Death and Dying

Test Announcing Two New Resources

How do you start the conversation?

To read our latest newsletter online click here or see below.

There is much written about the need to start the conversation. For patients and families, the why matters most. “To get the care I want.” “To have a say in my care.” “To be treated with dignity.” Once people understand why the conversation is important to their future care, the what and how are easier.

“Whenever we use the Conversation Game within a session on ACP the trainees give positive feedback, often stating that it puts it into context and offers an opportunity for excellent interactive learning.” -GP Commissioner

What’s The Conversation Game?

The Conversation Game helps to facilitate exploring patient wishes and values.This deck of 36 cards provide an easy way to think and talk about what’s important if you were to become seriously ill. Each card has a single phrase on them in large print, based on research of patients and carers facing the end of life and the key things that would matter most to them.

Used now by thousands of health and social care professionals, educators and in each of our facilitated training and community engagement processes, the research based* Conversation Game is the one tool that assists the public, staff and communities to start the conversation. It is nearly impossible to see the phrases on the cards and not have an opinion, a reaction, a response-all of which are conversation starters.

Developed originally by a group of hospice and palliative care organisations in the US, to assist people in starting (ACP) conversations.They have been reviewed and amended by the Lancaster University End of Life Care Observatory Peer Educators, and used in the nationally endorsed Conversations for Life public health pilot, and now are being used by staff across health and social care in the UK and abroad. Most recently, a study reported patient’s preferred the use of the Conversation Game Cards to a list approach of statements of wishes: J Clin Oncol 33, 2015 (suppl 29S; abstr 44)

You’ve spoken. We’ve listened. We hope to help as many educators, facilitators and staff add our approach and tools to your toolkit, as part of your own awareness, education or community engagement initiatives in 2016. With requests internationally about the Conversations for Life approach and materials, we have spent the last 6 months re-designing ways we can help support you to achieve the benefits we have seen facilitating more than 2000 staff, 8 communities and hundreds of members of the public to engage in the conversation.

“Years on, I’m still using the tools with patients and families.”-Admiral Nurse

Each newsletter, we will be launching a new product or pack with instructions for use by facilitators, staff or educators internationally.

This newsletter’s special: The Conversation Game “An FY2 reflected that he identified family was so important to him using the cards but he hardly acknowledged the family involvement of his patients in his work, he vowed to alter his practice to explore further with his patients how much to include family in information and decision making.”-GP Commissioner

“I attended a workshop for Chaplains and had terrific feedback from the use of the cards. Well done.”-PHINE Network It helped our patient who couldn’t speak have the conversation…

“A patient of ours was severely agitated, yet couldn’t speak due to a trach. Our team couldn’t find a way to help her communicate. I’d been on your course and had the cards with me. I told her that we knew something was bothering her, and we wanted to help her. I showed her the card pack and said, there were phrases on these cards that others found important-concerns, wishes. I left them with her and said if she felt like it, to take a look. No pressure. And they may not speak to her. Yet if any of these phrases were her concerns, to let us know.

The next day, her daughter was visiting-sitting on the bedside of her mother. There was a single card on the bed between them. “Not to be a burden on my family.” They both wept and hugged. It allowed them to express what they needed to. Her anxiety and agitation dropped significantly afterwards.” -Acute Trust RN

Does someone you know have a story that could help others?  

Families from black, Asian and minority ethnic communities (BAME) are being asked to share stories and help shape a new regional awareness initiative across Greater Manchester, South Cumbria and Lancashire. The project aims to raise awareness of some of the end of life care issues and needs in the BAME communities across the SCN footprint in order to enhance communication between patients, families and care professionals, including hospices and palliative care teams.

