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Handling the effects of difficult news

Check the person's reaction, ("How are you feeling?)

Acknowledge any distress, ("e.g. I can see this is distressing for you").  This may seem superfluous, but it shows the patient that you have noticed the distress.

Is the person accepting the difficult news?  Even if they are, they should be monitored for anger, anxiety, depression.

Is the person overwhelmingly distressed?

Is the person denying or holding unrealistic expectations?  If the person is coping well with their present feelings, do not persist in challenging the denial.  If they are not coping with their feelings, gently challenge the unrealistic expectations, e.g. "Is there ever a moment, even for a second, when you think this may be more serious?"

Is the person ambivalent? Acknowledge the uncertainty and offer the opportunity to talk further.

Is the relative or partner colluding? (If so, see CLIP tutorial: Collusion and denial)

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