Good communication can facilitate the development of a comprehensive treatment plan that is medically sound and in accordance with patient’s wishes and values.

Discussing the topic of end-of-life may be the hardest part of a provider’s job. When providers are uncomfortable delivering bad news, they may avoid the discussion or relay unrealistic optimism.

One way to help ease the discomfort and increase confidence in delivering bad news is to have a plan and strategy for determining the patient’s values, wishes and distress level when they receive the information.

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Initiate the Discussion

“I know this is a very difficult time for you and your family. You have never been this sick before and I know that it must be frightening to you. I want you to know that as bad as it is, we will deal with it together.”

Clarifying Prognosis

“While I can’t cure you, there are still many things I can do for you. I want you to be able to speak openly with me, so I can best help you. No matter what happens, I can be here for you — you are not alone.”

Identifying Healthcare Goals

“From what you’ve told me, here’s the plan I suggest. Please let me know if I am correctly representing your views.”

“As your doctor, I want to ensure we are focused on doing things that might help you and bring you comfort. What things are most important to you? How do you wish to spend your remaining time?”

Developing a Treatment Plan

“I’m feeling fine, so we don’t need to talk about this now. We can wait and handle things as they come up.”

“While it can be hard to talk about, it’s very important for your family. When left to guess your wishes, family and friends often feel anxious about making the right decision. They may disagree and not know what to do.”

What the Evidence Shows

  • Patients want to discuss end-of-life issues with their doctor.
  • Patients do not have anxiety or distress as a result of hearing the truth about their illness.
  • Advance care planning reduce stress, anxiety and depression in surviving relatives.