A practical guide to help clinicians communicate more effectively with seriously ill patients and their families about what matters most.

Physicians who care for patients with life-threatening illnesses face daunting communication challenges. Patients and family members can react to difficult news with sadness, distress, anger, or denial. This book defines the specific communication tasks involved in talking with patients with life-threatening illnesses and their families. Topics include delivering bad news, transition to palliative care, discussing goals of advance-care planning and do-not-resuscitate orders, existential and spiritual issues, family conferences, medical futility, and other conflicts at the end of life. Drs Anthony Back, Robert Arnold, and James Tulsky bring together empirical research as well as their own experience to provide a roadmap through difficult conversations about life-threatening issues. The book offers both a theoretical framework and practical conversational tools that the practising physician and clinician can use to improve communication skills, increase satisfaction, and protect themselves from burnout.

Physicians who care for patients with life-threatening illnesses face daunting communication challenges. Patients and family members can react to difficult news with sadness, distress, anger, or denial. This book defines the specific communication tasks involved in talking with patients with life-threatening illnesses and their families. Topics include delivering bad news, transition to palliative care, discussing goals of advance-care planning and do-not-resuscitate orders, existential and spiritual issues, family conferences, medical futility, and other conflicts at the end of life. Drs. Anthony Back, Robert Arnold, and James Tulsky bring together empirical research as well as their own experience to provide a roadmap through difficult conversations about life-threatening issues. The book offers both a theoretical framework and practical conversational tools that the practicing physician and clinician can use to improve communication skills, increase satisfaction, and protect themselves from burnout.

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

'The Textbook of Palliative Care Communication' is the authoritative text on communication in palliative care. Uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, it unites clinicians and academic researchers interested in the study of communication.

This exceptional work explores the complexities of communication at one of the most critical stages of the life experience--during advanced, serious illness and at the end of life. Challenging the predominantly biomedical model that informs much communication between seriously ill and/or dying patients and their physicians, caregivers, and families, Sandra L. Ragan, Elaine M. Wittenberg-Lyles, Joy Goldsmith, and Sandra Sanchez-Reilly pose palliative care--medical care designed to comfort rather than to cure patients--as an antidote to the experience of most Americans at the most vulnerable juncture of their lives. With an author team comprised of three health communication scholars and one physician certified in geriatrics and palliative medicine, this volume integrates the medical literature on palliative care with that of health communication researchers who advocate a biopsychosocial approach to health care. Applying communication theories and insights to illuminate problems and to explain their complexities, the authors advocate a patient-centered approach to care that recognizes and seeks to lessen patients’ suffering and the many types of pain they may experience (physical, psychological, social, and spiritual) during life-threatening illness.

For many health care professionals and social service providers, the hardest part of the job is breaking bad news. The news may be about a condition that is life-threatening (such as cancer or AIDS), disabling (such as multiple sclerosis or rheumatoid arthritis), or embarrassing (such as genital herpes). To date medical education has done little to train practitioners in coping with such situations. With this guide Robert Buckman and Yvonne Kason provide help. Using plain, intelligible language they outline the basic principles of breaking bad new and present a technique, or protocol, that can be easily learned. It draws on listening and interviewing skills that consider such factors as how much the patient knows and/or wants to know; how to identify the patient's agenda and understanding, and how to respond to his or her feelings about the information. They also discuss reactions of family and friends and of other members of the health care team. Based on Buckman's award-winning training videos and Kason's courses on interviewing skills for medical students, this volume is an indispensable aid for doctors, nurses, psychotherapists, social workers, and all those in related fields.