The Hardest Talk of All: How to Engage in an End-of-Life Discussion

Published Thursday, August 1, 2019

At some point, all of us confront the time when a close relative or friend is dying and we ask ourselves: What should we say? What shouldn’t we say? Should we say anything at all?

Every family is different. Each family’s history, and the dynamics of relationships among family members will be determinants in what gets addressed, what has been left undone, and what might invite discord. No one wants to be seen as the protagonist of harshness. Beginning these conversations is, admittedly, often not easy.

Some people are fortunate in being able to approach their dying process at peace with themselves and with those they love. But that’s not always the case. Some may rage against being cheated out of life. Some may feel frightened, confused, and anxious, making it difficult for them to express what they want and need. This can make it difficult for family members to make medical and caregiving decisions. People who are dying may worry that sharing their end-of-life wishes will be a burden to loved ones, when, in fact, it can ease important decision-making.

This is also a tumultuous time for the relatives of loves ones. Family members who have been estranged may regret that they have wasted time and now there is a limit to what can be done to repair relationships. Some may want to confess to things that have happened in the past, or to ask for forgiveness. This can be painful but also powerfully healing.

The Gift of Listening

When facing the situation of a close family member or friend dying, remember that those who are dying want to be understood and accepted like anyone else. They have “soul needs” – to feel heard, cared-for, connected, and emotionally safe.

The most important gift you can give to a seriously ill or dying person is to listen. Here are a few golden rules of good listening which can help you open up communication:

  • Be honest. Often in difficult situations we tend to search for the ‘right’ thing to say. Or we deny what’s happening and make a joke. While such reactions are understandable – humor has an important place, even in death – serious illness and dying is a profound process. The act of just being there, perhaps, holding a hand, and sharing ourselves openly can be very soothing for the dying person.
  • Use engaged body language. Don’t be afraid to look your relative or friend in the eye. Be alert and attentive to what he or she is telling you, and the way he or she is saying it. Listen to his or her tone of voice and be aware of his or her willingness to engage with you and to meet your eyes. Try to respond to what you think is really being asked for and needed.
  • Stay calm. Ground yourself by planting your feet firmly on the floor. This will help you to be present and accepting.
  • Don't fear tears. It’s okay to cry. Being brave enough to express yourself can have a powerful healing effect on your relationship, as well as give your relative or friend permission to grieve for the life he or she is leaving behind.
  • Don’t steer the conversation; just let it happen. Just your presence lets your loved one know that you will be there for them. If you feel anxious, you might consider having a practice conversation with someone you trust or start by writing a letter to your dying loved one so you can shape what you want to say.

Finally, YES, have the conversation with your loved one. It is in your loved one’s best interest—and in your best interest to share true feelings and to acknowledge the important roles you’ve played in each other’s lives. Separation is hard but creating a sense of closure—and even celebration—of the life you’ve lived together can make an ending that is painful somewhat comforting.

Heidi Weiss, LMSW, MHA, is Coordinator of WJCS Addressing Alzheimer’s and Health and Healing Support. For information about end-of-life care, please email [email protected].

This article was first published in Westchester Jewish Life and is published on with the permission of Westchester Jewish Life.


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