Asking sensitive questions in a respectful home visit.
English for Healthcare Professionals. Lesson 11.
You are on a community or home visit. The environment is less controlled, the patient may be embarrassed, and sensitive topics may be clinically important. Your goal is to ask difficult questions respectfully, explain why you are asking, and keep the conversation safe and non-judgemental.
You will practise normalising language (so the patient does not feel singled out), neutral vocabulary, and gentle but clear question forms. You will also work on responding to hesitation or avoidance without pushing too hard: offering options, allowing pauses, and checking if the patient would prefer to speak privately. A key focus is boundaries and safeguarding awareness: how to explain confidentiality limits in plain language, and how to state what you need to do next if you are worried about risk. You finish with a short written summary of the relevant points, using careful, factual wording and appropriate certainty.
1. Arriving on the home visit and setting a safe tone.
You’re on a home visit today, which means the communication is slightly different from a clinic room. The patient may feel more exposed, more embarrassed, or simply more in control because it’s their space. Your job is to keep the conversation calm, respectful and safe, while still asking the questions you need to ask.
In this lesson we’ll stay in one realistic scenario: you’re visiting a patient at home for a follow-up, and you need to ask about mood, alcohol, drugs, sexual health, and safety at home. The key is not just the questions, but how you introduce them. At B2 level, small phrases make a big difference: normalising language like “we ask everyone”, giving a reason like “because it can affect treatment”, and offering choice like “we can come back to this”.
In this first part, you’ll practise opening the sensitive section of the visit. You’ll sound professional, non-judgemental, and clear about what will happen next, without sounding intense or suspicious. Then you’ll write your own short opening in a way that would work in a real home visit.
The situation (stay in this story all lesson).
You’re a community clinician on a scheduled home visit. The patient is Maya Patel (39). The referral is for ongoing tiredness, poor sleep and headaches. You’ve already discussed her physical symptoms and medication, and now you need to move into sensitive but clinically important questions.
In a home environment, two extra challenges often appear:
Embarrassment and fear of judgement ("What will you think of me?").
Lack of privacy (someone else may be in the next room; the patient may not feel able to speak freely).
Your first job: signpost and normalise.
Before you ask anything sensitive, do two things:
Explain why you’re asking (clinical reason)
Normalise it (so the patient doesn’t feel singled out)
Here are strong, natural phrases you can rely on:
“I ask these questions because they can affect your health and treatment.”
“We ask everyone these questions as part of routine care.”
“Some of these questions are a bit personal, but they help me support you properly.”
“You don’t have to go into detail if you don’t want to, but even a general idea helps.”
Keep your tone respectful (soft, but clear).
Notice how these question starters sound calm:
More direct
Softer and more workable on a home visit
“Do you take drugs?”
“Do you use any recreational drugs at all?”
“Are you depressed?”
“Have you been feeling low or hopeless recently?”
“Are you safe at home?”
“Is there anyone at home you don’t feel safe with?”
Mini model: how to transition into sensitive questions.
Clinician: “Thanks, Maya. We’ve talked about the headaches and your sleep. I’d like to ask a few routine questions now, because they can affect your health and the treatment we choose.”
Patient: “Okay… like what?”
Clinician: “Some are a bit personal. We ask everyone these questions as part of routine care. If anything feels uncomfortable, tell me, and we can slow down.”
What you will practise in this block.
You’ll write a short transition (about 3–5 lines) that:
sounds routine, not accusatory;
gives a clear reason;
invites the patient to pause or ask questions.
Practice & Feedback
Write 3–5 lines you would say to Maya at this point on the home visit.
Your lines should smoothly transition from general health into sensitive questions. Include:
a brief reason (why you ask),
a normalising phrase (so Maya doesn’t feel singled out), and
one gentle invitation for Maya to slow down, ask questions, or choose privacy.
Keep the tone calm and respectful, like you’re speaking in a patient’s living room. Use at least two phrases from the language on the screen (you can adapt them slightly).
Home visit snapshot (for context).
Patient: Maya Patel, 39
Reason for visit: tiredness, poor sleep, headaches; worries about stress
Setting: living room; you’re not sure who else is at home
Your next step: start routine sensitive questions in a non-judgemental way
Useful phrases you may include.
“I ask these questions because they can affect your health and treatment.”
“We ask everyone these questions as part of routine care.”
“If anything feels uncomfortable, we can take it one step at a time.”
“Would you prefer to speak privately?”
2. Alcohol and drugs questions with neutral wording.
Now we’ll focus on alcohol and recreational drugs, because these are common areas where patients feel judged. On a home visit, that feeling can be even stronger, especially if family members are nearby. Your aim is to ask clearly, but in a neutral way, and to make it feel routine.
