Sharing the last days and moments of someone you love can be confronting and scary, but also fulfilling and healing. Experts in end-of-life care share their advice on how to support loved ones on their final journey.
1. Keep it real
People who are dying are mourning – the loss of their future, their sense of purpose and their relationships. “They experience an extreme sense of loss and aloneness,” says Leanne Skipsey, an expert in Death Literacy, who runs discussion groups for people to meet and talk about dying and death.
The dying person is integrating a whirlpool of emotions; you can offer support simply by being present and listening. If the person has a long illness, they may move from feelings of hope for a recovery through to acceptance. The best approach is to be open, honest and authentic, Skipsey says. “Sometimes the dying person is the only one who’s honest about the fact they are dying, and everyone else isn’t ready to come to that realisation. It’s really refreshing for a person who is dying to have people around who are able to be real with them.”
- “I don’t know what to say.”
- “I’m deeply saddened about your situation.”
- “I love you and I am here for you.”
- “I’ll do what I can to help you to be comfortable and not suffer.”
2. Healing difficult relationships
There is nothing like the prospect of death to cut through the long term grievances that get in the way of people healing the rift. Yet the decision to repair a relationship must be a decision for the person who is dying and it’s important that you enable that to happen. “You won’t get this time back. Make that contact or you’ll regret you didn’t do it,” says Mary Waterford, coordinator of pastoral care at the hospice Clare Holland House. “It’s about offering yourself back into that relationship. Stand steady, feel the fear and do it anyway.”
Even if your contact is initially rejected, remember that he or she is dealing with a storm of feelings and emotions and may feel that facing you is just too hard. People who are dying are less able to deal with conflict, but chances are they will want to reconnect and forgive or be forgiven. So don’t be afraid to gently, carefully and compassionately create the opportunity for that to happen.
- “It’s unfortunate we went through this situation, but I really want you to know that I love you and respect you.”
3. A difficult conversation
Often when a person is dying they find that everybody around them wants to change the subject for fear of upsetting them. Yet for them, being able to express what they are really feeling can be incredibly powerful. Simply being with the person and listening may be the greatest gift you can give.
Don’t worry too much about finding the perfect words. Listen from a place of acceptance, compassion and non-judgement about what they need to express – whether it’s sadness, exhaustion, anger, guilt, shame or loss of purpose.
Help them to remember and celebrate their life, to reflect on what has happened and to acknowledge it has all been worthwhile. Dying can be a very lonely experience, and often what people want to hear is that they will be loved and supported until the end.
“Begin to explore what’s scaring them,” says Liz Arnott, a social worker at a children’s hospice. “You can reassure them that the medical side of things will make them more comfortable, that they will be surrounded by people who love them and they’re in a safe space.”
The four phrases identified by US palliative care physician Ira Byock as mattering most in our lives are especially important at the end:
- “Please forgive me.”
- “I forgive you.”
- “Thank you.”
- “I love you.”