Nurses caring for people affected by cancer are often challenged to assist individuals with managing difficult thoughts, feelings and concerns. Existential concerns are normal and common and can be a significant source of distress among individuals facing a life-threatening illness. Individuals who are successfully supported to overcome existential challenges may experience end of life as a time of enhanced relationships with loved ones, a deepened sense of self and heightened psychological growth.40
Guidelines have been developed to support health care professionals to effectively communicate with people with life-limiting illnesses regarding prognostic and end-of-life issues. Key recommendations include:41
- prepare for the discussion
- relate to the person
- elicit patient and caregiver preferences
- provide information
- acknowledge emotions and concerns
- foster realistic hope
- encourage questions
Clayton, J.M., Hancock, K.M., Butow, P.N., Tattersall, M.H.N., & Currow, D.C. (2007). Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness and their caregivers. MJA, 186(12): S77-S108.
Cancer Australia has developed a new resource called "Finding the words: Starting a conversation when your cancer has progressed"87 to assist health professionals and patients in communicating about changes in prognosis.
Reflect upon an interaction where you discussed end-of-life or poor prognostic information with people affected by cancer. Appraise the interaction in light of the guideline recommendations outlined above.
Reflect upon your own life and clinical experiences and describe your thoughts, feelings and attitudes regarding death and dying.