Recognising Dying in Hospitals: Lessons from Experts

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Across our healthcare system you'll find that end-of-life care happens everywhere. How do health professionals recognise dying, communicate uncertainty, and support families with compassion and clarity?

Caring for people who are approaching the end of life can be one of the most meaningful and often misunderstood aspects of acute healthcare.

In a recent End-of-Life Essentials (EOLE) webinar, Associate Professor Kim Devery, Founder EOLE, and experienced clinicians:

• Jessica Brown (Palliative Care Clinical Nurse Consultant)
• Linda Magann (Clinical Nurse Consultant) and
• Jeanette Lacey (End-of-Life Care Nurse Practitioner),

shared powerful insights into how we recognise dying, communicate uncertainty, and support families with compassion and clarity.

Their reflections can remind us that end-of-life care is not simply a clinical process. It is a profoundly human one that depends on curiosity, honesty, and presence.

Honouring the Realities of Prognostic Uncertainty

One of the key points to emerge from the conversation was the unavoidable uncertainty that surrounds prognosis. As Linda explained, palliative and end-of-life care often unfold in a space where prediction is limited. Families may seek exact timelines, but clinicians frequently need to balance hope with realism.

‘Uncertainty is inherent in palliative care. We can support people without pretending we have all the answers.’ Linda Magann

Honesty and transparency are critical. It is both acceptable and compassionate to say 'we do not know', while still helping families understand what changes may occur and what they might need to prepare for.

Curiosity as a Clinical Skill

Curiosity emerged as a central skill in recognising end of life. For Jeanette, curiosity means noticing cues, listening deeply and being open to what patients and families are trying to tell us.

'Be curious. People often give us hints, sometimes subtle and sometimes direct, about what they are worried about.' Jeanette Lacey

Curiosity helps clinicians avoid assumptions. Gentle questions such as 'What worries you most right now?' or 'Would you like to know what to expect?' can open conversations that clarify fears, preferences, and priorities.

The Power of Silence

All three clinicians highlighted an often-overlooked skill: the strength of silence.

In a system focused on action, filling space can feel natural. Yet, silence allows patients and families to process information, express their feelings, and find their own words. As Linda noted, silence is not passive. It is purposeful, active, and therapeutic.

'You will learn so much about your patients if you give them space.' Linda Magann

Silence also prevents information overload at moments of stress or grief. Sometimes the most caring act is simply to stop speaking and listen.

Dispelling Myths in the Acute Setting

Acute hospitals present unique challenges, including entrenched myths about palliative and end-of-life care. Many families and clinicians still equate end-of-life care with giving up or assume a ‘Not For Resuscitation’ order means a person will receive no care at all.

The panel addressed these misconceptions directly. End-of-life care is not abandonment. It is a shift in focus towards comfort, dignity, and aligning care with what truly matters to the patient.

'A Not For Resuscitation order never means do nothing' and 'End-of-life care is about transitioning someone to where they need to be.' Linda Magann

Recognising dying in acute care is not about forecasting the exact moment of death. It is about understanding when active treatment no longer provides benefit and when comfort, presence and connection become the priorities.

A Human Pathway into End-of-Life Care

The panel shared moving personal experiences that shaped their practice.

Jessica reflected on the power of communication and the importance of listening, pausing and not rushing to fix. Jeanette described her early work in haematology, anaesthetics and ICU, where she encountered profound moments of dying, organ donation and grief. These experiences eventually led her to develop end-of-life services within her organisation.

Their journeys demonstrate that end-of-life care is not only a clinical skillset. It is a calling grounded in empathy, respect and humility.

Supporting Families Through ‘Meaning Making’

Families navigating the end of life often carry fear, uncertainty and emotional overwhelm. Yet these moments can also bring opportunities for connection, memory making and legacy.

Linda shared a story about a patient whose daughter wanted to understand what mattered most to her mother. This simple question led to a heartfelt conversation about passing on family recipes and traditions.

This story highlights the importance of creating space for families to explore meaning and cherish what matters most.

'In the space where uncertainty lives, there is also the opportunity for families to create memories and legacy.' Linda Magann

Advice for Clinicians: Skills That Transform Care

At the close of the webinar, the panel offered practical advice for clinicians seeking to strengthen their end-of-life recognition skills.

1. Be curious.

Notice cues, explore concerns and ask open questions.

2. Keep learning.

Training through End-of-Life Essentials, End of Life Law for Clinicians, and programs such as PEPA, can build confidence and competence.

3. Find your mentors.

Learn from colleagues who communicate well. Observe family meetings. Seek guidance from experienced clinicians.

4. Embrace silence.

Allow patients and families time to speak and process.

5. Understand patterns of dying.

Knowing what typical dying looks like builds confidence and helps clinicians reassure families and escalate appropriately when needed.

'Knowledge is power. The more you understand, the more confidently you can support people at the end of life.' Jeanette Lacey

Looking Ahead

Recognising end of life in acute care is both an art and a science. It requires clinicians to balance clinical knowledge with emotional presence, clarity with sensitivity, and action with stillness. As this webinar demonstrated, every healthcare professional, regardless of specialty, plays a vital role in shaping the final experiences of patients and families.

With curiosity, compassion and a commitment to ongoing learning, we can help ensure that people not only die well, but are truly seen, heard and supported in their final chapter.

Learn more on the delivery of end-of-life care and the importance of your role for people who are dying in hospitals in the End-of-Life Essentials ‘Recognising Dying’ module.