Fear of Burdening Family:

• Ask for more information, clarify meaning
• Identify communication barriers
• Normalize feelings
• Open communication “disease is a burden, not you”
• Consider family support a gift

Fear of Dying/Leaving Family:

• Stay present emotionally
• Normalize (vs. “naturalize”)
• Reassure regarding symptom control
• Determine what has been done to prepare for death
• Identify communication barriers
• Acknowledge difficulty of communication
• Listen more than speak
• Acknowledge courage to speak of this issue

Denial vs Approach:

• Listen, ask reflective questions
• Clarify “accept” and “acknowledge”
• Assess impact on family
• Assess communication with family
• Do not be a prognosis “hammer”