Two practical techniques help here. First, keep the vocabulary neutral: avoid loaded words and avoid sounding shocked. Second, give the patient an easy route to answer, for example by asking about a “typical week” rather than “how much do you drink?”. That tiny shift makes the question feel more normal.
In a moment you’ll listen to a short model conversation. While you listen, notice three things: the clinician’s transition phrase, the exact alcohol question, and how the clinician responds when the patient minimises. Then you’ll write the key phrases you heard and you’ll improve one question so it sounds more routine and less judgemental.
Listening focus: neutral questions for alcohol and substances.
In the audio for this block, you’ll hear you (the clinician) ask Maya about alcohol and recreational drugs. This is a normal clinical step, but the feeling can be uncomfortable for patients.
Before you listen, read this tip: neutral language is not vague language. You can still be specific. You’re simply removing judgement.
Patterns that work well.
Here are patterns you can recycle across many home visits:
Normalise + reason
“We ask everyone these questions as part of routine care.”
“I ask these questions because they can affect your health and treatment.”
Alcohol: “typical week” pattern
“How much alcohol would you say you drink in a typical week?”
Why it works: it invites a realistic estimate and avoids sounding like an accusation.
Drugs: “at all” pattern (gentle, but clear)
“Do you use any recreational drugs at all?”
Why it works: it allows a simple “no”, but it’s still direct enough to be safe.
How to respond if the patient downplays.
Patients sometimes say: “Not much… just a couple.” Your job is to calmly clarify, not to challenge.
Useful clarification lines:
“When you say ‘a couple’, is that per day or per week?”
“Would that be beer, wine, or spirits?”
“Roughly how many units would you say that is?” (If units are relevant in your setting.)
Micro-noticing task.
As you listen, write down:
the exact normalising line,
the alcohol question,
the drug question,
one phrase that keeps the patient comfortable.
You’ll use those phrases in your own speaking and writing later in the lesson.
Practice & Feedback
Listen to the short home-visit extract. Then do two things:
A) Write the three key questions/lines you heard (copy the wording as accurately as you can):
the normalising or reason line,
the alcohol question,
the recreational drugs question.
B) Maya says, “Oh, not much, just a couple sometimes.” Write one calm follow-up question that clarifies the amount without sounding judgemental.
Aim for 4–6 lines total. Keep everything in the same home-visit scenario with Maya.
3. Mental health questions and handling hesitation.
Let’s move to mental health. For many patients, this is the most sensitive part, and it’s also where your phrasing has to be both gentle and clear. You don’t want to hide the question, but you also don’t want to sound alarming.
A very useful approach is to start broad, then become more specific, and to give the patient space to answer. In English, that often means using a supportive lead-in, a simple question, and then a follow-up that checks risk if needed. When a patient hesitates, your job isn’t to fill the silence with pressure. Instead, you can acknowledge the difficulty, offer options, and slow the pace.
On screen, you’ll see examples of respectful wording for “feeling low” and self-harm thoughts, plus a few lines that help you respond when the patient avoids the topic. After that, you’ll write your own short sequence: two questions and one supportive response, keeping the same patient, the same home visit, and the same calm tone.
From general wellbeing to risk (without sounding dramatic).
In this part of the home visit, you’re still speaking to Maya. You’ve covered routine lifestyle questions, and now you’re checking mental wellbeing.
A safe, patient-friendly pathway often looks like this:
Coping / day-to-day (opens the door)
Low mood / hopelessness (clear but not labelling)
Risk check if indicated (direct, calm, unambiguous)
Language that works (chunk-bank aligned).
You can use these exactly as they are:
“How have you been coping day to day?”
“Have you been feeling low or hopeless recently?”
“Have you had any thoughts of harming yourself?”
“Thank you for telling me; we can take this one step at a time.”
Notice how the questions are simple and concrete. That matters under stress.
What to do when the patient hesitates or avoids.
Avoidance can sound like:
“I don’t know.”
“I’m fine.” (but the body language suggests they’re not)
“It’s complicated.”
Rather than pushing, try one of these moves:
Acknowledge + give control
“That’s a difficult question. Take your time.”
“You don’t have to answer everything today.”
Offer options
“Would it help if I asked it in a different way?”
“Would you prefer to talk about this when we’re somewhere more private?”
Clarify gently
“When you say ‘fine’, do you mean you’ve been managing, or that you’ve not had any low days?”
Mini model (3 turns).
Clinician: “How have you been coping day to day?”
Patient: “I’m managing… I guess.”
Clinician: “Thank you. Have you been feeling low or hopeless recently? Take your time.”
