Grief-Sensitive Communication: Patients and Their Supporters
Delivering Difficult News
News related to death or end-of-life decisions, as well as changes in diagnosis, treatment effectiveness, prognosis, function, or long-term quality of life, can carry significant emotional weight and involve grief.
For patients and supporters, these moments may reflect losses of certainty, independence, identity, or anticipated outcomes.
How the news is delivered can shape a patient’s understanding, trust, and ability to cope.
Create Space for Processing
Research suggests that clinicians may move through conversations more quickly than patients are able to process and may interrupt patients early in clinical encounters.
One analysis found that physicians interrupted patients after an average of approximately 18 seconds. In the context of emotionally charged information, this tendency to push forward can leave patients feeling unheard or unsupported.
Allowing silence, resisting the urge to immediately respond, and giving patients space to absorb information can help them begin to process what they are hearing in their own time.
Communicate Truthfully and Compassionately
It is natural to want to spare others pain. In healthcare, this can manifest as an impulse to soften or avoid difficult information in an effort to reduce immediate distress.
While well-intentioned, this approach can leave patients feeling unprepared, confused, or unsupported.
Clear, truthful communication honors patient dignity and supports trust, understanding, and informed decision-making within the care relationship.
That’s a role that we play in the medical field, delivering hard truths so that people can calibrate their expectations and not continue a false expectation and then have to deal with it later.
Using Grief-Sensitive Language When Sharing Difficult News
Grief-sensitive language acknowledges change, validates emotional responses, and leaves space for patients to define what the news means for them. Below are examples of how this approach may be used when delivering difficult news in healthcare settings.
When a condition is chronic but not terminal:
- “This diagnosis means some things may change, and it’s understandable to have mixed emotions about that.”
- “Many people experience grief related to changes in how they expected life to look. We can talk through what this may mean for your day-to-day life.”
When treatment is not working as hoped:
- “Hearing that this treatment hasn’t been effective can bring up a lot of emotions.”
- “This may not mean there are no options, but it may mean we need to adjust expectations and talk together about next steps.”
When news affects function, independence, or quality of life:
- “This may change how you move through the world, and it’s understandable to grieve that change.”
- “Changes in ability can bring up grief, even when recovery or adaptation may still be possible.”
Compassion is conveyed not by minimizing the news, but by acknowledging its significance. Language that recognizes change, uncertainty, or loss can help patients feel supported as they adjust to a new reality.
Scenario: A healthcare professional must tell an oncology patient that a limb-sparing treatment was not successful and that amputation is now the recommended course of action.
Grief-sensitive language you may use:
“I know how much hope was placed in preserving your limb, and it’s hard to learn that this approach did not work as we hoped.”
“This is a significant change, and it’s understandable to feel overwhelmed or uncertain.”
“We can take time to talk through what this means for you, both medically and in your day-to-day life.”
A Helpful Phrase: “I Wish”
Anne Chiang, MD, PhD, an Associate Professor of Medicine in the Section of Medical Oncology, shares a phrase she has found helpful when delivering difficult news.
The phrase “I wish” can help balance honesty and compassion when hope no longer aligns with medical reality. It acknowledges shared hopes without shutting them down, while gently signaling change.
Recognizing Differences in Perspective
In some situations, healthcare professionals may underestimate the emotional impact of difficult news because it feels familiar or expected within a clinical context.
Repeated exposure, knowledge of treatment pathways, and focus on outcomes can shape how information is perceived. What may feel routine or manageable to a clinician can represent a significant loss or turning point for a patient.
This difference does not reflect a lack of care, rather a difference in perspective. Recognizing this gap can help providers pause, check in, and respond with greater sensitivity to how the news is experienced on a personal level.
Grief Sensitivity in Difficult Conversations
Delivering difficult news, across a range of clinical contexts, can benefit from grief-sensitive approaches. Clear communication, acknowledgment of loss, and validation of emotional responses can help patients and supporters process information more safely.