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The education topic for this edition covers the following CAHPS Survey question:

While your family member was in hospice care, how often did the hospice team explain things in a way that was easy to understand?

The options to answer this question are:

A. Never

B. Sometimes

C. Usually

D. Always

The answer you want, not only for scoring but because patients deserve to be treated with respect & dignity, is ALWAYS!!

5 Tips to Improve

I. Is now the right time to teach?

It’s not just what you say or how you say it, often WHEN you say it is just as important. As the expression goes, Read the room.

If this is a visit early in the process, or during a crisis, or multiple family members are around and the situation is new to them, is the family member simply too worn out and no matter what you say or how you say it, will they be able to absorb the information?

Prioritize your information. If the timing for education isn’t right, only teach what the caregiver must absolutely know and save the rest for another visit.

II. Assume that patients, family, & caregivers are entering this situation with zero knowledge of the subject.

Don’t fall into the ‘expert blindness’ trap. Often clinicians are so comfortable in the topics that are dealt with daily that the subject matter is run through quickly assuming the audience understands. Assume that your patients and families need everything explained in simple, easy terms and then move the conversation forward educating from there based on their comfort level. Ask yourself, ‘would a six-year-old be able to understand this’?

Hospice topics, such as administration of opiates, changing a colostomy bag, or placing a loved one in a skilled nursing facility, can be overwhelming and scary for patients and families. Before you dive into instruction, make sure they’re calm and receptive to the information. Ask them how much experience they’ve had and reassure them that they can perform each task before you begin teaching the next. Gauge their comfort level and background knowledge.

III. Explain in personalized bites.

Don’t explain how all opiates work and start comparing and contrasting options. If the patient is on Morphine speak specifically to that medicine for that patient; how it works, the effects, when to take it. If the medicine changes you can explain the next medicine at that time.

Remember the line: The shoemaker’s children go barefoot. Whether “the patient is a doctor” or “the daughter is a nurse” does not mean they don’t require the same education and explanations as someone with no health care background. Provide all the guidance you can offer.

Teach in bites prioritizing the most important information first, especially when patients and families are overwhelmed or in crisis, and let it all come together naturally.

IV. Apply the “Teach Back” method.

Have the person that you are speaking with show you, or explain back to you, what you discussed. This is an easy way to catch what they’ve missed or misunderstood.

Patients and families may not want to admit they don’t understand or may feel they are bothering you by asking questions or to see the procedure again. The Teach Back is especially helpful in these cases.

V. Keep asking the patient or family “what questions do you have for me?” Don’t ask “do you have any questions?

Asking “what questions do you have for me?” maneuvers the patient, family, and caregivers to feel as if their questions are not only welcomed but expected.

Always allow enough time to answer questions and review what was explained. Sit down with the patient or family and be present when hearing their concerns and questions. Often there may not be enough time to cover every issue. Prioritize the information and follow up!


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