Gabriella
What is the best way to break the news of the death of a family member to their family?
I am intending on becoming a physicians assistant and I recognize that I may be put in this situation at some point. I would like some tips for this hard topic. #medicine #working-with-children #death #physician-assistant #students-interested-in-career-as-physician-assistants #medical-practice #coping #grief-counseling #family-medicine
2 answers
Daniela Silva
Daniela’s Answer
Gabriella,
When someone dies and it’s down to you to break the news, the way you deliver the message is crucial for the person you have to speak to, and for yourself. Whether you are breaking the news to a close relative, friend or carer, or to someone you don’t know very well, the following guidelines may help. </span>
Breaking bad news guidelines
It’s important to remember that the manner in which bad news is delivered will stay with the person. Therefore, it is best to break the news face-to-face. Even when this is not possible - relatives may, for example, be abroad - be sensitive to the impact that the news may have on the person at the other end of the telephone.
It may help to prepare yourself by rehearsing what you are going to say, especially when speaking to someone who may have disability or learning issues, or may not have English as their first language. The health of elderly people also needs to be taken into account.
Give yourself plenty of time when you are with the person, and make sure you break the news, as far as possible, in a safe and confidential setting.
If possible, make sure there are no interruptions. Switch off mobile phones and telephones, and turn off radios and televisions.
Stick with the task in hand. Use plain, simple language, and don’t waffle or bring in unrelated issues as it can cause confusion.
In the majority of cases, people who hear bad news will only be able to take in a small amount of what is being said. So validate what they understand has happened, and encourage them to express their feelings. Gently correct them if necessary, and be prepared to repeat yourself if necessary.
Don’t swamp the person. They may need physical space to take in this news. So leave it up to them if they want to be touched or held.
Don’t promise anything that you can’t deliver or commit to anything you can’t carry through. This will destroy trust.
If the person becomes very distressed, and you are unable to stay with them, you may need to ask about someone you can contact on their behalf, such as a neighbour or friend, or family who live close by and can stay with them.
You may find that delivering bad news plays on your mind afterwards. If it starts to cause you distress, do find someone to talk to about it: find professional help.
Daniela recommends the following next steps:
Valerie F
Valerie’s Answer
This is a very tough question, as the answer changes based on the patient.
I typically start out by introducing myself and asking how they have been since the last time I have seen them. I usually am reviewing their results with them at the time of diagnosis. So I ask if they understand why they had this testing done. I always check in to see if they are feeling well currently and if there is anything I can do for them.
Then I will ask the patient is it ok if we discuss your results/diagnosis. Some patients will not be ready at this time, and this give the patient autonomy to control something they are not in control of.
If they are ready I will explain to them that in terms that a patient can understand. For example, you have bone cancer instead of osteosarcoma.
I will give them time to process this situation, give tissues, hold their hand/hug them depending on each patient. Then I ask if they have any questions and talk about next steps.