When is the best time to have an important conversation with a dying parent or relative? "Now," says David Kuhl, a palliative care doctor who studied the most important wishes of people with terminal illnesses for his book What Dying People Want.
When Kuhl was a newlywed at the bedside of his dying father-in-law, before he became a doctor, he and his wife missed that opportunity. "The hospital staff said to us, 'Why don't you go home? He could be here for a long, long, long time,'" he recalls. "Now I know that, by the way he was breathing, they knew it wouldn't be a long, long, long time. I wish somebody had said, 'We're not sure whether it will be a day or two, or even just hours. So if there's anything you want to say to him, or if you want to just be with him or hold him, now would be the time.'"
After recording the stories of 21 dying people for his book -- and sitting beside thousands of others through his clinical work -- Kuhl found that connecting deeply with loved ones, particularly children, is one of the most important things to people at this stage of life. "It's the responsibility of the parent to make sure their child is heard and seen when they are young," Kuhl says. "And as parents grow old, they want to be heard and seen. People would say to me after we'd spend time together, 'I only wish I had told this story to my children, because they don't really know me and I don't know them. And I'd like to hear their stories, too.'"
Even children who spend a lot of time with dying parents often find it difficult to talk to them on an other than "mundane, day- to-day basis," says Kuhl. And terminal illness can exacerbate this because parents and children often try to hide the truth about the illness from each other, further hampering the possibility of an honest discussion. "We start taking care of each other through a conspiracy of silence," Kuhl says, "and that doesn't serve us well."
If it feels awkward to start a conversation, he says to begin by admitting that. "Say 'Mom (or Dad), I really want to know you better and I'm not even sure how to begin,'" Kuhl says. Then start at the beginning, talking about her early childhood and working through her life and up to broader questions such as: "What's been most meaningful in your life? What's been most challenging? What are you sorry about? What was the funniest stuff? When did you have the most fun in your life?"
Ultimately, these intimate conversations are important for children as well as parents, Kuhl found. "My sense is that when children don't have those conversations with their parents, their grief will be greater after the parent has died. My rule of thumb is: If it's worth doing when someone has six months of life left, it's worth doing today."
Read the fulll interview with David Kuhl.