How to talk with the family of a dying patient: anger to understanding, rage to compassion, loss to acceptance

Abstract

Informing families about the impending or actual death of their relatives is one of the most challenging and complex tasks a physician may face. The following article describes goal setting and provides five roles/recommendations for conducting the encounter with patient families regarding the imminent or actual death of their relatives. Importantly, the encounter should be family-centred, and the physician should be highly attentive to family needs. The following roles should be applied based on family needs and should not be sequential as numbered. The first and basic role is to inform the family at the earliest possible time and as often as possible. The second goal of the physician is to convey to the family that their relative received the needed therapy during his hospitalisation or in the community. The third goal of the physician is to help the family reach acceptance of the death of their relative and leave the hospital having moved beyond anger and bargaining. The fourth goal of the physician during the encounters is to reduce or alleviate guilt by stating that nothing could have changed the course of the disease and that all efforts were made to save the patient. The fifth role of the physician is to try and help the family as a single entity and maintain their unity during this stressful situation. Following these roles/methods will help families in the stressful situation and will create the difference between anger and understanding, rage and compassion, and loss and acceptance.

How to talk about dying? The development of an evidence-based model for communication with patients in their last days of life and their family caregivers

“…Conversations about and in the context of approaching death are one of the most challenging communication scenarios that healthcare professionals (HCP) may face. Because of their possible impact on all persons involved these conversations remain a demanding task even though caring for dying patients and their family caregivers (FC) is an integral part of the clinical work of HCP [ [7] , [8] , [9] , [10] ]. However, conversations about approaching dying and death itself rarely belong to their training.…”