It is likely that anybody working with people with intellectual disabilities, at some time or another, has had to break bad news to them, sometimes perhaps in an unhelpful way. For some people with the intellectual disability, the comprehension of what they have been told may not be readily observable. Understanding is sometimes inferred. At other times, it is clear that the news has had a profound impact. Is there a right or wrong way of breaking bad news? Clearly certain approaches should be avoided at all costs.
What is refreshing about this book is the ever-present understanding that relationship is at the core. Relationship may not always be readily apparent, given the level and extent of some people’s individual disability, but it is nonetheless present. Implicit in relationship is knowing and understanding the person. This knowledge and understanding is central to how the bad news is given. A person with an intellectual disability does not easily understand information and its consequences. Information has to be broken down in ‘chunks’ that the person can understand. The author deals very well with timing and the right amount of information to give.
The guidelines the author puts forward are very helpful, as are the examples throughout. She also sensitively addresses the tensions which can exist between staff, family and friends about breaking bad news. Examples are given of breaking bad news of a serious illness; that a friend has dementia, staff leaving or where a well-planned activity will not now take place (e.g. moving house). At the heart of all the examples is relationship and knowledge and understanding of the person and their right to know.
At the end of each chapter there are very helpful reflective thinking points, often linking back to the networks around the person; important people in a person’s life and their involvement in the process.
The author deals effectively with the challenge of a person’s limited or non-existent communication skills and reminds the reader not to make assumptions about how individuals, regardless of their level of intellectual disability, react to loss and disappointment. The author gently reminds the reader not to forget the person and the importance of a respectful engagement.
This book is timely and the offered guidelines are relevant to the daily lives of people with intellectual disabilities and their supporters.