Finding the right words: approaching the end-of-life conversation with a loved one

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Confronting end-of-life decisions is more a resolution than a choice – it takes resolve to face the harsh reality of one’s mortality. Some people are so uncomfortable with the very idea of death that they’re simply unable to deal with the practical and financial arrangements that must be made until death is imminent. That’s when a loved one can provide a steadying hand and help a close friend or relative deal with those final, bitter details.

It doesn’t have to be an emotionally overwhelming conversation if approached in a careful manner and with tact and good timing. End-of-life care considerations need to be worked out and funeral plans finalized. There may be unresolved financial and legal issues to resolve. These are always difficult subjects, but there are ways to alleviate some of the discomfort.

Coping with the grief

Anticipatory grief is a complex emotion. The individual in question is still with you but facing impending death. It can cause awkward situations in which it’s very hard to know what to say, or what not to say, around your loved one. You may feel depression, sorrow, guilt, anger and acceptance all at once, not knowing exactly what to say or do. This can make it difficult to make the most of their final days with you.

If you’re at a loss, try talking with sympathetic acquaintances who have been through a similar situation. There are also grief support groups that allow you to talk through your feelings. You can find several books and online resources that will expand your understanding of what you’re going through. Bear in mind that one of the most healing exchanges you can have with a loved one nearing death is to say “I love you” and to assure them they can let go when they’re ready.

Broaching the subject

Look for openings to broach end-of-life topics with a terminally ill relation. Some people wait for their loved one to allude to the situation before pursuing a more in-depth discussion. If you feel as though you can’t wait, try making references to another family member or acquaintance who faced a similar situation. Alluding to an end-of-life scenario in this way may be all your relative needs to open up about their thoughts and feelings. Avoid forcing the subject on them if they’re clearly not ready for it.

Provide a forum

Sometimes, just knowing what to say to a terminally ill loved one can be a real challenge. If you’re having trouble starting a meaningful conversation, try beginning with a caring inquiry, such as “Would you like to talk about something today?” or “What worries you most?” Let them unload without interrupting with insipid and shallow statements and don’t deny a discussion about death by assuring them that they’re going to be fine, or that “They’ll find a cure.” Letting someone talk freely about whatever’s on their mind can lead to the kind of productive conversation you need to have. Author Elizabeth Kubler-Ross wrote that people periodically fall into denial, and it’s OK to let them work out the situation in their own way and in their own time.

Directives and funeral plans

If a loved one hasn’t made living will, power-of-attorney, do-not-resuscitate or funeral arrangements, try to address this need as soon as possible to avoid difficult and emotionally wrenching decisions, and family conflict, when things get difficult. Check state laws carefully as they vary widely from state to state.

Be as honest and forthright as possible with a loved one who’s nearing death. Give them every opportunity to raise the issue and to bring up specific concerns and wishes. And remember that sometimes people just need a little prompting to open up about such a difficult subject.


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