Listening to, recognizing, and responding to patient emotions is an essential skill for physicians who care for dying patients. The skill of responding empathetically to patient emotions can be learned.
8 tasks guide the adequate response to patient emotions.
1. Listen to the patient; do not interrupt while they are talking. Patients and families facing end-of-life decisions want an opportunity to talk about what they are thinking and feeling.
2. Be aware of your own emotions. Your feelings of sadness, anger, anxiety, fear, or happiness are often the first sign that a patient is communicating an emotional message. Avoid the trap of quickly acting on your emotions.
3. Reflect back to the patient their thoughts, feelings, and behavior. Restate what they have said using their own words and phrases. This achieves 3 things.
- It tells them that you are listening and giving permission to discuss sensitive topics.
- It allows them to listen to their own thoughts, heightening their self-awareness.
- It allows them to confirm, correct, or amplify upon your interpretation.
4. Affirm and support patients and families; understand that they take a risk when they share their emotions.
5. Be empathetic and curious, e.g., "Please tell me more about the sadness you're feeling."
6. Summarize; repeat the patient’s story in your own words. In contrast to reflection,
paraphrase and summary involves interpretation and condensation of the patient’s narrative.
7. Make a plan, if needed. Sometimes a patient simply wants to talk about their feelings, other times action may be important. Actions can include making changes in how you and the patient communicate, helping the patient identify sources of social support, and changing their plan of care.
8. Offer follow-up within a short time (days) to see with how things are going. Let them know that you can talk again sooner, if they want to.
See reference for more information. Adapted from Ambuen B. Palliative Care Network of Wisconsin. Fast facts and concepts #29. Internet. Accessed on December 30, 2019.