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WCN 2023 | Conveying an ALS diagnosis: challenges and the ALS SPIKES protocol

Melinda Kavanaugh, PhD, LCSW, University of Wisconsin, Milwaukee, WI, delves into the complexities of conveying an ALS diagnosis, introducing the ALS SPIKES protocol as a tool for effective communication. One primary challenge involves the physician’s comfort level in delivering the news. This reflects a lack of training in navigating personal feelings related to the diagnosis, mortality, and patient reactions. Similarly, the readiness of patients and caregivers to receive the diagnosis, including preconceptions, poses another hurdle. The ALS SPIKES protocol addresses these challenges by underlining advanced preparation for healthcare providers. It emphasizes self-preparation by acknowledging personal feelings and ensuring a comprehensive understanding of the disease to address family inquiries. The protocol also highlights the importance of choosing a comfortable and quiet location for the diagnosis delivery and provides training for physicians to respond with empathy to the emotional aspects of the situation. Importantly, the ALS SPIKES protocol is adaptable for integration into various healthcare settings. This interview took place at the World Congress of Neurology (WCN) 2023 in Montreal, Canada.

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