An introduction to effective
Communication in
End of Life Care
Ground Rules
• Give time for everyone to have their
• Confidentiality – stays in the room. No
real names to be used for residents,
relatives or other professionals
• Time keeping
• Respect each others views
• Mobiles
• Housekeeping arrangements
• Explore some essential skills of
communication in end of life care
• Identify barriers to effective
End of Life Care Strategy Communication
All staff in health and social care, and the
voluntary and independent sectors,
need some training to ensure they are
able to communicate effectively with
people who are dying and their carers
about issues surrounding end of life
(DOH 2008 p.113)
What do you understand by this word?
What do we want from
• Information – delivered in a language
we can understand
• Honesty
• Companionship
• Opportunity to reflect
Exercise 1
• Why is effective communication so
important in relation to end of life care?
– Take 5 minutes to discuss in groups why
you think it is important
Essential communication
Listening skills
– Language – words used
– Paralanguage – how it is said, tone, pitch,
– what we understand and transmit from
body language
Listening Skills
Plan the environment
Be Attentive
Hear what an individual is saying
Use appropriate body language
Effective skills - language
• Questioning –open, closed, leading
and multiple
• Encouragement
• Picking up on cues
• Reflection
• Silence
• Clarification/Summarising
Paralanguage –
Tone of voice
Try saying ‘are you ok?’ considering
some of the above to the person next
to you and see what response you
Non-Verbal Communication
• Is the message or response not
expressed or sent in words
• Over 65 percent of the social meaning
of the messages we send are
communicated non-verbally.
• Actions speak louder than words.
Non-verbal behaviours
Personal space
Facial expressions
Non-verbal Communication!!
Barriers or blocks to effective
communication especially at EoL
Barriers to effective
Feeling stressed by other concerns
Environment noisy or disturbed
Not feeling confident
Low motivation – bored or tired
Being in a hurry to pass the person on
Interjecting with own experiences
Formulating answers to queries before
hearing exactly what is needed
‘Verbal's’ for you to avoid
• Mumbling
• Passing judgement or giving unwanted
• Interrupting
• Discussing your own experiences
• Jumping to conclusions
• ‘I understand’
• Confusing people with multiple questions
• Using jargon
Useful Tools
Listening skills - active not passive
Use of Questions - open not closed
Reflecting Back
Identifying emotions…
• Anger
• Sadness
• Surprise
• Guilt
• Anxiety
Remember to look after
yourself too…
• Understand that looking after a dying person
will put added strain onto you and the team
• Beware of your own emotions, if a specific
task is difficult, find someone who can help
• There may be events in your life that mean
you are not the best person to help this
client/relative on this day – that’s ok.
chats, supervision, reflective meetings or
talking to another professional may help
Dealing with limits of your
Its OK to
 To admit you don’t
know something:
Who might know?
How will it be
followed up?
Explain likely time frame of response
Its NOT OK to
• Block a question
- Ignoring it
- Dismissing it
- ‘Jollying the client
• Guess / say
something you’re
not really sure of
Issues for Individuals in your
Discuss in groups what you think the
dangers are if staff do not possess
effective communication skills
You have been caring for Mary for
several months. She has become gradually
more frail both physically and mentally. On
this occasion, she seems quite agitated
and tells you “that woman has been horrible to
me. She shouts at me, hasn’t given me
anything to eat and won’t let me have a bath.”
What would you do???
Pause for thought!
A 75 year old lady rings her local NHS hospital and
had the following conversation:
‘Hello, I’d like some information on a patient Mrs
Tiptree. She was admitted last week with chest
pains and I would like to know if her condition has
deteriorated, stabilised or improved’
‘Do you know which ward she is on?’
‘Yes, ward P, room 2B’
‘I’ll put you through to the nurses station’
‘Hello, ward P, can I help?’
‘Yes, I’d like some information on a patient Mrs Tiptree.
She was admitted last week with chest pains and I
would like to know if her condition has deteriorated,
stabilised or improved’
‘I’ll just check her notes. Yes, I’m very pleased to say
Mrs Tiptree has improved. She has regained her
appetite, her observations are stable, and following
a few more checks we are hoping to discharge her
‘Oh, thank you, I’m so pleased and happy!’
‘Are you a close relative?’
‘No I’m Mrs Tiptree in room 2B,
no-one tells you anything at all in
this place!!!!’
Remember help is always at
hand for you
Useful Information
• Ellershaw J, Wilkinson S (2008 edition) Care
of the dying ‘A pathway to excellence’ Oxford
University Press
• Local hospices
• End of Life Care Learning Resource Pack,
Housing 21:

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