Chapter 7 180 When do I introduce the LGP? • The LGP can be used at any time within the palliative phase, from the time a person is diagnosed with an incurable disease. • The LGP is used to prepare for conversations of physicians and nurses (both 1st and 2nd line) with patients in the palliative phase. For example, conversations about symptoms (what bothers them based on the results of the USD), about end-of-life decisions or other expected problems/questions about the course of the illness based on the subject list. The earlier these discussions are held in the course of the disease, the more useful they can be for the patient. What use is the LGP to me as a clinician? • It provides an overview of possible topics to discuss in the palliative phase. • It lowers the threshold to bring up topics that are difficult to discuss. • How the patient has filled out the LGP can provide insight into o Dealing with the disease, o The ease with which the patient can talk about the illness and its consequences, o Whether the patient needs little or a lot of information, o Whether the patient prefers not to discuss specific themes. For example, there are patients who say ‘not applicable’ when asked about the dying phase. How do I introduce the LGP to my patient and his/her loved ones? • The LGP can be emotionally challenging for patients and loved ones. Therefore, when handing over the LGP, it is wise to give a brief verbal explanation. For patients who have a lot of difficulty talking about the end of life, it may be more appropriate to only introduce the USD and leave the topic list for now. Give the patient enough time to complete the LGP by giving it to them well in advance of the consultation. Important points to tell patients when introducing the LGP are: • Palliative care is more than care in the dying phase and focuses primarily on quality of life. • The LGP is a list of common discussion topics and possible questions from patients in the palliative phase and their loved ones. • The LGP is a tool that allows the patient to gain insight into his/her questions and issues that may become important in the coming period. • There are questions in the LGP that are not (yet) applicable. Ask the patient to tick only those questions that are appropriate for him/her. • The LGP is used as a guide for the discussion with the clinician. In this way, the patient controls which topics he does or does not want to discuss.
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