It can be difficult to know what to say and do when we are caring for a dying patient. As a CNA, you have an ethical responsibility to provide comfort and support for your patients as they cope with the end of life. This blog will give you some tips on how to communicate effectively with your patients who are dying.
1. Speak in a soft tone
Remember to use a calm, low-pitched tone of voice. This will help the patient feel safe and secure with you being there for them at their time of need. If they are not responsive or have difficulty communicating verbally, try reading poetry out loud to them which may evoke memories that can be comforting during difficult times. CNAs should also take care of themselves and not feel guilty if they are unable to meet all the needs of their patients.
2. Use reflective statements
Be sure to use phrases that are not too personal or accusatory. For example, instead of saying “You look very sick today” you could say “You don’t seem like yourself today. What’s wrong?” This shows the patient that you care and want to help them get through their struggle. Reflective statements can also help you determine if the patient is happy with their care, in pain or even uncomfortable.
3. Be honest
If there are bad news to break to a dying patient let them know! For example, “I have some very sad news for you…” This will lessen the blow of what they must hear and make it easier for them to accept what you have to say. You should also be open about difficult decisions that need to be made regarding their care if they are unable to participate in the conversation themselves.
4. Be aware of nonverbal communication
When communicating with a dying patient, remember that your body language speaks volumes as well! Make eye contact and maintain a relaxed stance. The patient will feel more at ease with you if they sense that you are calm and collected as well. Try not to fidget or wring your hands because this may signal a sign of nervousness, which could be uncomfortable for them.
5. Remember the five senses
Sometimes it can be helpful to bring up memories from their past that may evoke a good memory for them. Nurses can also try using other senses to communicate with their patient, such as touch or smell if they are still able to experience these sensations.
If the patient you’re caring for is responsive and has enough strength in their hands, give them a back rub or hold their hand while talking about a fond memory from their childhood. If they are unable to verbalize, try stroking the arm closest to you and see if it stimulates a response.
Try bringing in some familiar scents that may cause positive memories for them such as perfume or freshly-baked cookies! Their favorite flower can also be helpful when trying to make the environment more home-like and comfortable.
8. Be patient
Remember that you do not need to be able to communicate with your dying patients in the same way that you would if they were healthy or even injured! You can still provide comfort by listening to them, being aware of their needs and trying different forms of communication. If nothing seems successful, it may be helpful to ask another nurse or family member for assistance.
9. Don’t avoid difficult conversations
If there are things that need to be said, do not wait until the patient is too sick to respond. Use direct communication and ask them if they would like you to contact their family members or make funeral arrangements for them. They may not be able to express what they need from you.
If the patient is unable to communicate, observe their behavior and nonverbal cues for clues about how they are feeling. Are they expressing any anxiety or fear? Keep in mind that even if a person cannot verbally speak, their body language can still give away feelings of pain and discomfort.
10. Listen to your patient
Being there for your patient means listening to them, their stories and what they are going through. Nurses should allow the person time to share memories of their loved ones who have died or talk about death in general. It can be comforting if you acknowledge that you understand how difficult it is to lose someone close by sharing a similar experience from your own life. This may open up a dialogue between you and your patient about their fears, feelings or regrets from the past.
11. Be open about your feelings
It’s okay to feel sad and uncomfortable about a patient who is dying. You don’t have to pretend that you are not affected by the situation because it can be comforting for your patient if they know that you understand what they’re going through, too. Let them know how much their well-being means to you as an individual human being rather than in the capacity of a nurse.
If you are unable to be professional with your feelings, let another member of your healthcare team know that they will need to take over for you at this time. The most important thing is how well we can communicate our needs and emotions through words or actions both when life is easy and especially when it’s difficult. As a CNA, you should be able to work so closely with your patients because you have the knowledge and resources necessary to provide competent care.
12. Don’t tell them that they’re going to die
it’s not your place as a CNA to tell your patient that they are going to die. Your job is to support their journey and make the most of every minute you have with them until it’s time for them to pass on peacefully.
If you know someone who is dying, let them express what they need from others if possible or try asking questions like “What can I do to make you feel more comfortable?” It is okay to be honest and open about your awareness of their prognosis. If they do not wish to talk about it, respect whatever boundaries they set for conversation in that moment or offer support through other means.
13. Allow family members to be part of the conversation
You may feel as though you have to protect the person from their family members, but this does not need to be a one-sided conversation. Remember that your patient’s loved ones are grieving as well and it is important for them to know what they can do for their dying relative at home or in hospice care. You should encourage open discussion between all parties so that everyone can express their feelings and concerns.
14. Let them know they are not alone in their worries and fears
It’s possible that your patient may be thinking about death and what it will mean for them, their family members or friends. You can offer your patient reassurance by telling them about the research you have done on coping with death. They might also find it helpful if they know that there are support groups and counseling services offered through their hospice or in-home care team that may be able to help them deal with difficult emotions after a loss.
15. Write down your patient’s wishes
If you think it is important to write down your patient’s final requests before they pass on, be sure that this information sets a foundation for the family members and loved ones who will need guidance. It can help if everyone involved in their care knows what type of procedures or treatments the person would have wanted when faced with another life-threatening illness or a terminal diagnosis.