Mayo Clin Proc

Key phrases to avoid when communicating with seriously ill patients

November 28, 2024

Engaging in sensitive conversations with seriously ill patients is increasingly complex due to evolving therapies for conditions like advanced heart failure, cancer, and end-stage pulmonary disease. Mayo Clinic authors recommend avoiding specific "never-words" that cause emotional distress and reinforce power imbalances. They surveyed clinicians to identify problematic language and best practices for difficult conversations. Their insights highlight the importance of clear, empathetic communication to improve patient outcomes and experiences. Below are some of the examples provided:

Never-words and their alternatives

"There's nothing else we can do."

• Alternative: "We will continue to support you and manage your symptoms to keep you comfortable."
• Rationale: Even without a cure, clinicians can still provide meaningful care.

"She will not get better."

• Alternative: "We are focusing on quality of life and making sure she is as comfortable as possible."
• Rationale: Express concern rather than a definitive negative prognosis.

"Withdrawing care"

• Alternative: "We are shifting our focus to comfort care."
• Rationale: Avoid implying abandonment; emphasize refocusing care goals.

"Do you want us to do everything?"

• Alternative: "Let's discuss what treatments align with your goals and values."
• Rationale: Invite dialogue rather than leading questions.

"Everything will be fine."

• Alternative: "We are here to support you through this journey."
• Rationale: Offer realistic and humane support.

"Fight" or "battle"

• Alternative: "We will face this difficult disease together."
• Rationale: Avoid implying that willpower alone can overcome illness.

Source:

Lee Adawi Awdish R, Grafton G, Berry LL. (2024, October). Mayo Clin Proc. Never-Words: What Not to Say to Patients With Serious Illness. https://pubmed.ncbi.nlm.nih.gov/39177542/