Submitted by James Cantwell on Thu, 03/07/2025 - 09:20
A new paper published in European Geriatric Medicine offers vital guidance for clinicians navigating the complex task of discussing uncertain prognoses with older adults facing multiple serious health conditions.
Led by Dr Simon Noah Etkind and colleagues from the University of Cambridge, Primary Care Unit, this research asked older adults with multiple serious health conditions, their families, and healthcare professionals about their experiences and views on discussing an uncertain future. The findings were discussed at two stakeholder workshops to develop practical recommendations for communicating uncertainty.
The recommendations, based on input from 89 research participants, emphasise the importance of personalised communication, with open and honest discussions within agreed-upon boundaries. Clinicians are encouraged to engage in parallel planning when the future is uncertain, outlining various future scenarios to help patients and carers understand the range of possible outcomes.
These co-designed recommendations aim to improve the experience of care for older adults with multiple serious health conditions by addressing the challenges of uncertainty that they face.
Dr Etkind said “By using these strategies in practice, healthcare providers can better support patients and their families in making informed decisions amidst the unpredictability of complex health trajectories.”
Contributing to the co-design, Sarah Dixon, Patient Governer at Cambridge University Hospitals NHS Foundation Trust, commented:
“It has been a privilege to contribute to this project, which I believe will be greatly beneficial to doctors, patients and families.”
“I have had personal experience of doctors’ poor communication of uncertainty. My father was ill in hospital for many months before dying there, following an operation which was thought to be successful. As he became weaker, puzzled medical staff either struggled to explain the situation or simply avoided my mother and me, which was stressful and upsetting for all of us. Patients understand how difficult it must be, to be both an expert and unable to predict progress, but nevertheless they need helpful words from those in charge of their care.”
“This important study offers an in-depth consideration of the complexities of medical uncertainty and the challenges in communicating it, together with ways forward. I have no doubt that it will have a far-reaching impact on clinical understanding and significantly improve the wellbeing of patients and families at a critical time in their lives.”
The full study, titled ‘Communicating prognostic uncertainties in advanced multimorbidity: a multimethod qualitative study to co-design practice recommendations’, is available with open access here.