Dear Readers:
Jeanne Frye is a longtime hospice nurse of uncommon experience, intelligence and compassion. About 40 times in the past year, readers have emailed me, asking how to deliver the bad news — word of impending death — to someone they love. Here’s Jeanne’s brilliant and thoughtful reply:
“No one wants to be the bearer of bad news or use words that may make someone “emotional.” As if emotion were to be avoided at all costs. Personally, I travel with tissues, and water proof mascara!
Here is what has helped me.
First, ask the family or patient if you have their permission to be honest. Simply asking, “May I be honest with you?” opens the door for using real terminology and grown up words.
Second, acknowledge the difficulty of the moment. We are all human after all and this is hard stuff! “This is hard for me, but in all honesty, what I see is the dying process taking place.”
Third, watch for the opportunity to shift hope…from hope of a cure, to hope for comfort and peace. In my head, I hear Tina Turner…”What’s hope got to do with it?” By asking, “what would your loved one hope to accomplish before dying?” we enable the family and/or patient a rare opportunity. Helping them accomplish a small task is worth it. Even a really small one matters.
Using real language when discussing end of life and dare I say it, “death” is difficult and maybe it should be. This is hard stuff, but most appreciate being spoken to in a truthful and upfront, but gentle manner.
Just my two and half cents…”
Worth a million dollars any day, Jeanne, and thank you again.
Jeanne Frye is proof that there is no substitute for a wise and caring nurse.
When you ask people if you may be honest with them, does anyone respond in the negative?
In reply to Shari….yes, but it is generally rare. Sometimes families will not want anything discussed in front of the patient for fear it will “upset” them. So, I respect their wishes and will speak with the patient and family at separate times. I try to work them towards honesty because I have found patients seem to “know” something is terribly wrong and “no one will talk to me”. How sad the ones we love the most are the ones we are not able to speak with. Most people want honest, non judgemental information. Some just need time to process it in small increments.