Good communication at end of life

Good communication is extremely important for providing good care to someone with a terminal illness. You may have conversations that are difficult throughout the person’s illness, but communication can be particularly challenging towards the end of life. There are skills that you can learn to help prepare for these conversations and give the best support for the people you care for.

On this page:

Why is communication important?

Good communication allows you to connect with your patient and those who are important to them, understand their priorities and wishes, and support them to make informed decisions about their care.

A person’s needs and preferences can change quickly in their last months, weeks and days. Good communication is essential to making sure their needs are understood and can be met by the healthcare team.

How can I improve my communication skills?

There are skills you can learn to help you prepare for difficult conversations. Many health and social care professionals feel nervous about having difficult conversations. Although you might not always be the best person to have these conversations with your patients, everyone should be prepared to talk about difficult topics. You can always ask for help from a more experienced colleague if you don’t have all the answers.

There are things you can do with every patient to help communication, including:

• Take time to get to know your patient and how they communicate. It might be helpful to ask people who know them well such as family members, friends and carers. Read more about specific communication difficulties.
• If possible, have important conversations in an environment that makes communication easier. This should be a private place that is quiet and calm without distractions.
  
• Always introduce yourself with your name and role when you meet someone new.
  
• Say why you’re there at the beginning – for example giving medicines, personal care or having a conversation.
  
• Be aware of your body language. An open posture with arms and legs uncrossed can make people feel more at ease. 
• Some people may find touch, such as hand-holding, reassuring.
• Share information in a way they can understand.
  
• Use plain language instead of medical jargon.
  
• Avoid euphemisms – for example, say ‘dying’ instead of ‘passing away’. It might seem harsh but it’s important to avoid confusion.
  
• Provide written information such as booklets or websites. This allows people to find extra information in their own time and gives them support when you’re not there.

Everyone is different – no one size fits all – think about person’s preferences, needs, likes and dislikes. If they do not want to have a conversation, this must be respected. Don’t force them to talk about anything they don’t want to.

What other support is available?

If someone has questions about their illness that you can’t answer, it might be helpful for them to speak to their doctor or specialist nurse. If they’re distressed or anxious about dying, speaking with a psychologist or counsellor can help them to explore their thoughts and feelings and find ways to manage them. They might also wish to speak to a chaplain, spiritual advisor or faith leader to discuss spiritual issues. A social worker can help with practical issues such as finances.

Taking care of yourself

Having difficult conversations can be challenging for you as well. It may trigger memories of people you have lost or care about in your personal life. This is normal but if your feelings are interfering with your work or personal life, it is a good idea to get some support. Talking to your manager or other colleagues about your experiences can be helpful. If you feel you need extra support, you could consider seeing a counsellor or psychologist.

Good communication is a skill that can be learned and improved. Reflect on your conversations and think about what went well and what you could do better next time. Ask your manager if there are any communication skills courses you could attend. Many people find face-to-face courses where you can role play different scenarios helpful.

back to top

Useful resources