People commonly experience confusion as serious illnesses progress. Clocks or calendars can be brought in to help a person remember what day and time it is, but the person may still be confused about where they are or who visitors are – even if those visitors are sons and daughters or lifelong partners. This can be very difficult for family members and close friends; it may feel as though you have already lost the person, even before they have died. If you can manage it, try to calmly reassure the person that everything is alright. You can continue to provide support to the person and take part in conversation, even without being recognized. 

If the person seems anxious or uncomfortable, you could offer gentle reassurance or acknowledgement. One way to approach a person who seems stressed and in need of support might be "How are you doing? You seem different today."

In the hours before death, the person may be no longer conscious. Family and friends should feel free to speak to the dying person in any case. No one can be sure whether the words will be heard or not, but even the act of speaking to them can provide comfort to family and friends who wish to say goodbye.

Sometimes people who are nearing death seem to want reassurance that it is okay for them to die. They may feel they cannot die – not while a family member is still convinced they will come home one day. "It’s okay, you can go now" or "We are going to miss you terribly, but we will be all right" are words that may lead to a sense of calm or acceptance in the person who is dying.

Sometimes the dying person may feel that they are the glue holding the family together. Letting them know that the family will continue to stay together can provide needed reassurance and a sense of peace. If the healthcare team says that death is very near, but the person seems to be hanging on, you might consider providing reassurance that it is all right for them to die.