The difficult questions about prognosis are also an opportunity to uncover some of the deeper concerns of the patient and family. What the patient wants may differ from what the family wants or is hoping for.
When they ask a question is also an opportunity to reflect it back. What would you like to do with the time you have left? Who would you like to have with you at this time? What would you like to do in regards to treatment? This may also be a time to discuss advanced directives; if it comes to a time where you want to stop treatment, what other treatments would you consider? Would you like to be intubated? What does CPR look like to you?
There are so many questions and so many potential answers. It is likely we may not have all the answers. That’s okay. We can pause before answering; pause long enough to remind ourselves they chose you to ask. They picked you.
Ann Brady is the symptom management care coordinator at the Cancer Center, Huntington Hospital, Pasadena, California.
1. Hallenbeck J. Fast Fact #26: The explanatory model. CAPC Center to Advance Palliative Care Web site. https://www.capc.org/fast-facts/26-explanatory-model/. Accessed October 2, 2015.