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Irish Hospice Foundation
Toolkit for Compassionate End-of-Life Care
Step 3: Prepare them, and then be gentle as you deliver the news
Here are some example scenarios: •
Prepare them for what is coming next: “I wish I had better news to give you today”, “I’m sorry, but the news isn’t as good as we’d hoped it might be”, “Unfortunately, I have some bad news for you”. • Pause. Allow the warning to land. • Gently deliver the news using clear simple language and avoid jargon and euphemisms: “ e lump in your breast is cancer”. • If the news is complex, break it into small chunks. en check that the person understands what you have said, for example: “Can you tell me in your own words what you understand we’ve talked about?”
Step 4: Acknowledge the shock •
Even if the news was anticipated, hearing the confirmation can be a shock. It is important to acknowledge the emotional impact of the news: “I can see this news has come as a shock”, “I can see this is upsetting for you to hear”. • Give the person time; allow a silent pause. • Deal with the person’s concerns before you deal with questions of detail: “What is your biggest concern right now?”
Step 5: Plan for the future •
Give a clear plan as to what will happen next. Depending on how the person responds to the news, it might be appropriate to discuss treatment options or it might be better to make a plan to discuss further options at another time. It is useful to have written information available to enforce your spoken message. • e person affected by the news might be worried about how they are going to tell others. Offer to support them with this. Always make sure you have the person’s permission before giving information to others. • Find out if there is anyone in particular the person would like to talk to, for example , a social worker, or pastoral care. • Avoid phrases like “there’s nothing more we can do” - a better way is to say something like “ ere isn’t any specific treatment to make your illness go away, but there is a lot we can offer to help you to cope.” • Provide the name and number of a support person they can call if they have further questions. • Document the details of the discussion, using the same language used in the conversation, and the follow- up plan in as much detail as possible.
Communication 2
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