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Should patients be told they are dying?

When someone may be entering the last days of life, a healthcare professional should tell the patient that they're dying (unless they don't want to know).

mariecurie.org.uk - Talking to someone with a terminal illness about death - Marie Curie

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Giving information

Usually information about the person’s illness and treatment will be given to them by their doctor, or specialist nurse. But, whatever your role, there will be times when you have to give information or explain something to a patient.

These techniques can help the person to understand what you’re telling them:

Check what information the person knows already.

Give small amounts of information at a time.

Avoid using jargon.

Avoid euphemisms as they can cause confusion – for example say ‘dying’ instead of ‘passing away’. Avoid explaining things in detail – unless the person asks to know more.

Check how much they’ve understood.

Check how they feel after having the conversation – for example you could say: ‘That was a lot of information, how are you feeling about it?’ Allow them to ask questions. Don’t worry if you don’t have all the answers. It’s better to admit you don’t know than try to make something up. You can try and find the answers to their questions and let them know later. Other professionals, such as doctors or specialist nurses, may be able to help. It might take different members of the team to answer all of the person’s questions. It might be helpful to give them written information such as booklets or websites. This allows people to find extra information in their own time and gives them support when you’re not there. Marie Curie has online information for people living with a terminal illness and carers on a wide range of topics as well as booklets that you can download or order printed copies. You can also tell the person who they can contact when you're not there. If they have general questions or need emotional support, they can contact the Marie Curie Support Line.

Telling someone that they're going to die

When someone may be entering the last days of life, a healthcare professional should tell the patient that they’re dying (unless they don’t want to know). We have more information on telling someone that they're going to die. The best person to speak to the person and their loved ones about this is a healthcare professional who is confident and experienced and has a good rapport with the person. This is often the person’s doctor.

Denial

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Sometimes a person with a terminal illness will be in denial that they’re going to die. Denial is a normal reaction and can be an important part of them coming to terms with their illness. It’s important not to force them to accept that they’re going to die before they’re ready. Often, they will accept it in their own time. They might benefit from speaking to a counsellor or psychologist.

What other support is available?

If someone has questions about their illness that you can’t answer, it might be helpful for them to speak to their doctor or specialist nurse. If they’re distressed or anxious about dying, speaking with a psychologist or counsellor can help them to explore their thoughts and feelings and find ways to manage them. They might also wish to speak to a chaplain, spiritual advisor or faith leader to discuss spiritual issues. A social worker can help with practical issues such as finances as well as providing emotional support.

Taking care of yourself

Talking about dying can be challenging for you as well. It may trigger memories of people you have lost or care about in your personal life. This is normal but if your feelings are interfering with your work or personal life, it is a good idea to get some support. Talking to your manager or other colleagues about your experiences can be helpful. If you feel you need extra support, you could consider seeing a counsellor or psychologist. Talking about dying is a skill that can be learned and improved. Reflect on your conversations and think about what went well and what you could do better next time. Ask your manager if there are any communication skills courses you could attend.

Useful resources

NICE Clinical Guideline: Care of dying adults in the last days of life Royal College of Nursing guidance: When someone asks for your assistance to die

mariecurie.org.uk - Talking to someone with a terminal illness about death - Marie Curie

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