The Seven C's of Caring Conversations
At StoriiCare we are passionate about offering opportunities to connect people better. From the person receiving care or support, to the nurse and care worker, to the families - everyone has a role to play in supporting a truly person-centred care experience. Sometimes, however, taking those opportunities to connect can be tricky. There are hard questions that we sometimes would really like to have answers to but we might worry about what those answers will be. Here in Scotland, where StoriiCare first started, researcher Professor Belinda Dewar and colleagues at the University of the West of Scotland developed a framework to help guide care professionals, and others, in how to go about having important and compassionate conversations about people and their care (Dewar, Sharp, Barrie, MacBride, & Meyer, 2017).
The “Seven C’s” of the Caring Conversations framework encourage us to think about how we approach difficult questions and build relationships:
This encourages us to be brave, and focus on what important insight we could gain from speaking up or starting that conversation. For example, if you are struggling to discuss end of life care preferences with someone, think about who would benefit from you acknowledging and understanding their wishes? By approaching them about this, what is the worst that could happen?
Professor Dewar encourages people to not only explore and respect how the other person is feeling but also how you might be feeling too. By learning something new about someone you may feel strong emotions, such as worry or surprise. There may be a way of sharing that with the other person, such as “I’m grateful we could have this chat” or “I’m sad to hear that this has been so hard for you”. You are not asking them for emotional support, but simply relating to them on an emotional level.
Are there opportunities to explore what you have discussed further? This is about asking open questions where you can avoid making assumptions about what you think is happening. Instead, you open it up and hear from the other person.
This is about bringing in collaborative questions to the interaction, such as: What can we do to make this happen for you? How can we work together? How would you like me to be involved? By asking these collaborative questions, the emphasis is away from you leading the process and making decisions and towards the other person doing so instead.
Consider other perspectives
Exploring and thinking about the other person’s experience of this and their perspective - “Help me understand where you are coming from”
Professor Dewar acknowledges that there are financial, time, or other constraints that can make it difficult for care services to provide a solution to every wish and personal problem. This means thinking instead about what IS possible, asking the person “what is the most important thing here?” or “are there any elements of this that you are willing/able to do without?” The answers to these questions may help to establish a good plan of action that meets everyone's needs acceptably.
This refers to exploring what so far has been working well, and why that might be. It means thinking about how we can help this to happen more often, recognising what strengths we have collaboratively to achieve these goals. Making comments on positives in the situation is a great start: “I value that you shared this with me” as an example.
Tips for Caring Conversations
The tactics above are not hard and fast rules for eliciting exactly what information you want from someone. Instead the framework is a way of thinking about how to interact with someone else with compassion. Professor Dewar also explains that a Caring Conversation does not need to contain all seven elements in order to be successful or beneficial, and certainly not all in the given order. It is intended to give you a rough structure for how to go about discussing their care and how it might be changing according to their wishes or their needs. It’s a way of making the care you provide truly person-centred. Many family carers express that care professionals are so busy or time-pressured that they don’t ask them or their loved ones about the truly important, individual elements of someone’s life or personality. For a real, and moving example of this, watch carer and campaigner Tommy Whitelaw share his and his mother Joan’s story. He makes a very valid point: how can care professionals show that they care if they don’t know or ask “what makes you smile/sad? What makes you feel like you?”.
StoriiCare Can Help
You can watch a video by Professor Belinda Dewar discussing Caring Conversations via the link below: Caring Conversations - Prof. Belinda Dewar (My Home Life Scotland)