End-of-life Conversations

Below are resources for talking to patients, residents or clients about end of life.

(Note that Montgomery Hospice staff members are available by phone to talk with patients and families about hospice services and about when a patient may be eligible for hospice. They also visit patients in their homes to provide more specific information. No referral is necessary. Call 301-921-4400 any time, any day. A staff member from our Admission Department can be reached directly at 301-637-1888 between the hours of 8:30 am and 4:30 pm, 7 days a week.)


Conversations about end-of-life care

Maintaining hope at the end of life

Letters for families:

Below are letters (in English and Spanish) explaining our services to your patients who are facing a life-limiting diagnosis.

Informational letter for patients and families (English)

Informational letter for patients and families (Spanish)

Treating Cancer: Hope vs Hype

‘How Long Have I Got, Doc?’ Why Many Cancer Patients Don’t Have Answers
In a study published last year in the Journal of Clinical Oncology, only 5 percent of cancer patients with less than six months to live had an accurate understanding of their illness. Thirty-eight percent couldn’t remember ever talking to their doctor about their life expectancy.

Advice for Practitioners

SPIKES: A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer
Widely used by hospice and palliative care professionals.  Developed by Robert Buckman, MD

National Hospice and Palliative Care Organization (Caring Connections)
Talking About Treatment Options and Palliative Care: A Guide for Clinicians

National Hospice and Palliative Care Organization (Caring Connections)
Advice for Physicians Caring for Dying Patients

Montgomery Hospice Online Seminar

Difficult Conversations: Strategies for Talking with Patients and Families

Other Articles about Communicating with Patients

American Family Physician 
End-of-Life Care: Guidelines for Patient-Centered Communication

JAMA Commentary 
Communicating With Seriously Ill Patients (Better Words to Say) 
JAMA. 2009;301(12):1279-1281. doi: 10.1001/jama.2009.396

British Medical Journal 
Spotlight: Palliative Care Beyond Cancer
Having the difficult conversations about the end of life

Journal of Clinical Oncology 
American Society of Clinical Oncology Statement: Toward Individualized Care for Patients With Advanced Cancer

Journal of Clinical Oncology 
Faculty Development to Change the Paradigm of Communication Skills Teaching in Oncology

Medscape Today (free registration required) 
Communicating Diagnosis and Prognosis to Patients with Cancer: Guidance for Healthcare Professionals

Canadian Medical Association Journal 
What people want at the end of life
CMAJ - November 9, 2010; 182 (16).

University of Washington
Improving Oncologists' Communication Skills

Center to Advance Palliative Care
Fast Facts provide peer-reviewed, evidence-based summaries of key palliative care topics.

Research about End-of-Life Conversations


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