Talks At The End Of Life (Conversations No One Wants To Have)
Someone you care for is at the end of his or her life. How do we talk with someone who is dying? No one is ever really prepared for conversations near the end of life. What do we say and how do we say it? These are very important talks for both the living and the dying.
Our own emotional vulnerability makes it difficult to find the right words and to avoid awkward displays of grief. While it is not our role to create meaningful moments of conversation, we can bring comfort to the dying person by recognizing and respecting their attitudes and feelings.
Conversations will be shaped by our intentions to create the best possible day we can. The reality cannot be changed, but we can be open to what’s possible, such as creating or embellishing positive experiences. Our role is to comfort within the limits of a situation we cannot change. That includes accepting the situation with our words and our silence.
Initiate conversations with general inquiries. Be as natural as the situation allows. Remember that 90% of communication is non-verbal so your body language needs to be receptive and congruent with your words. Sit close, relax, lean in, make eye contact and stay connected with the conversation. Accept any topic, no matter how mundane or profound. When you identify a thread, listen actively and follow it.
One of the greatest kindnesses we can offer a dying person is to listen attentively to whatever they want to talk about. They get to choose the topic, the depth and the duration. Our task is to be present and understand their meaning. Here are some ways to engage:
Restate your understanding of what was just said:
“Things have been difficult, but today it seems better.”
“Your nausea is ruining your appetite.”
Paraphrase the essence of what you heard:
“It sounds like you’ve had a rough couple of days.”
“You really miss your dog.”
Reflect back the feeling of what was said:
“It sounds like you really miss your grandchildren.”
“It’s exhausting to have so many medical procedures.”
Avoid interjecting new topics or questions because they may shut down the conversation. Follow the person’s conversational threads into new topics or periods of silence.
During these conversations, emotions can become intense. They need to be accepted and expressed. If you are concerned that your feelings or expressions of grief may be too much for the person, here are a few examples that may help:
“This is hard for me.”
“It’s hard for me to see you suffer.”
“You mean a lot to me.”
“It means a great deal to me to be here with you.”
You can always facilitate a conversational thread by telling stories, laughing, crying, praying or sitting still.
Stories about the dying person’s life provide invaluable comfort.
They inspire memories and each telling provides an opportunity to recall or share meaning and connections. Enjoy embellishing these stories with pictures, music and people.
Each conversation with a dying person is a gift. Simply hold your intention for care and comfort and be grateful for the opportunity and the time together.