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Healthy Outlook

Talking to the Dying

By Linda Russell, LMFT

Wednesday, April 3, 2013

A while ago, a friend of mine I'll call Rob told me about an old pal of his who was in the hospital. His friend, Mick, was very ill and there was a good chance he wouldn't survive. Rob felt like he should see Mick, but he was reluctant. Even though the two had been friends for more than 40 years, Rob said he didn't know what to say.

I could tell Rob knew what he wanted to do, but he needed a nudge. "How would you feel if Mick died before you got a chance to see him?" I asked.

Rob eventually went to see Mick. While Rob was profoundly sad to see his friend dying, he was incredibly glad that he went. When Mick passed away, Rob was at peace.

From my experience as a social worker in palliative care, which focuses on quality of life for patients with serious or terminal illnesses, I know there are many people out there like Rob who are nervous about talking to loved ones who are dying or have been given a short time to live. There is no simple formula for how to have a conversation about death or how to comfort the dying. I learned this from my own personal experience when my late husband was diagnosed with bladder cancer. In life, beginnings are always easier than endings.

Let me offer a few tips on how to have end-of-life conversations and also some ways to offer help to the terminally ill, their partners and immediate caretakers.

  • Listen: I think a lot of friends and family members are paralyzed by the thought that they must have "the big conversation" when their loved one is ill. But often, simply being there is enough. Don't worry about what to say. Just go and be with your loved one and listen to what he or she has to say. Talk about what they want to talk about.
  • Help them enjoy life: People who are extremely sick miss out on the little pleasures that made life enjoyable. So if they miss going to A's games, take them to an A's game. If they're too sick to go to the ballpark, have a "tailgate" party on your porch and watch the game at home. Get creative. Remember - quality of life still matters even when life is changing.
  • When offering help, be specific: So often friends and family will say "Let us know if you need anything." When my husband was sick, I was so overwhelmed that I often couldn't think of what to ask for. People can help by offering to do errands, watch the kids, cook dinner, or drive the sick person to a medical appointment.

I should acknowledge that some people choose not to see a dying loved one because they want to hold onto the memory of the person before he or she became ill. If that is what they choose, this should be a conscious decision, not fear-driven. I think many people are like Rob – they want to come and be with that person, but they are afraid to do so for a variety of reasons. For those folks, my advice is to try not to worry about what to say. Sometimes just being there for someone says more than words ever could.

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at For more health information, go to
About the Author
Linda Russell is a Medical Social Worker and Licensed Marriage and Family Therapist.