Patients with serious illness may gradually develop a form of “double awareness” — the ability to hold hope for continued living while also preparing for the possibility of dying.
Optimistic prognostic discussions could result in hopeful perspectives, but they may lead to disappointment or depression if treatment does not work. Conversely, clinicians may not provide enough assurance, which may threaten hope and meaningful engagement with life.
An analysis of discussions between clinicians and patients with hematologic malignancies and their caregivers revealed readiness for prognostic dialogue