| Step | What you can say |
|---|---|
| Ask what the patient knows | What have others told you about your prognosis or future? How much are you thinking about your future? |
| Discover what information is useful | For some people prognosis is numbers or statistics about how long they will live. For others, prognosis is about living to a certain date. What is most helpful for you? |
| Anticipate | Talking of the future can be scary. If you are not sure, can you tell me how you see the pros and cons of discussing this? If deteriorating, from what I know of you, talking about this information might affect decisions you are thinking about. |
| Provide | Providing statistics: The worst case scenario is 25th percentile and the best case scenario is 75th percentile. If there were 100 people with your similar situation, by median survival, 50 will have died and 50 would be alive. Provide no statistics: From my knowledge of your situation and how your heart is responding, I think there is a good good/50-50/slim chance that you will be around on XXX date or time. |
| Track emotion | I appreciate that you want to know what to expect. I wish I had better news. I see this is not what you were expecting. I can only imagine how this information feels to you. |