Difficult Conversations: Tips for Health Care Providers on Starting the Hospice Conversation with Patients and Families

For many health care providers working in assisted living facilities, nursing homes and other environments, beginning a conversation about hospice care with a resident, patient or family member can be extremely difficult. Yet, as a trusted source of information, you can play an important role in ensuring patients are informed about—and receive—the most appropriate care available to them.

First, know that it is OK to talk about hospice care:

  • It doesn’t mean there’s nothing else that can be done,
  • It doesn’t mean there is no hope,
  • It doesn’t mean dying is coming soon,
  • It doesn’t have to be scary; it can actually be comforting, and
  • It can be the right thing to do.

When should I talk about hospice care?
There are a number of circumstances that may lead you to consider talking about hospice care with the patient, family member and/or the patient’s primary physician:

  • Following diagnosis of terminal illness
  • After repeated hospitalizations or trips to the emergency room
  • When you are seeing consistent decline
  • With family and resident at care conferences
  • When resident and/or family is requesting no further treatment or doctor visits

How do I start the conversation?
Choose a private, relaxed time when you can have a one-on-one discussion with the patient or their family member without distractions. Be sure that the patient or family member is comfortable.

Looking for an opening in the conversation will make the discussion easier; such as when the resident refers to his or her condition, or perhaps talks about “giving up” on treatment. Similarly, wait until a family member refers to their loved one’s condition.

A list of sample conversation starters for residents or patients, as well as family members, is available on our website.

Most importantly, remember to ask and then listen. Ask open ended questions—those without a “yes’ or “no” answer to get the conversation going. Let the patient respond; your silence is OK. If need be, prompt the patient with additional questions. If there is resistance, you may need to postpone the conversation. Accept the person’s response, and don’t judge. Remember that your opinions and their wishes may be different

Additional tips:

  • Offer to call Hospice to set up a visit
  • If a Hospice staff member is in the facility, he/she will be able to answer questions
  • Offer to be a part of the conversation, or let the family visit with Hospice alone
  • Offer Hospice material whether a visit is scheduled or not
  • If resident/family member is not ready to talk, encourage them to let you know when they are

Remember, additional information about hospice care is available on our website, or by calling Hospice of the Red River Valley at (800) 237-4629. To all of our partners in care—thank you so much for all you do.

About Hospice of the Red River Valley
Hospice of the Red River Valley is an independent, not-for-profit hospice serving all, or portions of, 29 counties in North Dakota and Minnesota. Hospice care is intensive comfort care that alleviates pain and suffering, enhancing the quality of life for patients with life-limiting illnesses and their loved ones by addressing their medical, emotional, spiritual and grief needs. For more information, call toll free 800-237-4629, email questions@hrrv.org or visit www.hrrv.org.

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