Discussions with families about e.g. escalation decisions, end of life plans etc often go badly as the wrong questions asked e.g.

“What do you want for your mum?”

When we should be asking

“What do you think your mum would want in this situation?”

They are not the same thing

*In above scenario the individual lacks capacity to be involved (otherwise just speak to them, and their family if individual wants that)

Couple of other things I do

- Rest of life not End of life can sometimes be a better term

- Don’t say futile (futile = pointless, and no one wants to think their life is pointless)

- “Symptom control” not “keep comfortable” (often seen as euphimism for euthanasia)

- Big fan of “Hope for the best, prepare for the worse” and “Sick enough to die”

- dying, die, dead (no montypythonesq euphimism)

- one more thought (although I have many more on this topic!)

I reckon that with 99.9% of the “difficult families” situations I have encountered the fault has been due to poor communication skills by health care professionals, and the families are just scared and confused