the patient lacks capacity) expresses interest in discussing end of life care, no matter how vague the interest might seem
death is imminent.

See Therapeutic Guidelines Palliative Care 2016 Version 4 on the Clinicians Health Channel at your health service

¹For example, renal dialysis, total parenteral nutrition or non-invasive ventilation

Reviewed 19 April 2024

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