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I'm looking for thoughts on how you feel about talking to the family about signs the patient is close to death while at bedside? Do you ask to talk in the hall or remain at bedside pointing out mottling, breathing patter, cold extremities?
It depends upon the family, the patient, and the circumstances of that specific situation. I often speak to the family in the presence of the patient, in my opinion, there are very few secrets in hospice and patients are often reassured to know that their family members are getting good support.
Having said that, there are also many times when it is not appropriate either because of the patient or the family situation. It is our job to be observant and sensitive to the communication needs of the patient and family.