Finding the words

What do you tell someone whose life is nearing its end?

There is no “right” or “wrong” thing to say; it’s a matter of finding a way to express your feelings and, hopefully, allow the dying person to do the same.

Many people don’t want to talk about death. It’s scary. It’s sad. It’s uncomfortable to discuss. Most of us aren’t used to seeing people die, the way elderly relatives used to do at home, encircled by loved ones. We’ve come to expect a cure or treatment for just about every illness, and that makes end-of-life conversations less likely to happen.

Sometimes a critically ill just person doesn’t want to “go there,” and it is important to respect his or her wishes. On the other hand, Ned Cassem, MD, a psychiatrist and Jesuit priest based at Massachusetts General Hospital, has said that “death actually has the secret of life in it. If you confront death with somebody you love who is dying, out of that will come learning that transforms your life. It leaves you stronger, braver, calmer.”

Anne, a Maine-based psychiatrist, had an experience like that with her grandfather, whom she adored. When he was dying, she went down to visit him in Florida, and they were able to affirm their special and enduring bond. This is how she described the goodbye to me:

“My grandfather was very ill, and he had a Do Not Resuscitate order above his bed. On the last day of my visit, I sat on his bed and said, ‘I don’t think I’m going to see you again, and I really want to tell you how much I love you and what you’ve meant to me.’ He was very weak and nearly asleep, but he raised his head from the bed and looked at me with such clarity and depth. For a moment everything was quiet and his eyes seemed to grow huge. Then he said, ‘You will always be a part of me.’

I told him that he would also always be a part of me, too, and that I would carry this love as long as I lived. This is one of my most treasured memories.”

Here are a few ways to spark a farewell conversation:

Bring along a photo or other memento (yearbook, scrapbook, etc.) from the person’s life and talk about it.

Offer to help the dying person write a letter to a child or someone else.

Collect memories or compliments from the person’s friends and family and read them aloud.

Say something along these lines: “This may be the last time we see each other, and I wanted to let you know how much you mean to me.” Or, “You’ve had an incredible life. Thank you for letting me be part of it.”