Your goal in this block.
Write a short sequence that keeps Maya comfortable, but still collects essential information.
Practice & Feedback
Write a short 3-line sequence as if you are speaking to Maya on the home visit:
Ask one general coping question.
Ask one clearer mood question (low/hopeless).
Maya hesitates and says: “Um… I don’t really want to talk about it.” Write your response to that hesitation.
Your response should be supportive and give Maya some control, but it should still keep the consultation moving. Use at least one phrase from the chunk bank (you may adapt it slightly). Keep the language simple, calm and non-judgemental.
Supportive responses you can borrow.
“That’s a difficult question. Take your time.”
“Thank you for telling me; we can take this one step at a time.”
“You don’t have to go into detail right now. A general sense helps me support you.”
“Would you prefer to speak privately?”
Reminder: core mental health questions (use if appropriate).
“How have you been coping day to day?”
“Have you been feeling low or hopeless recently?”
“Have you had any thoughts of harming yourself?”
4. Privacy, confidentiality limits and safeguarding language.
Now we’re going to handle a key safety skill: explaining confidentiality and its limits in plain English. On a home visit, you may not know who is listening, and the patient may be worried about consequences if they share something sensitive.
At B2 level, you can do this well by using short, clear sentences. First, reassure: what they tell you is confidential. Then add a carefully worded limit: if you are worried about their safety or someone else’s safety, you may need to share information with the right people. This isn’t a threat; it’s a safety promise.
You’ll listen to a short extract where Maya hints that things at home are not entirely safe. Notice how the clinician offers privacy, asks a safeguarding-style question, and then explains confidentiality limits without sounding frightening.
After listening, you’ll write your own version of a confidentiality explanation plus one next-step line, as if you are keeping Maya safe and informed.
Confidentiality on a home visit: clear, calm, and honest.
When you ask safeguarding-style questions, patients need to understand two things:
Most of what they say stays private.
There are safety limits.
You should not over-explain with legal language. Aim for plain English that builds trust.
Core phrase (chunk-bank).
“What you tell me is confidential, unless I’m worried about your safety.”
This one sentence is strong because it’s short, clear, and focused on safety.
Add two helpful details (optional).
If the situation needs it, you can add:
“If I do need to share something, I’ll explain what I’m doing and who I’m contacting.”
“My aim is to help and keep you safe.”
Offering privacy without making assumptions.
In a home environment, you can’t assume the patient is alone.
Try:
“Is now still a good time to talk?”
“Would you prefer to speak privately?”
“We can step into another room if that’s easier.”
Safeguarding-style question (neutral, not leading).
“Is there anyone at home you don’t feel safe with?”
Notice it doesn’t accuse anyone. It gives the patient space.
Listening task: notice the sequence.
In the audio, look for this order:
offer privacy
ask the safety-at-home question
confidentiality + limit
supportive reassurance
This sequence feels safe because the patient is not pushed into disclosure without understanding the frame.
What you’ll produce.
You’ll write 2–4 lines that explain confidentiality limits and what you’ll do next, using calm, everyday language.
Practice & Feedback
Listen to the short extract. Then write 2–4 lines you could say next to Maya.
Your lines must include:
an offer of privacy (one sentence),
the confidentiality statement with its limit (use the chunk-bank phrase exactly or very close), and
one calm next-step line (for example, “we can talk through options”, or “I may need to get support to keep you safe”).
Keep the tone supportive, not threatening. Imagine you are speaking quietly and respectfully in a living room where someone might be nearby.
5. Chat-style home visit simulation with Maya.
You’ve now built the key pieces: you can introduce sensitive questions, ask about alcohol and drugs neutrally, check mental wellbeing, and explain confidentiality limits. The next step is to put it together in a short, realistic simulation.
In this block, you’ll write a chat-style conversation with Maya. Think of it as a mini OSCE in writing: you need to sound human, not robotic, while still being safe and structured.
Here’s what I want you to practise in the conversation. First, a routine transition line that normalises the questions. Then ask two sensitive questions, but keep them gentle and clear. When Maya hesitates or answers vaguely, respond in a way that lowers pressure but still moves forward. Finally, offer privacy and include the confidentiality limit line if the topic becomes safety-related.
Don’t worry about being perfect. Focus on: calm tone, neutral wording, and a clear next step. After you write the conversation, you’ll get feedback and an upgraded version you can reuse in real practice.
Simulation: the same home visit, now in one continuous flow.
You are still on the home visit with Maya Patel (39). You’ve discussed sleep and headaches. Maya looks tense and keeps glancing towards the hallway.
Now you’ll run a short section of the consultation in a chat-style script.
