Having been a hospice nurse for the last 12+ years, I know how to be with someone at the end of life from a clinical perspective. However, last year, a very dear friend of mine died of FBC…the other kind: F-bomb Bladder Cancer. It was awful. Truly horrendous. She had been a super healthy (we frequently compared which exercise regimes we were doing or which detox programs we were interested in trying). It was a crazy, confusing and very, very sad time.
One of my dear blog readers wrote to me and told me that, sadly, one of her good friends is dying…also of the other FBC. She asked me: What do I say? What do I do?
So, first of all, if you are in this situation, I’m so f-bomb sad for you. It’s a rotten place to be. However, the Silver Lining is that being with a person at the end of life is one of the most sacred and powerful experiences and there are ways to help you both.
Be Present
People who are dying need to feel the presence of loved ones at the end of their lives. Be assured that dying isn’t a person’s whole identity. They still need to be a real person in your life. They can still talk about other things besides death and sickness. My beloved mother-in-law talked about celebrities until days before her death. It was a great diversion for her.
It’s also important to know that not all silence needs to be awkward. A calm physical presence may be all a dying person needs or wants.
Don’t Pretend Like Everything Is Ok
Many people believe that talking about someone’s illness or impending death will only upset them and therefore pretend like everything is ok. Many people are surprised to find that a dying person wants to talk about what’s happening to them. In fact, many dying people are thinking the same thing – that talking about what’s happening to them will only upset their friend or loved one. All of these assumptions are such a waste of precious time. When in doubt, just say: “What would you like to talk about right now? I would like to hear about anything and everything that is on your mind. I am here for you no matter what.”
Gestures Speak Louder Than Words
Assure your friend that you are here to help in any way needed. I recommend that you don’t wait for your friend to ask for help because she might be overwhelmed or may not want to be a burden. So, go ahead and prepare dinner, offer to clean the house, shop, or go with her to doctor appointments. But be sure to follow through. If you say you’re going to do something, do it.
Avoid Clichés
Saying things like, “Everything happens for a reason,” and “It’s God’s will,” is NOT the way to roll. Most people know they are dying, whether they admit it or not. Saying things like, “You’re strong. You’ll get through this. You’ll be ok” is an outright fib. Though the emotions surrounding death can be hard for some people to hold, please acknowledge and normalize all feelings and by all means, don’t try to talk your friend out of her feelings.
Share Memories
Sharing memories of good times is a wonderful way some people find peace near death. In fact, this can be comforting for everyone (Silver Lining).
It is really, really important to know that hearing is the last sense to go. So, even if a person is unconscious and cannot communicate directly, believe that it is very likely that your friend can hear you.
Therefore, always talk to, not about, the person who is dying. When you come into the room, it is a good idea to identify yourself, saying something like “Hi, John. Hollye’s here. I’ve come to see you today.” Know that it is never too late to say how you feel or to talk about delightful memories.
Physical Contact
The simple act of physical contact—holding hands, a touch, or a gentle massage—can make a person feel connected to those he or she loves. It can be very soothing and calming. One of my favorite things to when I was a hospice nurse in the hospital was to give afternoon hand massages. Patients absolutely loved it!
Set the Mood
Try to set the kind of mood that is most comforting for the dying person. Think about what she always enjoyed. Was it a party with lots of people? …or was it quiet time with just a few close friends? Try to create the kind of environment that your friend always enjoyed.
When working with patients, I always find that when death is very near, music at low volume and soft lighting are soothing. In fact, near the end of life, music therapy improves mood, helps with relaxation, and often lessens pain. For some people, keeping distracting noises like televisions and radios to a minimum can be soothing.
Offer Assurance
Many people at the end of life feel unprepared for death. Your friend may be worried about who will take care of things when she is gone. As a friend, you can be of great assistance by assuring her that you will help organize and complete unfinished tasks. You can begin by helping to figure out what is most important on the list of things left undone. Then you can actually help complete those things. For example, you can help write letters. You can help make lists about where things like important documents are located. Reminding your friend that her personal affairs are in good hands can also bring comfort.
Be Hopeful
Even when cure is beyond the realm of possibility, there are many opportunities for hope. While you may change what you hope for, hope is actively present. You can hope for pain free days. You can hope for a peaceful death for your friend. You can hope for the opportunity to do something special with your friend.
