It is helpful to keep it simple when talking with families

Delivering a grave prognosis to a family can be an extremely difficult task for physicians. For professionals devoted to saving lives, it may seem overwhelming to deliver heartbreaking news. It is natural to want to provide something potentially positive with the delivery of a grave prognosis, and it might seem right to mention the potential of helping others through donation during this emotional injury.

However, it is important for families to fully understand that there is no hope for recovery prior to donation being introduced.
Many physicians have shared with us that sometimes it is helpful to keep it simple when talking with families. Below are some basic tips which have worked well for physicians in this situation.

When telling a family their loved one is dead or dying, it is helpful to recognize the sadness of the situation:

  • “I am very sorry to tell you this.”
  • “I wish I could tell you something different.”
  • “This is a horrible situation.”

Depending on the time frame, this may be unexpected and/or shocking. Let the family know that their feelings are valid:

  • “I imagine when you woke up this morning you didn’t expect to be here today.”
  • “This can be very overwhelming.”

A family in shock may not understand brain death or the need for comfort care despite their level of education:

  • “It can be hard to understand because she looks like she is sleeping, but her brain has lost all function.”
  • “The time of her final brain death exam is her legal time of death.”
  • “He is not in a coma.”
  • “Sometimes, even if it makes sense in our head, it is hard to understand or believe in our heart.”

It is okay and even a good thing to give the family TIME to slow down:

  • “This is a lot to absorb.”
  • “Talk to your friends and family about this.”
  • “We have time.”
  • “Take some time and get a cup of coffee.”
  • “There are more things to talk about…why don’t you take a break, and we will reconvene at a later time.”

If donation comes up and the they are unsure, it is important to keep the conversation open for more dialogue:

  • “The decision to donate is a very important one; someone will be in to talk to you in more depth about it soon.”
  • When donation comes up too soon and a family reacts negatively, it is important to note that they may be saying “no” to the death and not to donation. Some families may need more time to absorb the death.
  • “Now may not be the right time to decide whether or not donation is right for XXX, why don’t you take some time to be with your family and sit with XXX. Someone will check in with you in about an hour.”