End-of-Life Conversations for Providers

Follow this six-step guide to introduce a terminal diagnosis to patients and their families in a sensitive, supportive way. 

Step 1

Request a meeting with the patient, and ask what loved ones they’d like to invite. If the patient has cognitive difficulties but has not chosen a durable power of attorney for health care, invite their next of kin or another relative to meet with you.

Plan what you’ll say about your patient’s condition and future, considering how informed the patient and family are coming into the meeting. Reserve a quiet, undisturbed room, and allow plenty of time to answer questions.

Step 2

Find out how much the patient and family want to know. If the family has said they do not want the patient to hear their prognosis, explain the benefits of sharing the information and propose talking to the patient together.

Step 3

Ask what the patient and family already know about the patient’s condition. Assess their ability to understand new information. Postpone the conversation if they seem emotionally unprepared to talk about the end of life.

Step 4

Share your diagnosis, avoiding medical jargon or euphemisms. Give the patient and family opportunities to reflect in silence. Ask questions and observe facial expressions to check for the patient’s and family’s understanding.

Step 5

Prepare for a wide range of reactions, including strong emotion. Observe family dynamics so you understand how to work with the family in the future.

Step 6

Plan for next steps. Affirm your continued support, and discuss other sources of assistance. Provide a written summary of what you shared, and offer printed information that may help the family.