Chapter 1: Communication essentials

Pacing and confirming

The speed at which you deliver the news is an important factor in a family’s ability to process what they’re hearing. When receiving painful news, people often shut down after the core message has been delivered and don’t hear much after that. 

Slow and steady

Establish a step-by-step rhythm for sharing bad news. Speaking too quickly creates misunderstandings, which can increase anxiety. Giving out information too slowly can also be difficult for families. 

Periodically check to make sure the person you’re speaking with is following. Find a pace that works for you and the family.

Progressively giving out the news a little at a time allows the family to gradually integrate what’s being said. Stop often to let the information sink in. 

Conversation Prompts

Does everything make sense so far? 

Am I speaking too quickly? Are you ready for me to continue?

Confirming the information is understood

Paramedic:  I have some difficult news. Your husband is deteriorating quickly. I expect he’ll die soon. We’re going to do everything to keep him comfortable. Is there someone we can call to support you?

The family hears:   I have some difficult news. Your husband is deteriorating quickly. I expect he’ll die soon. BLAH BLAH BLAH BLAH BLAH….

Try instead:  I have some difficult news. Your husband is deteriorating quickly. We’re doing everything to keep him comfortable. Is there anyone else we need to call to be here as we expect he’ll die soon?

 Reflecting back

Ask the family member to reflect back to you what they’ve heard. This will help you determine what they’re retaining and understanding. 


Conversation Prompts

Are you able to tell me what you understand I’ve said?

Allow lots of time for questions – and for tears.