Palliative Care Part 2: Having End of Life Discussions

Palliative Care Part 2: Having End of Life Discussions

On starting an end of life conversation:

“It starts with asking an open ended question.  And waiting long enough for the person to provide a response because we are often uncomfortable with silence and we will fill in the spaces before letting the individual to express themselves.  They will need that extra time because it is a hard conversation.”

I continue my discussion with Palliative Care Physician Dr. Heather Sung.  We pivot the conversation on to how to start to talk about end of life.  These sensitive discussions with our loved ones are critical to ensuring that they live the life they want to live all the way to the end.  How do they want their medical treatment plan to progress if their bodies are not responding to treatment?  How can we help them  when death is imminent?  How do we as caregivers react and create an atmosphere that is supportive for the one we are caring for?   We are so afraid to even bring up the topic that oftentimes people are further isolated and then die in ways they never wanted.

Palliative care teams – a physician, nurse, social worker and minister – work together to talk with the patients not only about treatment plans but also about their quality of life.  What is important to them?  Is it attending their granddaughter’s graduation?  Or a wedding?  Or is it simply to be home?  We won’t know the answers to these questions unless we ask.

Palliative Care and hospice care teams work hand in hand once death is imminent.

They act as guides for the patient and their families to deal with the roller coaster of emotions that ensue.  This is all a part of normal life.  We need to put it all on the table so that palliative care teams can provide the best support possible.

As we continue to develop this series, we want to hear from you.  What is important to you?  What issues would like to see addressed?   This series is for all of us and we want to make sure that the information is valuable and useful.  Email us at hello@modernage.tvand let us know!!

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Dr. Sung’s private practice website


Dr. Heather Sung has been in medical practice for twenty years.  She received her medical degree at the University of Connecticut and completed her residency in Internal Medicine at Dartmouth Hitchcock Medical Center in 1998. She attributes much of her knowledge on doctoring to her early career as a community physician in Boston with Massachusetts General Hospital.  There, she was inspired by the devotion and compassion of her colleagues and the richness and diversity of her patients.

She moved back to Connecticut to begin a family and worked as a Hospitalist at Danbury Hospital from 2002-2016.  With a great interest in the humanism of medicine, Dr. Sung became board certified in Hospice and Palliative Medicine in 2012. In 2016, she transitioned fully into the practice of this specialty and became the Clinical Leader of Palliative Care at Norwalk Hospital.  Recognizing the growing complexity of disease and the increasing needs of our aging population, as well as the shortage in meeting these needs in the outpatient setting, Dr. Sung has now embarked on establishing a community-based Palliative Medicine practice.

In addition to her clinical work, Dr. Sung strongly believes that experience and knowledge should be shared.  As such she has been very active in education.  During her time in Boston, Dr. Sung was an Instructor in Medicine for Harvard Medical School and was part of the Clinical Faculty of the Massachusetts General Hospital Internal Medicine Residency. She is a Clinical Assistant Professor at the Robert Larner College of Medicine, University of Vermont, and she has done the Palliative Medicine lecture series for the Norwalk Hospital Internal Medicine Residency.  Additionally, Dr. Sung has taught the Palliative Medicine lecture series for Sacred Heart University’s Physician Assistant School.

Dr. Sung believes that being entrusted by her patients is a true gift.  In her free time, Dr. Sung enjoys being active outside with nature with her husband and two teenage boys.