Using the PEAS technique to communicate in palliative care

Caring and supporting patients at the end of their lives comes with numerous challenges for healthcare professionals. One of the main challenges is how to communicate effectively with patients and those important to them. It is even more challenging when communicating with patients and families expressing emotions such as anger, aggression, guilt or psychological pain. Emotions have for decades been associated with different manifestations of behaviours (May, 1977:75), some of which result in people expressing anger, euphoria or aggression. May is clear that emotions take different forms wide enough to include physiological as well as cognitive expressions. Here, I shall focus only on communication with people expressing cognition-related aspects such as loss of logical thinking, disrespecting social norms or etiquette (e.g. being rude and then apologising, often after the emotions subside), fear, anxiety, hostility and anger. In palliative care, such emotions are provoked when we break bad news. It is important to note that all emotions, but particularly anger, use up a lot of energy. Therefore, they cannot continue for prolonged periods of time without making the patient tired and lethargic. This means that our approach to dealing with or handling most emotions is to find ways of reducing their intensity by trying to support the person.