Overview of communicating with and supporting patients with palliative care needs
Talking about death and dying, and communicating bad news or prognostic information, are necessary in caring for patients with a life-limiting illness. These conversations require sensitivity and empathy and can be difficult and distressing for patients, families and healthcare professionalsScott, 2013.
For healthcare professionals, training in communication skills and attention to self-care can diminish the stress associated with difficult conversations (see Healthcare professional wellbeing in palliative care). Additional resources on communicating about end-of-life issues are available at CareSearch and Vital Talk. Training can also help healthcare professionals recognise stigma impacting patients who are part of underserved population groups (eg people with diverse sexuality or gender identity, those living with a psychiatric disorder, people experiencing homelessness) and the care they receive.
For information about assessing distress and providing psychosocial care to patients, see Distress in palliative care.
Factors that influence the approach to discussing end-of-life issues include:
- understanding what ‘dying well’ means to a patient
- patient and family cultural beliefs and preferences about death and dying
- how much the patient and their family already know about their life-limiting illness and prognosis.
When discussing end-of-life issues for patients with a life-limiting illness, include treatment options and likely outcomes and ensure the goals of care are patient-centred.
Being diagnosed with a life-limiting illness impacts all other aspects of a patient’s life, not just their health. Patients may wish to express that they still have:
- life to live
- wisdom and knowledge to be valued
- emotional needs
- intimacy needs, including emotional and physical intimacy
- a desire to actively participate in the life of others
- emotional and physical desires to be fulfilled (eg bucket list, travel, other last wishes).
Patients may lose the ability to work, drive or walk. It can be beneficial to plan how these changes will be managed in advance, and arrange financial assistance and equipment aids if needed.