Chapter 3: Conversations as the disease progresses

Talking to the person who is dying

She began to sleep more and more; and when awake, she was often confused and irritable. I felt I was losing her slowly, day by day. Over and over, I was saying goodbye.

Knowing what to say to someone who is dying and when to say it can be difficult. The ideas on the next two pages may be useful at any point during a serious illness, but especially when the person is not expected to live more than a few weeks or days. Click on each suggestion for more information.

Some people who know they are dying avoid talking about it right up until the moments before death. It’s important to recognize that this is a valid choice and to respect it. More often, however, people who are dying feel respected and supported by openness and honesty in conversations. They may talk about symptoms such as pain, shortness of breath, or nausea. They may wonder what to expect when death is near. Rather than avoiding these concerns, acknowledge that they must be worrisome. You might say, “Tell me more about what you are experiencing,” or ask, “What do you think is happening?” You could add, “This would be important to discuss with your doctor. Can I help you make a list of questions for the doctor?” 

Inviting the person to share information from the healthcare team can lead to open conversations about the progress of the illness and an opportunity to ask, “What do you need most from me (or from other friends and family members, or from the healthcare team) now?” If the person has difficulty answering this question, offer examples of the support you could provide – perhaps being present and listening, running errands for the family, or helping with housework. 

Ask the person if there is anyone they would like to talk to by phone, via internet, or in person. This may include a visit from a religious leader in the person’s faith community, or the spiritual care provider in the hospital or hospice.