The Hardest Conversation in Care

By Rosie Tynan, Director of Care (Republic of Ireland and England), Praxis Care

Some of the most important conversations I’ve had in my career have also been the hardest.

Telling a family that something has gone wrong, or sitting with someone who has raised a concern about their care, asks a great deal of everyone involved. These conversations can be emotional, challenging and, at times, uncomfortable. Yet they are also some of the most important conversations we will ever have.

Over the years, these experiences have taught me something important about what people need from us when things are difficult. While every situation is different, the essentials remain the same: honesty, respect, compassion and a willingness to listen.

When concerns are raised, people want to know they are being heard. They want their questions acknowledged and their experiences understood. They want clear information about what has happened, what is being done to understand the situation and how we can learn from it. Above all, they want to feel that they, or their loved one, remain at the centre of every decision.

Taking the time to listen, and remaining open even when conversations feel uncomfortable, often lays the foundation for trust. I’ve come to believe that some of the strongest relationships are built during moments of difficulty and uncertainty.

The Conversation That Changed My Perspective

One conversation has stayed with me throughout my career.

A family once told me that what hurt them most was not the incident itself, but the time afterwards when they felt uninformed and unsure of what was happening. The incident had been difficult. The silence that followed was harder.

It was a simple observation, but a powerful one. It reminded me that while we cannot change what has happened, we can influence how people experience our response. Communication matters, particularly when emotions are high and uncertainty remains.

That conversation changed how I think about leadership.

Leading Through Uncertainty

Leadership is often associated with having answers. In reality, some of the most important moments require us to acknowledge uncertainty while remaining present, supportive and open.

People understand that you may not have every answer immediately. What they need is reassurance that they will be kept informed, treated with respect and supported throughout the process. They need to know that their concerns matter and that someone is listening.

Since that experience, I have placed real emphasis on transparency, active listening and maintaining communication when situations are at their most challenging. In my experience, trust is often built, or rebuilt, during difficult moments. How we respond when things go wrong can be just as important as how we support people when everything is going well.

For me, leadership is not about always having the perfect response. It is about being present, communicating honestly and staying alongside people through uncertainty.

Process Meets Person

Open disclosure is often described as a process. But for me, it is much more than that. It is a commitment to honesty, accountability and respect. It means engaging openly when things go wrong, acknowledging the impact on those involved and creating opportunities to learn and improve.

At its heart, open disclosure reflects the principles of person-centred care. It recognises that individuals and families have a right to information, involvement and meaningful communication. When approached with empathy and sincerity, it can strengthen relationships, build confidence and support a culture of learning.

Open disclosure is not simply about explaining what happened. It is about ensuring people feel listened to, respected and involved throughout the conversation. It is about creating an environment where openness is valued and where learning is seen as an opportunity for improvement rather than something to be avoided.

Advice for Colleagues Navigating Difficult Conversations

I also recognise that these conversations can feel daunting for colleagues.

No one wants to say the wrong thing, particularly when emotions are high and answers are still emerging. It can be tempting to wait until you have every detail before engaging with families or the people we support.

My advice is simple: never underestimate the value of being present and listening.

You can begin before you have every answer.

Be honest about what you know and what you do not yet know. Prepare carefully. Listen actively. Only make commitments you can keep. Most importantly, approach every conversation with empathy and respect.

People may not remember every detail of what was said, but they rarely forget whether they felt listened to, respected and treated with compassion.

The Moments That Define Us

At Praxis Care, we want people we support and their families to feel confident that they will be treated with dignity, respect and openness at every stage of their journey with us.

When concerns are raised, we see them as opportunities to listen, learn and improve. While difficult conversations are never easy, they can strengthen understanding, build trust and help us provide better support in the future.

Open disclosure is not about having all the answers. It is about showing up, being honest and maintaining trust when people need it most.

In my experience, those are the moments that define us, both as leaders and as care providers.