Core Modules

module 2 | Activity 5: The need for effective communication

The Bow Tie Model of palliative care

The Basic Model of Integrated Palliative Care (or Bow Tie Model) acknowledges the need for an approach to communication about palliative care that prepares people for the worst, but still allows them to hope for the best. Entering a pathway in which the only possible outcome is death can be unacceptable to many people. Communication regarding palliative care that allows for survival as a possible outcome can encourage people to engage in conversations about the benefits of palliative care, early in their experience with life-limiting illness. This model can be used to describe how the various components of palliative care might fit into the person’s journey along with strategies for disease management.[1]

Read more about this model of palliative care on the Canadian Virtual Hospice website: The Bow Tie Model of 21st Century palliative care

Expert Opinions

The following expert opinions highlight the need for effective communication when discussing palliative care and end-of-life issues with people affected by life-limiting illness.

Dr Geoff Mitchell

Geoff Mitchell has specialist qualifications in General Practice and Palliative Medicine and is a practising GP. His publications include numerous articles in peer-reviewed journals and co-authorship of clinical handbooks of Palliative Care entitled “The Blue Book of Palliative Care”, and “Therapeutics Guidelines: Palliative care”. He has also co-authored a national report into the palliative care education and support needs of GPs in palliative care.

Melissa Heywood

Melissa Heywood is a Clinical Nurse Consultant for the Victorian Paediatric Palliative Care Program at The Royal Children’s Hospital (Melbourne). Melissa has spoken extensively on communication principles and embedding them into practice through the use of simulation.

  1. Watch the expert opinion videos and describe two key strategies for holding difficult conversations with a person affected by a life-limiting illness.  How well do the clinician suggestions match the communication strategies identified in this section?
  2. Compare and contrast the PREPARED and SPIKES communication frameworks and discuss where, when and how you could use each of the frameworks.

Hawley, 2014. The Bow-Tie Model of 21st Century Palliative Care. Journal of Pain and Symptom Management: 47(1).