Though none of these suggestions take away the pain or sadness of the death of a friend, I hope that they will give you some tools to help in the process (Silver Lining).
If you have any suggestions that you would like to have, I’d sure love to hear them!
Thank you Hollye, because with you I always learn.
And you've such a special way to teach.
Thank you very much, Paula. I really appreciate your kind words!
This is a wonderful post. Everyone should read this. Most people feel uncomfortable because they don't know what to do when someone is very ill. Thank you for writing it.
Thank you so much for your note, Jan. I really appreciate it. You're so right that people feel uncomfortable because they don't know what to do or say…
Loved your post today, it was so intelligent and moving.
Best.
Gladys
Mexico City.
Muchas gracia, dear Gladys! I am always so appreciative of your feedback.
Thank you so much for sharing this approach to a "dying friend"…I will be glad to share this later on, after I finished my treatment as I planned to participate in one of a group here in Houston as cancer care giver.
Thanks so much for your comment, Camila. I really appreciate it. Best wishes as you give back as a care giver. What a gift!
I'm reminded of the days and weeks I spent with my mom at the end of her life. Those memories are painful, yes, but they are also some of my most treasured.
This list is perfect. Thank you.
Thank you so much for your note and sharing your story, Nancy. I sure do appreciate your perspective. All my very best to you.
My partner went home on 11.17.11. Thank you for this list. Not knowing it, I did it to the best of my abilities. Cancer is such a vile disease.
I'm sorry to hear your sad news, Banessa. I am confident that you did a wonderful job for your partner. I agree that cancer is a vile disease. Sending my very best wishes to you. Thank you for your note. Take good care. Hollye
Thank you, Hollye. Beautiful. xo
My absolute pleasure, Mimi. Sending my best to you , always!
Thank you so much for posting this list. I am an Emergency Medical Technician and sometimes we are called to homes where people are in hospice or still battling, but having a difficult time with cancer. It is sometimes awkward and no one knows what to say (even though I'm the one who should have the answer). Thank you again. 🙂
Thank you so much for your comment, Amy. I really appreciate it. Thank you also for all of the work that you do. Being an EMT is incredibly challenging. I appreciate your profession so very much!
Just beautiful Hollye… sending lots of love and light from Australia…
Dear Tanya, THANK YOU for your kind note!
I worked for 15 years as an HIV/AIDS Home Health Care Aide. My first experience in dealing with a dying friend was with my best friend who was in the end stages of AIDS and should have died long before he did. As his health declined at home; he became very withdrawn and angry at the world. A week before he died; my maternal Grandfather passed away unexpectedly. To attend the funeral, I had to have my friend put into respite care. I got a call at the funeral to get back A.S.A.P.; my friend had taken a turn for the worse, was running a fever of 105 and had slipped into a coma. He would not make it through the night. I left immediately and made it back to the respite home to take my friend back to our home where he wanted to die in his bed. I was told that just a trip across town would be too hard on him and would kill him. He wasn't going to survive the night so just let him die in peace. He was in a coma and wouldn't know where he was anyway. His mom and I sat up with him all night; (He lived until 11:48 pm the next night) taking turns just sitting at his bedside and talking to him, holding his hand and keeping him company. An hour before he died; his fever broke and he briefly came out of the coma. He said he had heard a lot of what we had said and was felt us touching him and our being with him in the room. He also knew (heard) what the nurse had said about going home and was fine with being in the Respite care home. We talked for about 20 minutes; before he said he was tired and wanted to rest. He closed his eyes and within 5 minutes his body started shutting down. His mom and I talked to him and held his hands as his breathing became labored and ragged, his hands and feet made small involuntary twitches, his bllod pressure dropped and his eyes rolled back in their sockets. As the tremors got more pronounced; I climbed up in the bed with him and held him in my arms as I rocked him back and forth. His mother held his hands and sang to him as his breathing got more shallow and came less often. I whispered to him that everything was going to be okay; we weren't going to let him go through this alone… we loved him very much and he would be a part of us forever. When he finally took his last breath; I felt his body go limp and a beautiful, calm expression melt across his face. I know that he heard every word we had said while he was in the coma and as he was dying in my arms.
Dear Steven,
What an absolutely beautiful and powerful story. I am so deeply appreciative and honored that you shared such a sacred story. I hope that many people can learn from it. Thank you for being such a dear, kind and thoughtful friend.
