How should I talk about death to a loved one who has a terminal illness?

Katie Ortlip
Hospice Nursing

First of all, not all people with terminal illnesses want to talk about death. Everyone is different in how they cope and how much they want to share. If someone has been very private or has tended to deny problems, they may never talk about dying. On the other hand if someone has usually been up front and faced problems head-on, they probably will want to talk. Some suggestions:

Start where the person is! That is, let the person lead the way.

Listening is the best thing you can do. Listen more than talk. 

Keep showing up. People who are terminally ill fear abandonment. By continuing to visit you are showing the person that you are not afraid and when he or she is ready to talk, you'll be there.

Don't give advise unless asked.

Resist the urge to cheer someone up or deny his or her feelings.

Use open-ended questions/statements that may help the person open up:

  • Tell me how you are feeling...
  • I'm here to listen if you need to talk.
  • I'd like to understand what you are going through.
  • What are your biggest concerns/worries/fears?
  • What is the most difficult thing for you right now?
  • Tell me how I can help.

Remember, sitting quietly with your loved one can be more important than any amount of talking!

Clearly, not everyone who is terminally ill is ready to talk about death. So how will you know when to talk and what to say to your loved one? Below are some words that may help you. Your task in this difficult time is merely to open the door to this conversation and promise to stay for it if the person you care for wishes to talk.
  • Look for openings. A song you heard, a book you read, or the way someone else's illness and death unfolded can be an opportunity for remarks that open the door. By commenting, you signal that you're ready to talk and needn't be protected.
  • Broach the topic gently. Elisabeth Kübler-Ross, psychiatrist and author of the book On Death and Dying, describes conversations with dying patients that start with the simplest question: "How sick are you?" While you may be too close to reasonably make that inquiry, there are other questions you can ask: "What do you worry about?" "How can I help?" "Is there anything you want to talk about?" Try not to rebuff tentatively expressed fears with hearty assurances, such as "That's a long way off" or "Of course you're not a burden." It might help instead to ask more specifically, "What are you thinking about?" If your loved one is receptive to talking about these issues, you may wish to open the door to questions like "What would be a good death?" Sharing your own thoughts on this may help.
  • Talk with your religious leader or hospice and hospital counselors. Priests, rabbis, and other religious leaders can offer real comfort to believers. Even people who do not regularly attend religious services may turn toward their faith as an illness progresses. Hospice workers and hospital social workers can also help you and the person who is ill grapple with the issues surrounding death. Even if you have chosen not to use a full range of hospice services, some resources are often available.
  • Ask a doctor to help. A doctor's reassurance about how physical symptoms might unfold and how pain will be handled can be invaluable. Some doctors can ask gently about fears, as well. Realize, though, that it's not unusual for doctors (and nurses) to shy away from talking about death. Some feel determined to try everything and view death as a failure. Being human, they have their own fears and discomfort to deal with, too.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.