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Irish Hospice Foundation
Toolkit for Compassionate End-of-Life Care
Giving bad news to children It is very upsetting to know that a family member or friend will die. is can be a very difficult time for a child if they do not fully understand what is happening. It is painful to see a child upset, but children do cope better with sad news when they are told the truth. Clear, age-appropriate language is the best way to communicate the news. Parents and guardians may find it helpful to get support from a friend or relative when they are breaking bad news to their child. Visit Irish Childhood Bereavement Network for more information: www.childhoodbereavement.ie Answering diʜcult questions
Working in healthcare, especially when dealing with people who are at end of life, often requires us to respond to these types of questions. ese questions are often asked at times we are not expecting them.
Answering difficult questions might make us feel uncomfortable, unsure about where the conversation is likely to lead and we may worry about ‘saying the wrong thing’. We often focus on keeping patients happy and comfortable and making them feel better. Sometimes we may respond with a jovial “you’re grand” or “don’t worry” or “not on my shift”. When a person (patient or resident) is concerned about something and they want to talk about it, they will choose who they speak to, and they will make this choice based on who they feel will be the best person to
‘This medication isn’t doing me any good. I don’t think I am going to make it, do you?’
have this conversation with. For the patient or resident, the best person is often a person whom they can trust, whom they feel will be most likely to listen to them and whom they feel will be empathetic. If the result is a closing down of the conversation, they might choose not to voice their concerns again. As a staff member, it is important to recognise that if a patient or resident chooses to have a conversation with you about what is worrying them, then it is because they believe you will listen and help. Your job is to accept that trust and explore their concerns with them within your role or appropriate to your role. You don’t need to have the right answers; it is not about that. It is about allowing the person to express what it is they are worried about, listening to them and then providing them with the support they need. While seeking out those who might help further is one part of these conversations, for many the provision of a kind, listening ear is often what is most beneficial. Whilst it is normal to feel uncomfortable when difficult questions are asked, it’s important not to panic and rush a response. Instead, gently probe to find out what lies behind the question: “What makes you ask that?” “Are you worried about something?” “Do you want to talk about what is worrying you?” “How can I help?”
Communication 2
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