Breaking Bad News - What Should I Do (Geriatrics)

Breaking Bad News – What Should I Do Geriatrics Revealing the diagnosis of a serious illness to your loved one Telling a person that he or she has a life-threatening illness such as cancer is never easy. Many others have had to face the same problem as you are facing this moment. However, with care and empathy, it is possible to reveal the diagnosis of cancer without causing much harm to the person.

Remember that receiving bad news is never pleasant but, with time, strong family support and love, the person is usually able to come to terms with the news and accept it well. You may wish to use the tips below on breaking the news.

Important points • Your loved one has the right to know about his own condition so that he is able make decisions and plans for himself • Do not underestimate the coping abilities of your loved one • The truth may hurt but deceit is worse for you and your loved one • Give information in small amounts and take time (up to days even) to reveal the condition

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according to how much the person is able to handle the news After telling him the bad news, accept whatever reaction that follows. It is important to provide support to the person throughout these processes

Step 1 – Explore if your loved one wants to know the diagnosis Ask your loved one if he would like to know everything about his condition. Ask him what he was told by the doctors and what he understands of his illness up to this point.

Step 2 – Give a warning shot You could tell him: • that the illness is more serious than what he thinks • that the results were not as good as was hoped for • that the doctor is concerned about the findings or investigation results Watch your loved one’s reaction and response. Is he ready for the next step?

Step 3 – Expand on the warning shot Some ways to do this: There may be a growth (at this point your loved one may wish to know if it is benign or malignant) which is serious. Your illness may worsen or be incurable.

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At this point, many people would have guessed that they have a life-threatening illness. The use of the word cancer follows from this.

Your loved ones may use the word himself or you ultimately will have to tell him that it is so. This step may take days as well.

Always maintain hope in your loved one. It may not be hope for cure or recovery but may be for control of pain and other distressing symptoms, not to be abandoned or that the family will be able to cope when the loved one is no longer around.

Step 4 Manage the possible reactions Expect the following reactions from your loved one: • Shock - if the warning shot was not given properly or the news was broken too quickly.

• Sadness - this is quite a normal way to react and should settle with time and loving support from the family members.

• Denial - this is a coping strategy and should also resolve with time.

Certain significant events can also bring much hope, e.g. coming wedding, coming graduation or birth of a new grandchild, etc.

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Never force the person to accept the diagnosis.

Acceptance - some individuals receive bad news and accept it well. Most people should accept the diagnosis with time and proper support from their caregivers.

If you are unable to bring yourself to reveal the diagnosis to your loved one, our doctor or nurse may be able to help.

Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group.

Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.

GRM.PE.01.0619