Communication skills in palliative medicine

Although palliative medicine is not institutionalized in Croatia, most healthcare professionals daily encounter patients suffering from incurable and terminal diseases. One of the most important and difficult aspects of doctor-patient communication is breaking bad news to patients and dealing with their emotional responses ranging from denial to depression. The crucial part is to accurately inform the patient of all the details of his or her disease and prognosis. Such a practice is common in western societies but not in Croatia, where paternalistic approach is still predominant. Family involvement plays an important role in the palliative care of patients, which also contributes to the complexity of communication process. In addition, many terminally ill patients suffer malignant pain. Within the concept of “total pain”, the multidimensional and interdisciplinary approach toward pain management in terminally ill patients is suggested, taking into account physical, emotional and cognitive aspects of suffering. A take-home message is that the main concern of palliative medicine is the action that can be taken presently to ease the suffering of such patients

Key words:
communication; palliative care; pain