module 2 | Activity 3: Providing supportive communication in palliative care

People affected by life-limiting illness often need help and support in order to overcome the challenges they face from their illness and to manage their expectations. The topics discussed in palliative care can be challenging. Most people want honest information about their situation and care options. This will help them to make decisions and establish realistic goals.[1, 2]

Providing support to people affected by life-limiting illness requires health professionals to use communication skills that assist with understanding the meaning of the illness and its effects on the person.[3, 4] Talking about dying and death, communicating distressing news and prognostic information, are a necessary part of this care.[1, 5-7] Early and ongoing conversations that build trust and include, careful questioning and active listening, can help health professionals explore and understand the wishes and expectations of the person and their family:

• Expectations can be better managed, even if they are unrealistic, if health professionals know what they are early on in the process[7]
• The person’s concerns and any sources of distress can be identified and appropriate management plans can be developed in partnership with the person and healthcare providers. This support commences from initial diagnosis and continues throughout the person’s illness.[3, 4]

Cultural influences

It is important to be sensitive to the ways that culture can influence communication. It is also important to be aware of the words and expressions used. For example, in many Aboriginal and Torres Strait Islander communities, direct statements about dying and death are not usually used. It is important to check with the person and their family to find out the preferred words to use in conversations. Also, in many cultures, silence is a key part of conversations as it provides an opportunity to consider and process information.[8]

Case study

Consider the concept of supportive communication in relation to Michelle, who was introduced earlier in this module.

Michelle’s CT scan shows that her cough is caused by the spread of the cancer to her lungs.

She also has evidence of metastases in her liver. She attends an appointment with Dr Meredith North, her medical oncologist. Meredith explains the significance of these results and what they mean for Michelle’s prognosis and further treatment.