What to say to someone who is dying: my guide to supportive conversations
I work as a counsellor with people living with a terminal illness, and their families and friends at the Marie Curie Hospice, Liverpool. Often people worry about how to start a conversation, or how to be honest about their feelings.
It can feel hard, particularly because it’s something we can’t control. But we can be there for our loved ones, and ourselves, and communication is an important part of that. Here are my tips for supportive conversations.
Being present and listening is as important as what you say
Think about responses not just words. When someone tells you they’re going to die, or they’re talking about living with a terminal illness, be in the moment with them. Listen closely. Think about body language: eye contact, leaning forward, not crossing your arms, nodding, perhaps touching them. These things tell them you care.
Try not to worry about not knowing what to say
We put so much pressure on saying the right words at the right moment. I often find these words from American author Maya Angelou helpful: "people may forget what you said…but people will never forget how you made them feel”. Don’t worry about the precise words. It’s ok to say, "I wish I knew what to say, but I’m here and I’ll continue to be here if you’d like me to be". And if you regret saying something – maybe you were in shock – you can apologise.
Remember, they’re still the same person they always were
When someone has a terminal illness, they don’t stop being the person you know. I hear so often from people who are dying that they want to be seen as a person, as themselves, not just as a patient. The situation has changed, your feelings right now may have changed because of this news, but they themselves have not. They're still your friend, your family member, your colleague. So, if you’ve always hugged them, then hug them. Don’t change how you are towards them.
Acknowledge what they’ve told you and thank them
They’ve shared this difficult news with you. That’s a privilege. They’re letting you in. Instead of going straight in with a question, validate what they’ve said: "Thank you for sharing that with me. That sounds like a really difficult situation. I want you to know you’re not alone. If you want to talk, we can". Being and feeling with someone – showing compassion and empathy – is much preferable to pity.
They're still your friend, your family member, your colleague. Don't change how you are towards them.
Start your conversation in the here and now
Often people worry their loved one may not want to talk. The key is to take their lead. Remember, they’ve told you. They want you to know. Ask open questions. Instead of big, "how are you feeling" questions, simplify it to right now. How are they feeling today? How has their morning been? It’s gentler and it lets them control how much they want to share.
Let them express their emotions, whatever they are
People often tell me that just being able to say what’s on their mind can really help relieve anxiety. You want that person to know they can be honest with you. They can be angry. They can feel ok. They can feel numb. They can cry. There’s no right or wrong. As a counsellor I don’t offer tissues immediately, unless the person wants one, because I don’t want them to feel they should block their emotions. However they’re feeling, thank them for sharing.
It’s ok to show your feelings too
Sometimes we put on masks to protect ourselves. Or you may worry you’re making it about you. But you’re human. Becoming emotional is a normal reaction to difficult news. Actually, it lets the other person know it’s ok for them to display emotion too.
You want that person to know they can be honest with you. They can be angry. They can feel ok. They can feel numb. They can cry. There's no right or wrong.
Ask what they need from you
Try asking what you can do right now, whether that’s something practical – cooking, shopping, a school run, a lift to an appointment – or how they want you to be around them. They might not know. But make the invitation a genuine, open one and tell them you’re here if there’s something in future.
You can talk about other things too
Often someone who is unwell still wants to have a joke, hear the gossip, catch up on family news. They might be tired of updating everyone, or feel sad that people have changed towards them. The difficulty with everyday chat comes if that person feels someone doesn’t care because they’re not asking. It’s about self-awareness and being led by them.
Now might not be the right time
Don’t take it personally if they don’t want to see you just now. They may be feeling particularly tired or unwell today. Try again at another time, or in another way. Sometimes people prefer the phone, or a text. Or maybe they’d rather go out for a drive together. Just let them know you’re there.
Reach out for support for yourself as well
If someone you care about is living with a terminal illness, you may feel very upset or worried. Acknowledging your emotions will also help you be there for your loved one. You could talk to a friend or partner, but there is also other support out there. Our hospices offer counselling for the loved ones of people receiving care, and we also provide support that’s available to everyone. Connect with others who may be experiencing similar feelings in our online community or access free specialist support by calling or emailing our Support Line or our Companions by phone service. We’re here to walk alongside you.
Call us for free on 0800 090 2309 or email us at support@mariecurie.org.uk to speak with our trained team.
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