• Elaine Wittenberg-Lyles, Joy Goldsmith, Debra Parker Oliver, George Demiris, Robin L Kruse, and Stephanie Van Stee.
• 1 Markey Cancer Center, Department of Communication, University of Kentucky , Lexington, Kentucky.
• J Palliat Med. 2013 Sep 1;16(9):1135-9.

BackgroundAlthough there is poor communication about pain management between informal caregivers and hospice providers, little research has examined these interactions.ObjectiveThis study explored communication between informal caregivers and hospice team members by investigating the use of medical words in care planning discussions.DesignTranscripts of clinical communication between caregivers and hospice team members were reviewed for use of medical words, word placement (statement or question), whether or not the word was explained, and the caregiver's response to the word.Setting/SubjectsAs part of an ongoing randomized clinical trial in the midwestern United States, informal hospice caregivers participated in recorded hospice care planning discussions.MeasuresA selection of videorecorded interactions from an ongoing study was analyzed.ResultsHospice team members used six times as many medical words compared to caregivers. The majority of medical words used by caregivers and team members were drug names. Medical words were predominantly used as statements rather than questions that sought clarification. Three-fourths of medical words used by team members were not explained to caregivers. Caregivers provided little response to medical word use, indicating a lack of understanding.ConclusionsThe propensity to use medical words during clinical communication with family caregivers is cautioned. In order to recognize the caregiver as a contributing team member, clinicians should limit the use of medical words, provide lay explanation alongside medical terminology, and use questions to check for understanding. More research is needed to determine assessment tools to capture the caregiver's level of understanding of medication and pain management protocol.

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