Back to basics: communication in palliative care

The delivery of palliative care comes with a number of sensitive issues for both patients and healthcare professionals (HCPs). To address these challenges, HCPs need to be able to communicate in a way that is not only effective, but also sensitive. Patients in the palliative care phase tend to come to us accompanied by family and friends, which also need to be included in any important discussions.

Arguably, it is more challenging to communicate with patients and their loved ones when they are often in a highly emotive state, perhaps manifesting in anger, guilt or psychological distress. For decades, certain emotions have been associated with varying behaviours (May, 1977), some of which include displays of aggression or euphoria, to name a few. May (1977) is clear that emotions take different forms that encompass physiological, as well as cognitive, expressions. In palliative care, it is evident that such emotions are often provoked when HCPs break news that alters or threatens patients' reality. As such, it is important to note that all emotions—anger, in particular—uses up a lot of our energy (May, 1977); therefore, these cannot be sustained for long periods of time without making the patient lethargic. This means that the initial approach of HCPs in dealing with their patients' emotions should be to find ways of reducing its intensity through trying to support that person.