The author examines the transformations in the perception of medical care of caregivers after the loss, with particular attention to physician-patient and familypatient communication. There is a persistent discontinuity between oncological and palliative care, which leads to strong difficulties in communication and has a negative impact both during the disease, and after the loss. The "simultaneous care" model represents a good alternative to improve quality of life and to allow a better communication and gives the patient and his/her family, a possibility to prepare for the end. It’s argued that an open communication is also associated with an early activation of coping strategies in the family group and has a positive impact on the elaboration of mourning. In Italian families still prevails a communication model based on "not telling" strategies, nevertheless, silence can have different meanings and is not always a synonym of an absence of awareness. In this perspective, it is important to adopt a personalized communication model, in order to provide all the information the patient needs, respecting, if necessary, his desire of "not to know".
Keywords: Antropologia medica; fine vita; narrazioni del lutto; dolore; assistenza continua; comunicazione.