For more information, please download a leaflet here or register your interest to receive an information pack by contacting: Keith Swindell Quality Improvement Manager – Palliative and End of Life Care, NHS Strategic Clinical Network for Greater Manchester, Lancashire & South Cumbria, Preston Business Centre, Watling Street Road, Preston, Lancashire, PR2 8DY Tel: 0113 825 4826    Mob: 07825 422444 Email:

Dying Matters Awareness Week, 12-17 May 2014

Download a calender for a week of events in Lancaster here or go to to find events in your area!

Expanding the Impact of Community Engagement

(November 2012) We’re pleased to be part of a ‘knowledge exchange’ with Lancaster Universtiy and to have held a stakeholder event of some who have initiated community engagement events around end of life conversations and care in the Northwest. Stay tuned for a resource to support other communities planned for the Spring!

Compassionate Communities Final Report July 2013

Engaging Communities Using An Asset-Based Approach (October 2012) A full workshop session of our community engagement approach and initiatives using an asset-based approach was presented at the 19th Annual Congres du Palliative Care, Montreal, Canada. For those who truly want to be inspired, see also the plenary closing talk by Balfour Mount (purchase the DVD here).

Please note that audio recordings of most presentations can be purchased through Swordfish.

The 20th edition of the Congress will take place from September 9-12, 2014 at the Palais des Congrès in Montréal, Canada.

Delivering a public health initiative around end of life conversations and care (August 2012) In June 2012, Katherine Froggat, International Observatory of End of Life Care Lancaster University, Lancaster, presented Conversations for Life outcomes at the 7th World Research Congress of the European Association for Palliative Care (EAPC), in Trondheim, Norway.

View the poster ‘Conversatons for Life: Implementation of a pilot public awareness campaign about end of life issues’ here.

Gaining multi-staff awareness and team support for advance care conversations (July 2012)  According to the National End of Life Care Strategy and a recent Northwest Scoping of End of Life training for health and social care staff, all staff must become more comfortable with their role in advance care conversations and end of life care if improving care of the dying is to be achieved.

As part of strategic interventions, to date more than 200 staff representing multiple services (see below) have attended our 1 day “Simple Tools to Start the Conversation” sessions focusing on supporting staff to overcome the fear of talking about death and dying in order to improve patient care and provides tools to assist them to begin to apply what they learn personally and with those in their care as a result. Sessions have been commissioned by GMCCN, NHS Manchester, NHS Salford, NHS Trafford, Pennine Care Foundation Trust, MacMillan and others.

Multi-service staff attend each session, providing greater awareness and wisdom shared, while supporting end of life, palliative care, and care pathway (LCP, GSF, PPC) interventions and projects.

Compassionate Communities…..How to Begin (June 2012) The evaluation of the national Dying matters week in one region in March 2010 identified the need to engage with the community as an ongoing initiative rather than just a one week campaign every year. Merseyside Clinical Networks Palliative and End of Life Care Network, local hospice and voluntary leads and community organisations partnered together to engage their communities. Mary Matthiesen, Director of The Conversations for Life programme provided materials to support them, facilitated local engagement events, produced summary reports / action plans and delivered follow up sessions based on mobilizing the existing strengths in these communities. Local hospices or community volunteer agencies including VCA Wirral, Halton Haven Hospice, Liverpool PCT /Marie Curie Hospice, Liverpool, Queenscourt Hospice, Southport, Western Cheshire PCT/Hospice of the Good Shepard, and Woodlands Hospice championed the initiative in their communities.

135 community group leaders have been engaged across 6 localities. Self-directed, community-led awareness initiatives are underway. Outcomes were presented at the International Society of Advance Care Planning & End of Life Care and published in the BMJ Supportive & Palliative Care Journal (June 2012).

Welcome to our new website!

We are delighted to be able to launch the Conversations for Life Programme with this new website!

Five years ago I held a conversation with my own mother that changed everything for her last days of living and I dreamt of being able to provide others with the information and tools to support what they want for their families and communities. Last year, with the support of many others, we developed and launched The Cumbria Conversations for Life pilot programme in collaboration with NHS Cumbria to help break the taboo Read the rest of this entry »

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