Talking to someone who is dying

Some people may not die the way that they would wish to. This is not just difficult for the person who is dying but it is also difficult for the people that love and care for them. You may feel dreadfully sad and unsure about what to do. Sometimes people wonder if they should speak to the dying person about what is happening to them or if it too sad or upsetting. Other people may wonder if the dying person will still want to see them when their time is so short.

However, it’s generally true that, in the long run, you hurt people more by the conversations you don’t have than by the conversations you do have.

Beginning to talk about dying takes courage and effort. It involves accepting things are coming to an end and dealing with strong emotions like love, fear and sadness. But most people say it is a relief to talk about it openly and be direct and honest. It can bring people closer together when they talk honestly about death and share their fears and hopes.

It can also help to talk about practical arrangements such as whether the person has made a will or if they would like to make one, what their wishes are for their funeral, care arrangements for dependents, or donating organs.

Things to keep in mind

It’s likely that the person who is dying has been thinking about subjects such as their care, and how they would like to be buried or remembered for a while, even if they have not shown it.

Watch and listen for signs that the person would like to talk about things- they might say things like ‘Well, I guess things are coming to an end now’, or ‘things seem very final at the moment.’ Or they may hint at being frightened of dying. If this happens, don’t shut the conversation down by reassuring them that things will be fine. Show them that you are willing to talk and listen. Don’t be afraid if one of you starts to cry. This is a normal, natural reaction to what you are dealing with.

These can be difficult subjects to discuss- they can be emotionally and physically exhausting for everyone. You don’t have to cover everything in one discussion. You might cover these topics over a few smaller conversations.

Sometimes people worry about getting it wrong with a loved one who is dying. If you like, try discussing it with someone else you love or trust, like a friend or a nurse.

Getting the conversation started

Choose the right place, and the right time. No one finds it easy to talk if they’re feeling particularly stressed. If possible, try to be in a place that is private, quiet, and as comfortable as possible.

If there’s time, it’s best to wait until there is an obvious indication from the other person that they want to talk. But when time is short, you may need to raise the subject directly.

Be honest about how you are feeling. You could try starting the conversation by saying something like, “I know talking about these things is never easy.”

Sometimes people are not ready to talk about how ill they have become. One good way to provide an opening is to ask the person how they feel about their illness, or their progress, and what they hope for in the next few weeks.

If the other person clearly doesn’t want to talk, or openly face the fact that they are going to die, you do have to respect that.

Listen to the other person, and show you are listening, for example by nodding your head. It’s good to be reassuring, but try not to overdo it or be unrealistic. For example, if you say “Don’t worry”, it might stop the other person from talking and being open about anxieties because their situation is serious and worry is going to be a part of that. Instead of saying “Don’t worry” perhaps try saying “I understand” or “I’m so sorry you are going through this.”

Try not to offer advice – things you might find helpful may not suit other people.

Try to avoid expressions like ‘I know exactly what you mean’ or ‘I have felt like that before’.

Don’t fill silences: gaps in conversations can provide people with the opportunity to bring up things that are worrying them or on their mind. You can show that you are there for the person and ready to listen by smiling or giving them a gentle touch. It takes courage and extra energy to do this but it can be very supportive to the dying person.

Starting a conversation about dying

Here are some ways that you can open up a conversation about dying or about someone’s fears or emotions:

  • How are you feeling about your situation at the moment?
  • Are you finding this difficult?
  • You must be feeling a lot of emotions at the moment?
  • Is there any one thing worrying you the most?
  • Do you feel frightened all the time or just sometimes?
  • Is there anything you want to talk about?
  • Is there anything that you want us to know?
  • Is there anything that helps you feel calm?

 

Questions about what will happen

Sometimes the person who is dying will have specific questions about what will happen to them in the final days or hours. You can tell your loved one, “I don’t know, but we can call someone who can help us with those questions.” For answers to these questions and concerns, it may help you to speak to the palliative care team. This can be either in the hospital or by contacting the home care team through your GP or a hospice care nurse.