Communicating with Families after Severe Acute Brain Injury

Communicating with patients and families after severe acute brain injury (SABI) is often considered an art, but the science of communication in SABI is advancing. Recent research demonstrates how surrogates perceive various styles of prognostic language in SABI, provides insight on factors that influence prognostic discordance between surrogate decision-makers and clinicians, and identifies sources of bias in prognostic communication and shared decision-making. In this article for Neurocritical Care's topical collection on palliative care, we review this latest research, offer strategies to approach difficult communication tasks with insufficient evidence to guide practice, and discuss ethical issues relevant to decision-making for this patient population.