Building Trust Through Life-Affirming Conversations About Hospice Care

BAYADA's Margot Lambright Explains How Thoughtful Discussions Can Improve Patient Outcomes

Starting and navigating conversations about hospice care ranks among the most delicate challenges health care providers face. Many providers find themselves hesitating to broach these essential discussions, which often leads to delays that can affect both patient outcomes and access to crucial resources.

Margot Lambright has witnessed these challenges firsthand in her role at BAYADA Hospice. As the Division Director of Psychosocial Support and a seasoned social worker specializing in hospice and palliative care, she has spent years guiding patients and families through these sensitive transitions. Her experience has equipped her with insights that can empower medical professionals to approach these conversations with greater empathy and clarity. Here's how she suggests approaching these conversations:

Honor the Patient's Voice

"The patient's autonomy must always come first," Margot says. Unless they specifically request otherwise, direct your attention and questions to the patient rather than family members. By carefully documenting and following advance directives, you help ensure their wishes remain at the center of all care decisions.

Create Space for Family Involvement

Instead of directing the conversation, try opening with questions that invite reflection: "What would you want your final months to look like?"

Margot believes that families naturally begin sharing their hopes and concerns through this approach. As trust builds, more challenging topics—like code status and advance care planning—can emerge organically.

Take Small Steps Forward

In general, a gentle progression tends to work better than diving straight in when broaching difficult subjects. Consider asking permission with phrases like, "Is it OK if we talk about your wishes regarding funeral arrangements?" or "May I share what typically happens next?" Using a more measured approach gives everyone time to process the situation and options with room to adjust as they navigate their emotions.

Present Hospice as Life-Affirming Care

Margot often encounters the misconception that choosing hospice means giving up. "In reality," she explains, "hospice care focuses on enriching the time that remains. It's about creating comfort, fostering meaningful moments with loved ones, and honoring each person's unique journey." Presenting hospice as a positive, proactive choice helps families recognize its value in preserving dignity and autonomy.

Strengthen Provider Communication Skills

Even seasoned health care professionals sometimes struggle with these conversations. Margot believes that health care professionals should consider ongoing education like workshops, written resources, and practice sessions to be prepared and confident when it's time to have these difficult but important conversations.

"When providers feel confident in their approach," she says, "they're better equipped to offer the compassion and clarity families need."

The Impact of Thoughtful Discussion

Research shows that early access to hospice care can significantly enhance quality of life—and sometimes even extend it.

"These conversations serve as gateways to better care," Margot adds. "When we approach them with sensitivity and skill, we help families navigate this profound transition with greater understanding and peace of mind."