Talking about dying and death: Essentials of communicating about approaching death from the perspective of major stakeholders

OBJECTIVES

Although caring for dying patients and their family caregivers (FC) is integral to patient care, training in communication about approaching death is almost inexistent in medical and nursing curricula. Consequently, many health professionals have insufficient knowledge about conducting these conversations. In order to gain a broader insight into essential aspects of this communication from different perspectives, we conducted focus groups with key stakeholders.

METHODS

Medical specialists, nurses, medical students, bereaved FC and patient representatives participated in five focus groups (n = 30). Following a focus group schedule, we elicited relevant aspects of communication about approaching death, associated emotions, and appropriate communication frameworks. We analyzed data thematically.

RESULTS

Four main themes were central to conversations about approaching death: (1) embracing care within medical expertise, (2) preparing the conversation while remaining open to the unexpected, (3) recognizing and reflecting on own emotions and reactions, and (4) establishing a meaningful connection with others.

SIGNIFICANCE OF RESULTS

Communicating about approaching death with dying patients and their FC can be complex and challenging at a professional and personal level. With the recognition of the dying phase, a process is initiated for which health professionals need solid clinical knowledge about but also effective communication skills, constant self-reflection and self-care strategies. Comprehensive training and supervision while dealing with the challenges of communicating approaching death to dying patients and their FC are key, particularly for trainees, less experienced physicians and nurses. The essential components identified in this study can help health professionals to master these conversations.

[Compassionate Cities: Strengthening Social Resources in Communities for Mutual Support at the End of Life]

Compassionate Cities: Strengthening Social Resources in Communities for Mutual Support at the End of Life Abstract. People at the end of life often wish to remain at home for as long as possible. To make this possible to a greater extent, not only health professionals who accompany those affected and their relatives are needed, but also educational programmes to strengthen health literacy at the end of life. Within the framework of the project "Compassionate City Lab of the Bernese People", experiences in dealing with the end of life were collected and published, and a course on advance care planning for elderly people was developed. The project is funded by Health Promotion Switzerland and supported by a partnership between Bernese institutions of higher education, specialised palliative care and primary care, the community, and volunteers in the city of Bern and the Bernese Oberland.