1. Difficult Conversations
Starting the conversation if someone close is seriously ill
Presented by Martha Flann

2. What is cancer?

3. Main treatments for cancer
Surgery
Radiotherapy
Chemotherapy
Hormonal therapy
Targeted therapies

4. What is dementia?

5. Main treatments for dementia
Non-drug treatment: talking therapies, counselling and support at home
Drug treatments: help with memory problems for a while; hallucinations and depression and anxiety

6. Treating cancer in someone with dementia
Benefits and disadvantages
Giving consent
Capacity: Understand the information and able to make an informed decision

7. What we are going to cover
Why it is important to talk about death
What you might need to talk about
What to bear in mind
Starting the conversation
Talking vs helping

8. What situation might you find yourself in
Someone very close is very ill
Some one you love is dying

9. Some myths
It is important to put on a brave/happy face when people are very ill or dying
Don’t waste time talking about things, it will only upset them.
They probably don’t want to talk about it, otherwise they would have already.
And there are more ……….

10. Why might you not want to talk ?
Relatives and Friends
Fear of saying the wrong thing or making it worse
Cure collusion - Refusing to face the truth.
Fear of what others might say
Not wanting to upset professionals
Fear of own mortality
Guilt shame of the past
Denial
The people who are ill or dying
Fear of being a burden
Lack of privacy or opportunity
Inner conflict /unfinished business
Fractured families
Secrets never shared
Denial – not facing the truth
Fear of upsetting relatives
Never liked to talk
Trusting the right person

11. Why we need to talk?
They may not have left a will or expressed wishes about funerals, arrangements, dependants
They may not have said something they wanted to say
You may have to tie up loose ends without any direction
You may have sadness and regret about not sharing your feelings with them
It helps to accept things are coming to an end, and helps to acknowledge strong emotions
It can bring you closer
It brings a sense of relief once things are brought into the open.

12. Principles to Bear in Mind
In general, in the long run, you hurt people more by the conversations you don’t have than by the ones you do
Its quite likely that the other person has been thinking about these things to but not said anything
Talking about the important subjects can’t be done in one cover all conversation but by lots of small ones
If you are worried about getting it wrong, you can always discuss it with someone else beforehand

13. Subjects to talk about
The type of care someone would like towards the end
Where they’d like to die
Funeral arrangements
Care of dependants
Organ donation
How they would like to be remembered
What worries they would like to discuss
What they would like people to know before they die

14. Starting and Having THAT Conversation
Right time and place
Focus on them
Reassure but don’t try to solve
Let them lead

15. How to Listen Be respectful. Be honest Engage and watch
Stay grounded and calm
Think of some questions
Offer options or alternatives
Don’t be scared of emotions
…………..Be quiet

16. During the conversation
“What would you like to talk about”
“I know these things are difficult to talk about”
“ is there anything you want us to know”
“how do you feel you are progressing”
“what are your hopes for the next few weeks”

17. Keeping the Conversation Going
Words aren’t always necessary
Encourage by asking and listening
Add your own recollections
Allow for negatives

18. Summary
It’s hard – but living with regret is too You are probably not the only one wanting to talk Being there and listening can be enough Emotions are part of life – they don’t hurt us as much as avoiding them does