Thank you so very much for sharing!
Warmly,
Hollye
Yes Steve I hope you see the thanks. That was what I was looking for.
Thank you so much, i have been with people who are dying and for sure know how difficult it is. I always wondered if my behavior with them that time was right or not. today after reading this I am greatly comforted.
Regards
Thank you so much for your note, Aradhana. Your note means so very much and I am so glad that you felt comfort.
Warmly,
Hollye
Thank you for all your posts folks on your experiences & helpfulness to those dying. I am sure you all did the right things and I appreciate your sharing. I too have questioned what to say, but "trust your gut" and "be there" is what I hear most & that's what & why I thank you for your input. Also remember "You never are alone, God is there, talk to him, he carried you when you could not walk, has seen you through life so far & will be there in the end" The Lord's Prayer say it often & talk to him, ask & you shall recieve peace. Bless you too Holley, good job as always. And remember to smile so the rest of them won't worry as their day/night will come too. No one knows the time or the hour so don't worry about it,enjoy living life.
Thank you for your note, Joan! Hope that we all enjoy living life!
How I could have used this information ten years ago when my son was dying from complications of diabetes! I refused to let him talk about not being here when I was old. But, our fanily and I were here at home with him to the end, playing movies or Star Trek DS9 in the background. Near the end, I replaced the movie with an Enya CD. He left us as she sang Orinoco Flow…sail away, sail away. It was a blessing to be with him through it all. I want to share this post so more can be equipped to help, and not avoid, someone at this time. After all, we will each come have this same need…..
Dear Debbie,
Thank you so much for your comment. I'm so, so sorry to hear about the death of your child. There is nothing more unnatural than the death of a child. I am honored and grateful to you for sharing your story…and the blessing that you saw to be with him through it all.
I know that your comment will help readers.
I'm wondering if you might consider submitting this to "Shared Stories"…here is the direct link: https://www.hollyejacobs.com
Many, many thanks!
Hollye
I just found this blog and it was what I needed. I have this horror story happening for my brother's sister and my best friend's (another sister) sister and it's just so damned hard to know how to help two women who I think the whole world of, much less my siblings who are in so much pain. We're coming to the end on both fronts and it is overwhelming. Thank You.
Dear Cissy,
I'm so glad that you found the blog, but am so so sad to hear about everything that you are going through. All so sad. Please let me know if there is anything at all that I can do for you! All my best, Hollye
when my best friend was dying of pancreatic cancer we would send each other e-mails everyday of a funny memory we had from our years of friendship.
Oh how special, Barbara. Thank you for sharing. I'm so sad to hear about the death of your best friend. Sending my best to you!!
Thank you. Though my mother is aging and seems to be doing fine I don’t want to wait until crunch time to become more nurturing and more of her foundation when time and emotion can be shaky.
Thank you so much for writing, Brigid. Sending my very best wishes to you and your family!
Tell them what they mean to you and that you love them just as much sick as you did when they were well. Let them be the same person they were, even though they can’t do what they used to.
Beautifully said, Dee. Thank you!
I couldnt have said it better myself…I am also a hospice nurse!!
Thanks so much, Kathy.
…and thank you for all of the work that you do!
I am a nurse practitioner who recently took a position with palliative care, looking for words for my patients, You have gave me hope that I can do this job.
So very glad, Lorraine. Thank you for doing this work. Your patients will guide you.
My daughter is in remission right now what the doc says she has about 5 years so we’re going on a road trip she’s an artist. We’re going to visit art galleries along the way
Enjoy, Rick! Thanks for sharing!
Very Inspirational and True! May I use this to inspire my group of Palliative Care Volunteers?
MN
Thankmyou for yiu helpful words. My friend is Hospic dying from the f-bomb liver cancer. And i want to say peaceful things and not make her feel more poorly than she already is.
Sorry for all the typos, I just very upset
My best friend is 2.5 years into a terminal cancer diagnosis. No matter what they try, the cancer keeps sneaking back in.
While I think your tips are wonderful – they’re all for people who are local. My best friend and her family moved about 3 hours away a year before her dx. I can’t be there to cook dinner, to watch her kids, to just sit and watch Hallmark movies, etc.
I send UberEats cards when I can. I talk to her as much as I can. But I’m now at a place where I don’t know what to do. She can’t travel, and I have 4 children who prevent me from trekking to see her.
Help?