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Research ArticlePractice

Family meetings

An essential component of comprehensive palliative care

Ramona Joshi
Canadian Family Physician June 2013; 59 (6) 637-639;
Ramona Joshi
Medical Director of Palliative Care Services at Toronto East General Hospital in Ontario and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto.
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  • family meetings palliative care
    kenneth r. nickerson
    Published on: 15 July 2013
  • Published on: (15 July 2013)
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    family meetings palliative care
    • kenneth r. nickerson, contract physician
    The SPIKES outline is a great little memory tool in an area that is so complicated for patient, physician and family. I have always found myself at a loss even though I have seen so many similar cases. My preparation was often hurried which makes the meeting and communication rather difficult. What bothers me looking back is that there seldom was need to rush ahead, but often not having a well thought out plan was my downfall....
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    The SPIKES outline is a great little memory tool in an area that is so complicated for patient, physician and family. I have always found myself at a loss even though I have seen so many similar cases. My preparation was often hurried which makes the meeting and communication rather difficult. What bothers me looking back is that there seldom was need to rush ahead, but often not having a well thought out plan was my downfall.

    I am particularly impressed with the need to give families time to think it out, which means you must get to the conversation early so the path of disease doesn't force you to rush things. It is so important to give room for followup ,because families are disappointed when change occurs to their surprise.

    There is one area that comes up a lot and gives me real problems and that is the issue of family members who want to serve their own private interests which can make the communication process very complex. This usually is tied up in the inheritance factors and members sometimes reserve comment and later come up with issues after some family members have decided. It would actually be an idea to have the CMPA give some feedback as a heads up for what they believe can be issues here. I must say the article has been a wake-up call to me.

    Conflict of Interest:

    None declared

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    Competing Interests: None declared.
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In this issue

Canadian Family Physician: 59 (6)
Canadian Family Physician
Vol. 59, Issue 6
1 Jun 2013
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Family meetings
Ramona Joshi
Canadian Family Physician Jun 2013, 59 (6) 637-639;

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