True Communication – A Challenge in Palliative Care (summary)
Communication is certainly the most used tool for members of a palliative care team. It is both utilized within the team as well as between the team and the patients or their families. The quality of the interdisciplinary team as well as the quality of patient care is dependent on the quality of communication. The need to communicate is stringent in palliative care, as if, no matter how much you talk about something, there is always something left unsaid. From communicating the diagnosis and the prognosis, to entering a direct dialogue with the patient and his or her family, communication – human, medical or psychological – has its moments of burden, pain and insufficiency.
In a fast-paced world, to “truly’ communicate, with patience, knowing how to listen or when to stay quiet is a challenge. Another sensitive issue is to do with adapting our communication language to our current technical means. When the social mask is lifted and the need for authenticity is key, knowing the principles which govern true communication as well as the obstacles in achieving it, are a must for members of the palliative care team.
Communication in palliative care moves back and forth between words and silence, and keeping the right proportions is often a real balancing act. That is because words can tie together, give hope and meaning, but they can also burden, pull apart, and bring you down. Some words help, while others hurt. On the other hand, sitting in silence with a patient is a way to include him or her, to shoulder the burden, to be there for him or her when words are not enough. There are silences which lift you up and silences which bring you down. There are silences filled with helplessness and silences when there is simply too much to say.
The purpose of this paper is to update the “true” communication model in palliative care. We are aiming for a meta-analysis of communication aspects, the most important filter being personal experiences. Further on, we will descriptively synthesize elements which form what we consider to be the “true” communication model in palliative care.
Using medical and psychological case studies in which people come together in suffering, we will describe both the experiences of words and those of silence – be they significant and meaningful for patients and their families or futile, showing just how difficult it can sometimes be to accompany patients with a life-limiting diagnosis.
This paper is born out of the words and moments of silence which determine the pace of time spent in the Hospice. It is meant to help all of us working in palliative care to be more genuine when interacting with others.
Psychologist Manuela Rusu
Doctor Ovidiu Măruşteri