“It’s not just what you say”: Communication at the heart of palliative care

Our clinical team at Thames Hospice are highly skilled, with years of experience and professional expertise. But in palliative care, it’s not just about the technical side of what we do. Communication - how we speak, how we listen, and how we create space for others - is just so important. It’s a vital part of our work.

That’s why our team are trained in advanced communication skills. Because often, it’s not what you say... it’s how you say it.

Liz worked in district nursing before joining Thames Hospice four years ago as one of our Hospice at Home nurses. Today our Hospice at Home service accounts for 80 per cent of our work. Liz’s role takes her out into the community, where she provides the same high standard of care we offer in the Hospice: expert nursing, complex symptom control, emotional support, and advanced care planning - all in the comfort of a patient’s own home.

“I’ve always enjoyed palliative care,” Liz says. “But I used to think it was this magical extra that palliative care nurses could give. Now I understand it’s not magic - it’s awareness. It’s understanding the value of silence, of really listening, and how important and precious that time is.”

“What we say isn’t always the most important thing - it’s how we say it. Patients and their families might not remember every word, but they will remember how you made them feel.”

Respect is at the core of everything we do. Respect for people’s choices, for the pace they need, and for the space they may need to think, to speak, or just to sit in silence.

“When we have difficult conversations - around care plans, or a patient’s options - respect and listening are so important,” Liz says. “Silence is powerful. Knowing how to give someone the space to think their thoughts through, to go at their own pace... that’s a real skill.”

“I remember one man who really showed me how important that silence can be. I was ready to move the conversation forward, but by staying quiet, he took the lead. He moved the conversation on - at his pace, not mine. That was a moment that’s stayed with me.”

“People also need space to tell their story. On my first visit, I might be there an hour and not say very much. People just want to talk, to tell me what’s been happening. We might be the first person who’s had the time to listen properly. Hospital appointments are five minutes here, five minutes there - but we can offer something else. We offer time. Presence. A chance for someone to be heard.”

“Sometimes all people need is someone who understands. It’s so isolating - caring for someone, or going through illness yourself. To have someone there who gets it, who isn’t family, who can just listen and offer some reassurance... that’s huge.”

And after 22 years in nursing, Liz still loves what she does.

“I wouldn’t do anything else. It’s such a privilege, such a blessing to be with people at such an important time in their lives. It’s rewarding in so many ways.”