| Awareness | Acknowledge personal and cultural perspectives. | What underlying assumptions about life and death do we bring to our encounters with patients? |
| Recognition | Understand patient and family perspectives. | What underlying assumptions about death do our patients and their families bring? How do they want to lead their lives before that event? |
| Engagement | Develop a repertoire of communicative approaches. | How is it that we best engage patients in jointly considering the topic? |
| Synchronicity | Practice “sharing” the topic with patients at appropriate moments. | When is it time to talk about death? When is it time to listen? |
| Equilibrium | Seek balance by recognizing reality and uncovering hope. | How can we, along with our patients, move toward conceptualizing death as a normal process in a full life? |