PT - JOURNAL ARTICLE AU - M. Connolly AU - A. Duck TI - Communication skills in end-stage respiratory disease: managing distressed patients and breaking bad news DP - 2008 Dec 01 TA - Breathe PG - 146--154 VI - 5 IP - 2 4099 - http://breathe.ersjournals.com/content/5/2/146.short 4100 - http://breathe.ersjournals.com/content/5/2/146.full SO - breathe2008 Dec 01; 5 AB - Educational aims To improve and give structure to challenging end-of-life communication discussions. To examine the assessment and management of symptoms associated with end-of-life respiratory disease. To examine the structured frameworks for caring for patients with cancer and explore the effectiveness of their application to end-of-life respiratory disease. Summary This review on when, how and whether to talk with respiratory patients about dying has been developed from a recent 3-day course, entitled End of life care in respiratory disease, which was run jointly by the British Thoracic Society and the Association of Respiratory Nurse Specialists. Aimed at respiratory specialists, the purpose was to raise debate and awareness within the specialty of the skills, evidence and best practice in end-of-life care. Participants identified their learning needs as follows: dealing with anxiety, depression, emotions and breathlessness; symptom control; and navigating the social services benefit system. The course aimed to present the key clinical skills required in a workshop style for experienced respiratory practitioners. Five doctors, 19 nurse specialists and two physiotherapists attended the course, which was held over a period of 3 days 2 months apart in 2008. This article describes the skills of end-of-life care as applied to the care of people with advanced respiratory disease, and how these were explored in this short course. We hope it will help other respiratory professionals develop and extend the relevant knowledge base and communication skills in their own teams.