Good Communication
Good communication with family and friends as things change is important.
- Family and friends try to get the person to eat or drink or to take artificial nutrition or hydration that is longer needed or does not align with the person’s preferences.
- Family and friends are concerned the person is not being well cared for if they are assessed as unable to swallow and not taking in food.
- Keep family and friends up to date (if the person consents) with the person’s choices and preferences.
- Use family meetings and case conferences to exchange information and build a shared understanding of the changing circumstances.
- Seek feedback from families and friends about their experience and how approaches could be improved.
When a person begins to refuse food or can no longer swallow safely, it can be distressing for their family and friends.12 They may fear the person will die of starvation or dehydration and want the person to have foods and drink, or expect that artificial nutrition or hydration be started or continued. Good communication is key to a positive end of life experience. Health professionals and care staff should sensitively explain that eating and drinking at this time can often be distressing, potentially harmful and not in the person’s best interests.11
Effective communication about a person’s nutrition and hydration choices is enabled by an approach that balances different perspectives about risks, benefits, burdens, and helps build a shared understanding of quality of life and considerations that avoid prolonged suffering.
Good communication considerations:
- Use clear language that avoids too many medical terms.
- Provide honest answers to questions.
- Content that is informed by evidence.
- Respect everyone’s contributions and do not talk over the person who is dying, their family or friends.
- Check whether there is good understanding of what has been discussed.
Family meetings and case conferences can be helpful
Family meetings or case conferences (where the person consents) are an important way of getting everyone together to facilitate communication and navigate conflicting views about treatment. They can play an important role in planning care and supporting decisions relating to end of life in accordance with the person’s wishes.