Irish Hospice Foundation
Toolkit for Compassionate End-of-Life Care
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“Am I dying?” is is a particularly difficult question to hear, listen to and answer. Using the responses listed above can help, but sometimes the person asking the question is looking for clarity. Maybe they have things they need to do, say or sort out, and are looking for an honest answer so they can plan for what is important to them. Often the person will have a sense that they are coming to the end of their life and are looking for another person to listen to them as they express this. It is important to be gentle but honest with a patient. If you do not know what to say, you might say, ‘I don’t know, but I can find someone who can talk to you about what you’re feeling.’ If you are aware that they are dying, you might say: ‘You are sick enough to die,’ or ‘Your mother is sick enough to die.’ Ask them what they are feeling, worried about or what other questions they might have. “Explaining to patient and/or family that the patient is ‘sick enough to die’ won’t make them sicker, but it will enable everyone to understand the gravity of the situation and to respond appropriately.” Talking about dying: How to begin honest conversations about what lies ahead . Royal College of Physicians, UK 2018 Tips for dealing with diʜcult questions: • Take a deep breath and pause before you answer. • Be genuine and compassionate. • Respond appropriately based on your role. • Give the person your full attention and listen to them - really listen. • Allow the person to express their thoughts and feelings. • Allow for silent pauses. • Use open-ended questions to gently find out what is on the person’s mind. • Be honest. It’s okay to say ‘I don’t know’ if you don’t. • It might be appropriate to say you cannot answer the questions but you will try to find someone who can. • Document the conversation and pass it to the relevant person. • Ensure you follow up and update the person with any further information. • Talk to a trusted colleague about how you feel.
Communication 2
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