A terminally ill young adult tells the nurse that he wants to discuss how to express his feelings to his wife and daughter before he dies, but they are hesitant to discuss it. Which nursing intervention is most appropriate?

• A. Facilitate discussions with both the patient and his wife about expressing their feelings in healthy ways.
• B. Encourage him to focus on physical comfort and postpone emotional discussions.
• C. Suggest that the wife should initiate the conversation about feelings.
• D. Advise him to write a private letter to express his feelings.

Answer: (A)

Open, honest communication within the family is essential in end-of-life care. The nurse’s role is to guide conversations so feelings can be shared in a safe, supportive way. Facilitating discussions with both the patient and his wife about expressing their feelings in healthy ways best honors the patient’s wish to communicate and helps the family work through their hesitations together. This approach promotes emotional processing, closure, and mutual understanding, which are important for quality of life even as death approaches.

Postponing emotional discussions focuses care on physical comfort at the expense of psychosocial well-being. Relying on the wife to initiate the conversation places the burden on her and may not align with the patient’s desire for joint communication. Suggesting a private letter can be helpful, but it doesn’t engage the family in a shared, real-time dialogue that supports collective processing and emotional support. If needed, the nurse can pair this with structured family meetings and referrals to social work or chaplaincy to further support the process.