A person-centred approach to breaking bad news

Abstract

Receiving a neurological diagnosis is typically an extraordinarily difficult time for patients and their families and has been described as a type of existential shock. Communicating the news of a serious diagnosis is a frequent yet stressful part of the work of many health professionals. In this chapter, an evidence-based resource on how to discuss difficult neurological diagnoses with patients and their families is provided. The SPIKES protocol for communicating bad news is described. Its applicability to communicating the diagnosis on motor neuron disease is then explored, with data from neurologists, patients, and their family members. A case study and real-life examples are used to illustrate the components and the complexities of best-practice communication of a neurological diagnosis. The delivery of bad news, such as communicating a serious diagnosis, is not an optional part of clinical practice; instead, it is imperative that health professionals are prepared to deliver bad news. Communicating the diagnosis in an evidence-based and person-centered manner is necessary in order to promote optimal outcomes for patients and their families; doing so also has the added benefit of mitigating against the stress experienced by health professionals when delivering bad news.