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Communication & End-of-Life Care

by Blair Stokes

“Our ultimate goal, after all, is not a good death but a good life to the very end.”

― Atul Gawande, Being Mortal: Medicine and What Matters in the End


Medicine is expected to save lives. But in cases of critical disease at end of life, patients often need comfort and palliative care rather than a cure. In his book, Being Mortal, Atul Gawande, MD, MPH confronts the limitations of medical intervention as patients approach death.

Like Gawande, more clinicians and physicians are rethinking end-of-life care, recognizing that extending a person’s life may not necessarily improve their life. This is especially true for patients with diseases such as dementia, who require a different type of care to ease both the physical and emotional pain of death.

One in three American seniors dies with Alzheimer’s disease or some other form of dementia. Dementia presents its own set of complications for caregivers. Because the symptoms of dementia can mimic death’s warning signs, it’s difficult to know when a patient is dying and when a patient needs hospice care. Home health, hospice, and home care agencies everywhere need to be prepared for this challenge. Yet few are trained for it.

In their research, Ariadne Labs has consistently seen that better communication between clinicians, patients, and families promotes better end-of-life care. Led by Executive Director Gawande, Ariadne Labs is a joint center between the Brigham and Women’s Hospital and Harvard’s school of public health that delivers health care innovations for people at critical points in their lives, including serious illness care. Their Serious Illness Care Program provides “guidance for clinicians to initiate these difficult [end-of-life] conversations in the right way, at the right time.”

As we discussed in our recent blog about The Conversation Project, talking about death is hard for almost everyone. Clinicians and caregivers are no exception. Understanding this, Ariadne Labs developed the Serious Illness Conversation Guide — a guide to help clinicians communicate effectively and appropriately with other clinicians, patients, and families. Clinicians using the conversation guide can help bring patient goals into end-of-life discussions and decision-making.


“If end-of-life discussions were an experimental drug, the FDA would approve it.”

― Atul Gawande, Being Mortal: Medicine and What Matters in the End


Want to learn more about dementia and end-of-life care? Watch our free webinar, Dementia at End of Life: What All Post-Acute Providers Should Know and get the Frequently Asked Questions Tip Sheet developed by renowned end-of-life educator, Barbara Karnes, RN.

Hear what attendees from last week’s presentation had to say:

"EXCELLENT! One of the best webinars I have ever attended. The information was accurate and immediately applicable." — Gail

"Barbara is always good. She has a way of making dying very 'normal.'" — Joni

"Excellent! I learned a lot about the signs to look for when deciding whether to admit a patient to hospice and then what to look for 1-3 weeks before death." — Linda

"Excellent! It gave me some specific ways in which to improve my education to families." — Krista

Read more in: Administration, Clinical, Therapy

About Kinnser software

Kinnser Software, Inc. provides web-based solutions that deliver clinical and business results to the home health, hospice and private duty industries. Founded in 2003 and headquartered in Austin, Texas, Kinnser Software serves more than 4,000 home health, therapy, hospice, and private duty home care providers nationwide. Kinnser helps thousands of clinicians and other staff in post-acute healthcare to manage scheduling, billing, electronic visit verification, day-to-day operations, and patient referrals. 

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