What “good” looks like here.
A strong script usually includes:
Transition + reason + normalise
“We ask everyone these questions as part of routine care.”
“I ask these questions because they can affect your health and treatment.”
Neutral questions
alcohol: “in a typical week”
drugs: “at all”
Mental health check
coping day to day
low/hopeless
risk check if relevant (keep calm)
Handling avoidance
acknowledge difficulty
offer choice (pause, privacy, come back to it)
Safeguarding and confidentiality
“What you tell me is confidential, unless I’m worried about your safety.”
Mini language bank you can copy into your script.
“Thank you for telling me; we can take this one step at a time.”
“Would you prefer to speak privately?”
“Is now still a good time to talk?”
“How have you been coping day to day?”
“Have you been feeling low or hopeless recently?”
“Do you use any recreational drugs at all?”
Your target length.
Write 8–10 turns (each turn is one message from clinician or patient).
Keep it realistic: short sentences, calm pace, and no lectures. Your goal is safe information-gathering and trust-building, not “winning” the conversation.
Practice & Feedback
Write a chat-style conversation of 8–10 turns (label each line Clinician: or Patient:).
Include these required moments:
A transition line that normalises sensitive questions and gives a reason.
One alcohol question and one recreational drugs question (neutral wording).
One mental health question.
Maya hesitates or avoids at least once (you create her line), and you respond supportively.
Offer privacy and include the confidentiality limit line if the conversation touches on safety at home.
Stay in role as the clinician on a home visit. Aim for a calm, non-judgemental tone and simple, clear sentences.
Communication cues: embarrassed; glances towards the hallway; answers briefly
Useful phrases to include (choose at least three):
“We ask everyone these questions as part of routine care.”
“I ask these questions because they can affect your health and treatment.”
“How have you been coping day to day?”
“How much alcohol would you say you drink in a typical week?”
“Do you use any recreational drugs at all?”
“Would you prefer to speak privately?”
“What you tell me is confidential, unless I’m worried about your safety.”
“Thank you for telling me; we can take this one step at a time.”
6. Writing a brief factual note after the visit.
To finish, you’ll turn the sensitive information into a brief, factual clinical note. This is where careful wording really matters. In documentation, we avoid judgemental labels, we record what the patient said as clearly as possible, and we show what we did next.
Think of your note as answering four practical questions for the next clinician: What was asked? What did the patient report? What is the risk level based on what you know right now? And what is the plan? You can communicate uncertainty safely by being specific about the source: “patient reports”, “patient denies”, “unable to clarify today”.
In this block, you’ll see a short model note style and a mini rubric. Then you’ll write your own note for Maya’s home visit. Keep it concise, readable, and professional. If you mention safeguarding, be especially clear about actions and next steps, without speculation. After you write, you’ll get corrections and an upgraded version you can reuse at work.
From conversation to documentation: factual, neutral, and safe.
You’ve completed the sensitive part of the home visit with Maya Patel (39). Now you need to document it.
A good note is not a story. It’s a clear record that supports safe care.
Plan: agreed follow-up call within 48 hours; provided contact details for urgent support if feeling unsafe.
Mini rubric (self-check).
Before you submit your note, check:
Clarity: could another clinician understand it quickly?
Neutral tone: no judgemental language.
Key facts: what was asked + what was said + relevant negatives.
Next steps: what you did and what happens next.
Your task.
Write a brief note for Maya’s visit. Keep it short and clinically realistic.
Practice & Feedback
Write a brief clinical note of 90–130 words about the sensitive-question part of Maya Patel’s home visit.
Include:
a date/time line (you can invent a realistic time),
alcohol and recreational drugs information (even if negative),
mental health check (coping/low mood and, if you choose, a risk check),
any privacy/confidentiality/safeguarding point that came up, and
the plan / next steps.
Use neutral documentation language such as “patient reports/denies/declined”. Avoid judgemental words. Keep it factual and readable, as if it will be seen by colleagues.
Suggested note starters (choose what fits).
“Home visit dd/mm/yyyy hh:mm …”
“Sensitive questions introduced as routine; reason explained.”
“Patient reports…” / “Patient denies…” / “Patient declined to discuss further today.”
“Offered private discussion.”
“Confidentiality explained, including limits for safety.”
“Plan: … Follow-up: … Safety advice: …”
Facts you may use (choose and adapt).
Alcohol: “approx. 2 drinks in an evening, 1–2 times/week”
Recreational drugs: “denies”
Mood: “feeling low at times” / “poor sleep”
Safety at home: “hints situation not always easy; no detail today”
Next step: follow-up call / GP appointment / signposting to urgent help if unsafe
