Communication in Hospice Care 

Injury, illness, and tragedy present challenges beyond the physical.  Whether the person in the midst of these challenges is a distant friend or close relative, we on the ‘outside’ often need guidelines to navigate these obstacles.  A common obstacle is communication. What to say and how to say it is not trivial in the hospice scenario.

A terminally diagnosed person knows they are facing death sooner than the average statistics state.  They do not need reminders of this fact.  They may also experience pain and physical discomfort more frequently and severely than the average person.  Drawing attention to that is seldom encouraging and may even add to it. 

 So, what should we say?  How do we communicate our care and concern without increasing their difficulties? 

 Let us consider our usual greeting: How are you doing? 

This is a broad, open-ended question with too many implications for a hospice patient to want to ponder.  A better question is: How is your morning/afternoon going?  This is a narrow question that allows the patient room to answer as specifically as they want.  If they are feeling introspective, they may share their reflections or emotions of the moment and we can be included in a deep conversation.  If they are feeling energetic and positive, they may go into detail about their day’s activities and accomplishments and we can enjoy the interaction.  If they are feeling closed or detached, they may simply say “Ok” or “Not so great.”   Then we should not follow that with “Just ok?” or “Why was it not so great?”  Instead, we have our cue to change the subject without causing frustration. 

A narrow question gives the hospice patient control over the type of answer they give.   

Sometimes beginning dialogue with a question shuts down a much-wanted conversation (like asking a teenager how was school).  Instead, we can begin with friendly observations that do not require a response.  This approach offers the safety of no interaction or emotional commitment on their part and no expectation on ours. 

For example:  I noticed your potted plants on the way in.  You have quite an assortment.  Hey, I think it’s supposed to rain this afternoon.  I wonder if they like the rain.  Some plants don’t.  I’d be glad to move the ones that do outside before I leave, if you want. 

No questions; no expectations.  Still, there is ample room for them to continue the conversation by touching on the weather or on how they used to care for plants or on the special memories of how they acquired that assortment.  Expressing our care and concern for what is important to them as well as desiring their permission to take action, shows that we care for them and regard them as viable decisionmakers.  This shows respect and dignity—valuable traits at any stage of life.

Friendly observations take the focus off the current challenges.

Recounting a personal experience shared by both is a beautiful way to convey appreciation for the terminally diagnosed.  Remembering positive encounters is healthy for both parties.  Sometimes the same event leaves a different impression on us than on them.  These different perspectives often lead to humorous interactions and pleasant new memories.

I remember an event while visiting my grandmother one summer as a young child.  She was driving us—my siblings and me—back to her house after shopping at the farmers market.  She inadvertently entered the freeway through an exit ramp facing oncoming traffic for a short stretch of the road.  Instead of panicking with three small children in tow, she exclaimed, “Better get out of the way.  Here comes the splatter truck!”

I was too young to fully appreciate the severity of our situation and much too short to see the oncoming traffic, so I laughed with my grandmother.  My sisters, on the other hand, were well aware of the real danger we were in and gasped instead.  They were convinced she was addlebrained and too old to be behind any wheel, splatter truck or not.  [She was in her seventies driving a compact four-door sedan!]  I thought she was brave and clever.  If I had been given the opportunity to ask her what she thought, she may have felt over-responsible and chose the best option: to keep going and keep a sense of humor. 

I will never know, but I still laugh at the recollection of the event.  Seeing the genuine panic on my sisters’ faces seemed so incongruous to my ignorant bliss that I had to laugh.  And now as an adult understanding the imminent danger we were in, I respect my grandmother’s choice.  This to me was proof of her love for us.  I think she would have treasured my perspective (and possibly laughed at theirs). 

Retelling a true story reveals the significance of our care for each other.

Asking narrow questions, making friendly observations, and recounting shared events provide channels of communication for us with our friends and loved ones in hospice.  End of life care goes beyond tending to the physical needs of a patient.  Engaging in meaningful conversation that generates respect and dignity for the terminally ill remain foremost in hospice care. 

At Gifted Hearts Hospice and Palliative Care in Seguin, TX, we offer holistic care to our patients and support to their caregivers and friends.  Let us know how we can help you.  Contact us to begin a conversation that truly addresses your needs.

Gifted Hearts Hospice and Palliative Care in Seguin, TX, is a fully staffed facility available to patients who call South Central Texas their home.  It is nestled in the beautiful New Braunfels area as the best hospice near San Antonio, Texas.  It offers palliative care for patients of any age in any stage of illness.  It also offers all four levels of hospice care and maintains its motto: “Live until you Leave.”