This conversation map includes specific phrases to use when talking to patients with COVID-19 about whether they prefer to receive home care if their illness becomes severe. You can also download an editable version of the script. Developed by VitalTalk.

1. Check In

Clinician: I’m calling from the medical center. How are you doing?
Patient: I'm ok, I am just worried.

2. Ask About COVID-19

Clinician: I understand from your regular provider that you have been living with metastatic cancer. Do I have that right?
Patient: Yes, I’ve been getting chemo.

Clinician: I also understand that you have tested positive for COVID-19.
Patient: Yes.

Clinician: I can imagine that when you are dealing with cancer already, hearing about COVID-19 must be worrisome.

3. Lay Out the Issues

Clinician: I am hoping that you do well and are not affected directly by COVID-19. I also want to make sure that we at the medical center provide the care you want. Could we talk about that?
Patient: Ok. I haven’t been sure what to think.

Clinician: Even when people get COVID-19, many have an illness that is mild to moderate and don’t need to be in the hospital. That is a better case scenario. I hope your case of COVID-19 turns out be mild.
Patient: Me too.

Clinician: Could we plan for the worst case too? Here is the issue. We know that when people who already have a serious illness get a severe case of COVID-19, the COVID-19 almost always takes their life.
Patient: Oh my gosh.

Clinician: I wish things were different.
Patient: Yeah, me too.

Clinician: I worry that if your COVID-19 becomes severe, there is a high chance it would take your life. Given that, would you still want to be in the hospital? I am asking because the hospital is going to be very different than usual.
Patient: Ok.

Clinician: Coming to the hospital may not be the best care for you. Some people in this situation would rather stay at home and have care that comes to them.
Patient: That actually makes sense to me.

4. Motivate Them

Clinician: You can tell me that IF your COVID-19 got severe that you would rather not come into the hospital and have care at home, or you could tell me that you do want to come to the hospital. You can change this anytime. What are your thoughts today?
Patient: Uhh… This is a lot to take in. I am leaning towards not coming to the hospital.

5. Expect Emotions

Clinician: This is a horrible epidemic, and I wish things were different.
Patient: It’s hard to say, but I don’t want to die on a machine.

Clinician: I want to honor your wishes.
Patient: Thank you.

Clinician: I respect what you are saying. What that means is that you would rather not come to the hospital.
Patient: That’s good for now.

6. Record

Clinician: I'll write a note in your chart, ok?
Patient: Ok.

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