HPHD Breaking Bad News and Coping with Dying

Question 1

What is the 5 stage grief model of adjusting to dying?

Answer 1

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
   (they are often a cycle and may not be in order)

Question 2

What are the positives and negatives of being in denial in coming to terms with terminal illness diagnosis?

Answer 2

Positives - can be a coping mechanism

Negatives - reluctant to discuss any treatments and illness, hard to have conversation with

Question 3

What is the SPIKES model for breaking bad news?

Answer 3

Setting and listening: ensure privacy, ask who the pt wants present
Patients perception: ask what the pt knows already
Invitation from patient: find out how much detail they want to know, allow for denial
Knowledge: give a warning shot, give info in small chunks, avoid any euphamisms eg tumour instead of cancer
Empathy: normalise their emotion by offering tissues, asks whats concerning them the most
Strategy and summary: summarise and understand its a lot to take in, offer future availability and agree on next step