Broaching the subject of death with a loved one
As frightening and painful as it can be, if your loved one is aging, you should consider talking to him about death before it's too late. If he has been given a terminal diagnosis, is extremely frail, or is showing signs of dementia, the issue is even more urgent. By avoiding the topic, you could be depriving him -- and yourself -- of the opportunity to share this final life transition. You'll probably find, too, that talking openly about his death is a relief to both of you. Not only is he likely to have some practical details he wishes to take care of, but an honest discussion of your mutual grief, love, and appreciation will enrich your last months together -- and your memories for years to come.
Starting the conversation
There's no single "right" way to talk to someone about his approaching death. What you say will be shaped by individual circumstances, including your family culture, the nature of your relationship, and his overall health and level of impairment.
Introduce the subject in a quiet moment
Find a time when he's alert and you have privacy and time to talk. You can say something like, "I'm sorry that you don't seem to be getting better" or, "I'm sad about what's happening to you."
Be a good listener
His response will help you gauge what you should say next. Let him take the lead and respond to him accordingly. If you raise the issue of your father's deteriorating health and he changes the subject, you can try to gently raise it again, without pressuring him. If he begins talking about the weather or the lunch menu, take that as an obvious signal that he isn't ready to talk. This doesn't mean you should give up. Try again when the timing seems better.
Give a careful response
If your loved one begins talking about his own death, try to just listen and be open to a range of feelings. In the face of his grief, fear, or helplessness, it can be tempting to jump in with reassuring words like, "Now, Dad, I'm sure it's not that bad!" or "Maybe the diagnosis is wrong, and we don't really have anything to worry about."
Learn the stages of grief
Elisabeth Kubler-Ross, who wrote extensively on death and dying, described the five stages of grief : denial, anger, bargaining, depression, and acceptance. In fact, these stages are common among people confronting all sorts of life challenges, from a romantic breakup to a wrenching job loss.
The stages may not progress in order
Those who work with the dying say that most people experience these stages, but they don't make a smooth transition from one stage to another. Instead, most move, in no particular order, from one stage to another and back again over the course of their illness -- and even over the course of a single hour or day. When talking to a loved one about his death, it's a good idea to take these stages into account -- not as a rigid formula, but as a guide to understanding his behavior.
Let him come to accept death in his own way
Your loved one may seem to accept his terminal diagnosis and be planning accordingly. Then one day when you visit him, you find that he's booking hotel rooms for a trip to Italy next summer, even though he has only two months to live. In such cases, it's not advisable to challenge his denial: "Oh, Dad, don't be ridiculous. You heard what Dr. Thompson said!" But neither should you go along with it: "Gee, Dad, that sounds great! Which cities do you plan to visit?" Instead, acknowledge the feelings behind his words. "I know you've always wanted to visit Italy" or "Wouldn't a trip like that be fabulous!" Your loved one is simply coming to terms with his death in his own way, and, unless he's genuinely delusional, will likely quietly give up his travel plans as the reality of his circumstances sinks in.
Try not to take anger personally, and reassure him that he's not alone
You might find that your loved one expresses anger -- at his doctor for not curing his illness, at the nurses in the
for not taking good care of him, at you for simply being in the vicinity. Again, it's most helpful not to argue with your parent -- or to humor him, either. Simply acknowledge his feelings: "I'm sorry you feel that way."
Some people die without ever moving out of the denial stage, refusing to acknowledge death until it's upon them. Others live out their last days in anger, bitterly railing against the miserable fate they've been dealt. Still others sink into a deep depression that makes it difficult to be around them. If your loved one fits any of these descriptions, it's still worth trying to talk to him about his approaching death, even if he's unreceptive, if only to let him know how you feel about him before he's gone.
Dying can be a lonely process. Visits and calls from friends and relatives often begin to taper off as death approaches, more often out of sadness or concern about intruding than indifference, but for the dying person, the result can be the same. Reassure him that you'll be a solid source of support throughout the process, and stick to this commitment. This doesn't mean that you must quit your job or forsake your family. You have a life, and you need to take care of yourself; your siblings or family friends may be able to help, too. At the same time, try to be a consistent, reliable presence in your loved one's life. Be sure to show up when you say you will, and stick around for the tedious moments, as well as the transformative.
Help your loved one deal with practical and spiritual matters related to his death
Besides helping your loved one come to terms with his death, you may need to discuss practical matters with him. For example:
An advance directive
If your loved one doesn't have an
(also known as a living will,) you should help him prepare one immediately. An
is a legal document that outlines an individual's wishes for how he wants to be treated during the dying process and after death.
If your loved one already has an advance directive, you may wish to review it together to make sure everything is up to date.
The location and currency of your loved one's will and other documents
If your loved one's illness came on suddenly, it's possible that his will is out-of-date or that other matters concerning his estate need updating. Work together to revise the will according to his wishes.
Other important personal and spiritual issues
As people approach death, they often feel a strong need for resolution. Let your loved one know that you're available to help him take care of any personal matters that are causing him worry or concern. If he's been helping to care for a beloved grandchild who's having problems, for example, talk the matter through with him and reassure him as best you can that you and other family members will take care of the child. If he wishes to speak or write to an estranged friend or relative before it's too late, encourage him to do
so, and help in any way you can.
Likewise, many dying people want to reconnect with a spiritual practice that they've allowed to lapse over the years. Even if your loved one is too weak to attend services at a place of worship, you can ask a representative to visit him and to provide readings and other material that will give him comfort. Your support in matters large and small will help him have a more peaceful passing.
The Needs of the Dying: A Guide for Bringing Hope, Comfort and Love to Life's Final Chapter
Elisabeth Kubler-Ross, On Death and Dying (Scribner 1997).
Elisabeth Kubler-Ross, On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss (Scribner 2005).
Stephen Levine, Who Dies? (Anchor Books 1989),
and other books.