An American counselling psychology expert wants end-of-life conversations to become a routine, structured intervention between patients and providers in health care delivery.

Santa Clara University Professor of Counselling Psychology Dale Larson will deliver a presentation on end-of-life conversations at the Australian Psychological Society’s inaugural Counselling Psychology Conference in Melbourne next week.

Professor Larson, who specialises in end-of-life issues but also conducts research on self-concealment, said he hopes his presentation will inspire and empower psychologists to be involved in the area.

Professor Larson said there was a strong case for the fit between counselling psychology and working with serious and advanced illness, grief and loss.

“I want to say to my colleagues that we are needed; they are needed, and there are many exciting roles for them in end-of-life care,” he said.

Professor Larson said breaking the silence on end-of-life conversations was “critically important” and could improve patients’ quality of life, providing patients with a much-needed sense of control.

“The quality and quantity of these conversations determine the quality of care and the quality of life at the end of life for patients and families,” he said.

The California-based Fulbright Scholar and award-winning author said patients, family members and health professionals often avoid the conversations for a range of reasons, which could jeopardise the patients’ quality of life.

He recommended a raft of measures to improve conversations, including teaching communication skills to health professionals, allowing patients to express their despair, addressing practical care issues, asking questions and actively listening, involving the family as early as possible, and understanding the meaning of the illness for the patient.

Professor Larson said nurses, the front-line caregivers, already hold many of these conversations.

“Although confronting loss and grief are always challenging, there are also tremendous rewards because these conversations are one of the healing encounters that often were part of the inspiration for nurses to get into the field,” he said.

“They wanted to make a difference in life's most difficult moments.

“There is tremendous meaning in this work and we are all meaning-makers, and it is so wonderful that nursing provides us an opportunity to do such meaningful work.”

Professor Larson said while the US, the UK and Australia are leading the way when it comes to end-of-life conversations, he said Australia’s move towards a national framework for advance care directives could break new ground on a global scale.

“I think the AU Health Ministers’ national framework for advance care directives is going to be one of the models for nations throughout the world,” he said.

Professor Larson has also developed a new professional role focused on end-of-life conversations in the US.

“It is basically a six-visit model with a nurse, social worker or other specialist offering support, education, and communication with the rest of the health care team,” he said.

“Think of it as a pre-palliative intervention in which patients and family members (there is a family meeting) can process things and understand the options that are available to them.”

About 350 delegates have already registered for the conference, being held from February 21-24. Visit here to register.