Protection often takes the form of withholding information that may cause pain. A conspiracy ensues, which is difficult to maintain. The family may repress their own grief to present a controlled front. This causes severe tension, which drives apart people who love each other. Conversations with different members of staff may well provide the basis for an assessment of whether the patient does or does not know.
Patients can often guess their diagnosis and feel isolated, needing their suspicions confirmed.
Sometimes the patient's imaginings can be worse than the actual diagnosis . By opening up fears and anxieties, they can be confronted and resolved. Relatives may be communicating non-verbally already. When we feel uncomfortable in a situation, e.g. telling lies, our eye contact, or lack of it, gives us away. Relatives can often feel guilt during the bereavement, if barriers have existed during the final part of life.