Communication and Serious Illness
Our podcast is hosted on Spotify and Anchor.
BJ Miller, Mettle Health founder, palliative care and hospice physician and author, and Patricia Liu, Speech-language pathologist, hold an informal and interactive conversation on communicating around serious illness, both for the purposes of planning for care, but also the logistics of communication.
Communication is at the heart of everything when it comes to navigating an illness. Talking and listening to doctors about treatment options, communicating with family and friends about choices to make, saying the things that matter most. On top of this, there’s the logistics of physically speaking: what if someone has recently had a stroke, or has an illness that is making speech more and more difficult. How can families learn to communicate in these situations in order to ensure care preferences are honored?
We discuss:
0:00 Introductions
4:38 What is communication? Getting information from one brain to another brain
6:10 Expressing emotions to connect with others
6:37 Who are the people we communicate with? The people who know us well vs. the people outside that group
7:23 Talking with doctors, nurses, pharmacist - this is where the complexity of communication and time pressure might add barriers
8:25 The sense of living and identity hinging on communication and connection
10:50 Getting information in, if someone is having trouble hearing or seeing, that may impact ability to comprehend questions or issues
12:00 Tailoring our approach to communicating with someone who has trouble getting information out, or in the other direction
14:05 Getting information out: the thoughts in our head, can we formulate a thought and get it to someone else? Might be through our mouth, or to our hands to write or point
15:52 Thinking of communication as a creative act
17:28 Laughter and smiles as communication on top of language
18:17 Thinking about the importance of silence in communication
21:18 Cultivating the skill of listening
21:47 Tools to consider for improving communication: amplification, pen and paper
23:22 Setting the atmosphere around the communication to lessen anxiety - preparing so everyone is in a comfortable place
26:00 High tech devices to help with communication
29:39 Low tech items: pen and paper, the basic communication boards, or pointing devices can be really helpful
33:00 Hospitalizations and breathing machines, confusion and delirium
34:28 Asking for a speech language pathologist consult - when to consider?
38:38 If communication is impacted, it’s going to be slower - best thing we can all do is slow
40:00 Tips for letting other people know what you need in relation to communicating
43:30 Expressing ourselves creatively outside of the normal modes of communication
46:32 Think about the kinds of difficult conversations that you might want to have in advance of a crisis or emergency situation
49:00 What about the emotional content of a serious illness communication?
52:23 What to do when someone isn’t ready to discuss a tough topic?
55:00 What to do when it feels like your doctor isn’t hearing your concerns?
57:03 Suggestions for thinking about future communication as relates to early Alzheimer's diagnosis?
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