Communication with older, seriously ill patients.

This article aims to provide more insight into effective communication with older people with serious illness and their surrogates/caregivers. To do so, if focusses on specific skills in three core functions of communication (i) empathic behavior, (ii) information provision and (iii) enabling decision making. Empathy is always important and can be provided using ‘NURSE’, meanwhile assuring a continued relationship. As older people’s abilities for information processing decreases, the importance of tailoring information is highlighted, using approaches as ‘SPIKES’ or ‘Ask-tell-Ask’ and providing chunks of information, while empathy also facilitates information processing. Eliciting patients’ goals of care, with or without the help of surrogates, is important to come to effective decision making. Surrogates need assistance when making decisions for patients while they also have their own caregiver needs for support and information. Lastly, several suggestions to ensure patients’ and caregivers’ needs are being met are made, with the aim to improve communication in challenging and uncertain times. (aut. ref.