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How to talk to someone who is seriously ill or dying
Experts explain how to maneuver through these very difficult conversations and suggest the best ways to offer support.
There is nothing easy or simple about facing death. And when a friend or loved one is diagnosed with a terminal illness, your whole world can shift. You might have a hard time finding the right words. You may have no idea how best to support them, even though that’s all you want to do.
First, it’s important to know that you — and your loved one — aren’t alone. About 90 million Americans are living with serious illnesses. And an estimated 6 million of them could benefit from palliative care, says the Center to Advance Palliative Care (CAPC).
Only a person living with a terminal illness knows what it feels like. But for them, and their loved ones, the emotions can feel a lot like grief, says Kevin Stowe. He’s a bereavement manager for hospice provider VITAS Healthcare.
“Some people might react with peace, calm, acceptance, resignation or determination to make the most of the time that remains,” Stowe says. “Some will question their religion, while others will turn to their spirituality to cope. Some will turn inward to protect themselves; others will turn outward to manage their affairs, find closure, pursue their bucket-list wishes and say necessary goodbyes.”
No matter how someone chooses to process the tragedy, one thing is for certain: Your loved one needs you now more than ever.
But you also want to be there emotionally. If you don’t know where to start, we’re here to help you have those difficult conversations and show your unconditional love.
Listen before you speak
When your loved one first receives a life-changing diagnosis, remember that your interactions should be about them — not you.
“First, take cues about how much they want to talk,” says Stowe. “Sit in that hard place with them without giving direction, without giving advice and without pulling them out. Just let them stay there and be present with them for as long as they need you. That is truly one of the best things you can do.”
Just being genuine and listening to their fear goes a long way, adds Andrew E. Esch, MD. He’s a senior education adviser at CAPC.
But that isn’t to say you shouldn’t say anything at all. When you do speak, keep it simple. “Instead of patronizing them, try saying things like, ‘I wish this wasn’t happening to you,’ or ‘This must be hard news for you to share,’ or ‘I’m here for you,’” says Stowe.
Refrain from offering advice
You can empathize and be there for them. But you can’t assume to know what’s best for them.
Give your loved one the space they need to verbalize their own needs. It’s okay to admit that this is also new and scary territory for you, Stowe says. Ask for their guidance about how you can be the person they want and need you to be at this time.
Dr. Esch adds that you need to realize that their situation isn’t something you can fix. “All you can give is support,” he says. “Tell them that even though you don’t know what the next weeks or months hold, you will be there for them every step of the way.”
Advice is best when it’s asked for, not offered. “You’re not inside their head,” Stowe explains, “so you don’t know what they need.” If they want advice, they’ll ask for it.
Avoid common clichés
Most grief and bereavement experts agree that it’s wise to avoid certain comments while speaking to someone with a terminal illness.
Stowe offers a few common phrases that may come off as insensitive:
- “Everything will be okay.” You can’t guarantee anything; what happens is out of your hands.
- “Everything happens for a reason” or “It’s God’s will.” These kinds of clichés and platitudes are often not helpful. And to those who do not embrace organized religion, these words can even be counterproductive.
- “I know what you’re feeling.” Only your loved one knows how they feel. And each person’s reactions are unique.
- “How do you feel?” This is a common question that can be frustrating for somebody you already know is not doing well.
- “Call if you need anything.” This might seem like a supportive thing to say. But the best approach is to simply offer to do whatever needs to be done. Let your friend or loved one give you ideas about how you can help — and then follow through.
Plan your visits around their needs
Just stopping by may not be the best move right now. If you plan to visit, call your loved one ahead of time and ask for specifics about when you should arrive and how long you should stay, Stowe advises.
This news can also create a new relationship dynamic. But try your hardest not to make things awkward. Greet them as you normally would. Make eye contact when you visit and engage in the same behaviors (hugs, handshakes, air kisses, elbow bumps) that you always have, Stowe suggests.
It’s also important to note that your loved one’s health and emotional state can change daily. Always let them know that you really care and want to understand what they’re facing today, Stowe says.
Make yourself available when they need you the most. “Let your friend or loved one know that you’re available whenever they need,” adds Stowe. Maybe they need someone to listen, talk to or just sit with them in silence. “Some wonderful conversations can arise out of silence.”
Manage your personal feelings
You’ve probably heard the saying a million times: You can’t help others until you help yourself — and that couldn’t be truer than in this situation.
Loving and supporting someone who is dying or suffering because of an illness can take a huge toll on your mental health. To provide the best support that you can, you have to take care of yourself, too.
“Your job is to face your own emotions,” Stowe says. This process is known as anticipatory grief. It’s essentially the emotions you face while watching a loved one slip away, knowing you can’t do anything about it.
If you need some extra help navigating this difficult time, consider speaking with a friend, spiritual leader or mental health professional. They’ll be there to listen and help guide you in managing your feelings and needs.
You must also find ways to cope with this grief, Stowe says. “Create your own emotional space for self-care and allow your friend to carry some of their own burdens,” he adds. That’s what will allow you to be a better caregiver and supporter in the long run.
It’s also okay to ask for help if you’re feeling burned out. After all, there are other ways to make sure your loved one is getting the help and support he or she needs. “If your loved one is referred to hospice care, an entire team of professionals will help address the physical, emotional and spiritual issues linked to the diagnosis,” Stowe says.
Maintain a sense of normalcy
Terminal illnesses can be all-consuming. And they can make people feel very removed from their everyday lives. “Encouraging people to not become their diagnosis is so important,” Dr. Esch says. “When it comes to serious illness, we talk a lot about quality of life, but without life, there is no quality.”
Try to remind your loved one of the essence of who they are. “If they’re a teacher, talk to them about teaching,” Dr. Esch adds. “If they like to work out, offer to do that with them. Support them in doing the things that are meaningful to their lives.”
At the end of the day, your loved one is still their own person with their own needs and opinions. You can walk this road with them, but you can’t walk it for them.
When it comes to treatment and serious illness, your loved one may make decisions that you don’t necessarily agree with, but it’s not your place to judge, Dr. Esch says.
“You have to put their needs and desires first,” he says. “Your role as a close friend or family member is to help the patient find their way, not become yet another hurdle for them to jump through.”
Palliative care facts and stats: Center to Advance Palliative Care
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