Repository logo

'It's a hard conversation to have'. Healthcare professionals' views concerning advance care discussions with young people affected by life-limiting neuromuscular diseases: an interview study.

Accepted version

No Thumbnail Available



Change log


Hiscock, Andy 


OBJECTIVE: Life-limiting neuromuscular disease, such as some of the muscular dystrophies, are often diagnosed in early childhood: when death comes, commonly in the second or third decade of life, patients rarely have advance care plans in place or documented end-of-life care preferences. There is very limited literature concerning the discussions about end-of-life plans healthcare professionals have with young people affected by life-limiting neuromuscular diseases. The aim of this study was to investigate the views and experiences of healthcare professionals concerning having discussions about advance care plans and end-of-life care with teenagers and young adult patients affected by life-limiting neuromuscular diseases. METHODS: Semistructured interviews with a maximum variety sample of nine professionals involved in the care of young people with life-limiting neuromuscular diseases in one region of the UK. RESULTS: While recognising the inevitable progression of the conditions, there was no consensus among interviewees concerning best approaches to discuss end-of-life care plans. Several environmental and personal barriers were identified that lead to avoidance of the emotionally challenging and difficult conversations. CONCLUSIONS: Community-based professionals with well-established relationships with patients and families may be best placed to take the lead and coordinate discussions, but individual case-by-case preferences need to be carefully considered.



Communication, Family management, Neurological conditions, Supportive care, Transitional care, Adolescent, Advance Care Planning, Attitude of Health Personnel, Attitude to Health, Communication, Critical Illness, Health Personnel, Humans, Neuromuscular Diseases, Professional-Patient Relations, Terminal Care, Young Adult

Journal Title

BMJ Support Palliat Care

Conference Name

Journal ISSN


Volume Title