Vancouver/Richmond Stream: Emotions

Back to 2.5 - Conversations About Serious Illness

Open up the the Serious Illness Conversation Guide and have this ready to follow along the video.


Observe the clinician demonstrating the conversation. Note the patient's emotions during the conversation. Emotions can come up anytime during the conversations. Emotions can be varied including tears, anger and refusal to talk.

How can I respond when a patient is upset?

Allow silence. Name the emotion and take time to explore it. Some examples could be:

  • You seem really upset. Tell me more about what you are feeling.
  • You seem surprised. Tell me about what you were expecting to hear.
  • This is really hard to hear. Tell me what you're thinking about.

Quick tips

  • The questions and order of the serious illness conversation is based on research. It is ideal to complete the questions in order, but in some situations, you may need to adjust it based on your clinical judgement.
  • The topics addressed might not feel right at first.
  • Reverting to what you are comfortable talking about is natural.
  • The first priority is learning about the patient's values and goals.
  • Discussion of treatments, interventions and the care plan comes after the Serious Illness Conversation rather than in the middle.
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