Saying goodbye to a dying relative or friend is no joke — What to say to someone who is dying, what to talk about, when, and how, this doesn’t come naturally to most adults. The irony is that all such conversations ask of us, ultimately, is what people appreciate hearing at any time of life: words of candor, reassurance, and love. Being confronted with a loved one’s illness or death brings us face to face with our own mortality and feelings of helplessness, as we try to figure out how to move forward in the face of the inevitable.
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Below is a guide on what to say to someone who is dying because sometimes, even with the best of intentions, we may not know what to do or say that will be of the greatest comfort to the person who is dying. We may not even know how to mentally prepare for conversations with a dying family member.
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First, the person who is dying usually knows that he or she is dying, and the secret is not to be afraid of that or to run away from it.
- Remind yourself that this is not about you. You may feel uncomfortable, but your loved one needs you. They may even be waiting for you to bring up the topic.
If the person talks about impending death either directly or indirectly through metaphor, go along. Don’t correct the person (No you’re not dying, But dear, we’re not going on a trip today, etc), Callanan advises. “It’s like trying to argue with a woman deep in full-blown labor,” she says. A helpful response like “Tell me more” is best
- Expressing anxiety about finishing certain tasks is akin to that did-I-turn-off-the-stove worry we all feel before going on a trip, she says. Follow the metaphor with reassurance: “You’ve done a good job; you’re all set.”
– Sometimes the person may ask, “Am I dying?” as a way of gauging your feelings. Instead of attempting to play God with a yes or no answer, reflect the question back: “I don’t know. How are you feeling?”
- Realize that the dying person usually knows what’s happening, Callanan says. “When those in the room don’t talk about it, it’s like a pink hippo in a tutu that everybody’s walking around ignoring. The person who’s dying starts to wonder if nobody else gets it. That only adds stress — they have to think about other people’s needs instead of dealing with their own.”
It helps to reassure the dying person that you understand and are ready; in a way, you’re granting the person permission to set aside the troubles of this world. That’s not to say you need to use direct language about death. The dying often use symbolic language that indicates preparation for an imminent journey or change, Callanan says. Especially common is talk about travel, preparing for a trip, or seeing a particular place, “as if they have a foot in two worlds.”
- Truth is good — but so is the little white lie. “I wish I’d been less direct,” says Elle, a thirty something consultant. When her mother, dying of lung cancer in Pennsylvania, asked her if she and her brother had reconciled after a long feud, she replied, “No, not really. Things are still rocky.”
“In retrospect, I wish I’d said something like ‘We’re working on it,” she says. “I think she was sewing up loose ends and wanted to know her children would go back to liking each other.”
- Being reassured that their loved ones will fare well in their absence helps people feel they can go peacefully, hospice workers say. It’s common to seek reconciliation with or between other people, with God or the universe, or within themselves. They often ask directly about particular relationships or express a desire to see someone they’ve been in conflict with themselves.
One Florida woman who was advised by a hospice worker to let her dying husband know she was OK with him leaving her snapped, “But I can’t. I don’t feel OK about it.” The professional then offered her alternatives that felt supportive but easier to say: “You look tired, sweetheart, please don’t worry about me.” “You’ve been such a fighter. If you need to rest, it’s OK.” “I understand what’s happening and it makes me so sad, but I’ll be all right.”
– You could talk about the person’s accomplishments or legacy: “I’m so proud to be your sister when I think of all the things you’ve done.” “We don’t like what’s happening to you, but you’ve shown us how to stick together and be OK.” Help your loved one see that he or she made a difference in the world or within a particular family, which satisfies the human need to feel our lives had meaning and purpose.
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- Don’t Forget to Say “I Love You”
“Connecting at that level has the power to convey openness, respect, affection and commitment,” Elster says. Marty Tousley agrees, pointing to the book The Four Things That Matter Most, by Dr. Ira Byock, professor of palliative medicine at Dartmouth-Hitchcock Medical Center in New Hampshire. Dr. Byock writes that dying people typically want to hear (and to say) four things: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you.”
- Be Truthful, But Kind
You don’t have to avoid talking about the fact that your loved one is dying. “It is very okay to say you don’t have answers to the big questions, or that you don’t know how to respond to some expressed need,” says Elster. “Always be truthful, but don’t clobber them with the truth.”
Most of all, you’ll want to let your loved one guide the situation. Says Dr. Doka, “It’s not so much the exact words you say as it is maintaining the openness of the conversation.”
- Encourage Them to Share Memories and End-of-Life Goals
Everyone is going to approach their mortality differently; some will find it most important to mend relationships with friends or family, while others will prefer to focus on remembering accomplishments or airing old regrets. Either way, it’s important to give your loved one a chance to open up and process what they have experienced, and what is to come. “People often approach death by making sure their life had significance,” says Dr. Doka. “Have conversations about the things they’ve learned, the legacies they’ve left, the memories you have of them. Help them feel like they were important.”
- Talk About How They are Feeling (and Listen)
Listening to your loved one is the first step to understanding what they truly need most. “As a caregiver, you can ask, ‘What do I need to know about you as a person to give you the best care possible?’” says Tousley. Elster agrees. “Let patients identify and talk about the things that they consider important,” he says. Ask them what they’re thinking about, what they may need – and if they need help in a concrete way, don’t hesitate, whether they ask for help with household chores or simply your company.
- Keep talking even if you’re not sure you’re being heard.
“My granddad was in a coma, and I felt I never got to tell him I loved him,” says a 38-year-old Atlanta engineer. “Later someone told me he probably could have heard me, and I’ve kicked myself ever since for keeping quiet.”
“Hearing is the last sense to leave the room, many studies show,” says Sherry E. Showalter, a hospice social worker in Tarpon Springs, Florida, and the author of Krumpled Kleenex: Stories of Heartache and Healing. That’s why you should always assume that a person who’s unconscious, in a coma, or seems otherwise unresponsive can hear you, she says. “Say what’s in your heart.”
- You can speak volumes without uttering a word.
It’s hard to say goodbye — but you don’t have to “say” anything. Most critical: Just show up. Be there.
Foot rubs, stroking an arm or shoulder, kisses, smiles, and gazing into someone’s eyes all communicate compassion, love, and gratitude for a shared lifetime. With or without accompanying conversation, your presence and your touch rank among the most eloquent, regret-free ways there are of saying goodbye.
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