What to do you say to someone that will soon die?

June 21, 2008 7:37 AM

A good friend of mine called me the other day. He wanted to see me (he is a good friend, but I haven't seen him in many years, we live in different cities) and ask me for help. We met, and he told me his wife has cancer, one of the most difficult ones. He spends a lot of money in treatments, but he realizes that the chances are minimal. The worst part, he said, is that he is completely out of words for her. He doesn't know if he should try to give her hope, or if they should face the inevitable fact. He is despaired, she is more despaired. What can he say to comfort her? What can he say to make her feel better while she's still here? They have two daughters, 8 and 12 years old.
posted by anonymous to human relations (11 comments total)

They should definitely face the reality and make peace with it. Time is precious now, spend it wisely.

As to what to say to her:
"I love you. I'll always love you and we'll this handle together, no matter what it is."
posted by Brandon Blatcher at 7:54 AM on June 21

Does his wife also realize that her chances are minimal? (Depressing aside: although I'm not an oncologist I work in a cancer-related field, and my understanding is that when clinicians tell their patients that a certain type of cancer has, say, a 95% mortality rate, it's a little white lie. The truth is closer to a 100% mortality rate, but they feel it's more important to give the patient a little hope than to tell the absolute truth. So your friend's wife may have a negligible chance of surviving, even though her doctor may have given her a 5% chance or thereabouts.)

If she accepts that she will probably die soon, perhaps the best thing to do is focus on what she can do to ensure her children's futures. She may not be in any condition to deal with finances and legal matters herself right now, but maybe she could talk to a lawyer and an accountant about a will, trust funds (not sure if that's the right term - a fund set aside for something specific, like college tuition), etc. Or at least have her husband do this and reassure her that these things have been taken care of. There may be some comfort in knowing that her love for her daughters will be felt beyond her lifetime.

If she doesn't accept impending death, I'm not sure what to say to her. Maybe do the same thing? Even if she recovers it's a good idea to have your will and finances in order. Best wishes.
posted by Quietgal at 8:18 AM on June 21

Hospice. Hospice workers have been through this before, and they can help your friend and his wife cope. There may be a support group through the hospital or cancer center.
posted by theora55 at 8:32 AM on June 21 [1 favorite]

Seconding hospice. While most people probably think of hospice as a sort of last resort when you accept the inevitable, the truth is that they are wonderful even when someone's death is neither imminent nor predictable. When my boss's mom was struggling through Alzheimer's, she was in and out of various care facilities while they tried to find one that suited her need level and unpredictable behavior. Hospice was a great advocate for her in my boss's dealings with all of the facilities, as well as an invaluable resource for my boss.

So whether your friend's wife has accepted it or not, or even if she miraculously doesn't die, hospice can provide services to help.
posted by Madamina at 8:42 AM on June 21

He might also encourage her to write letters to her children for when they are older. She's not going to be around to have some precious conversations with her kids and she (and they!) may find it comforting if she can do this.

There's been a fair amount of discussion lately about how oncologists are often not frank with patients about when it's time to stop anything but palliative treatment. The two of them should talk to her oncologist about prognosis and timeframe. When my mother was dying of cancer I know I found it difficult to say to her how much she had meant to me but I was glad I found the words. I don't think one has to have lots of conversations like this but encouraging your friend to say the things to her that he'd regret not saying will be comforting. We also found it took some pushing to get her shifted to hospice care despite the fact that everyone knew she was imminently dying. The hospice people were great though and really helped with freeing everyone to be totally frank about the situation.
posted by leslies at 9:18 AM on June 21

This previous question, How to talk to a friend about dying, might be helpful.
posted by LobsterMitten at 9:22 AM on June 21

I work in a cancer-related job as well. And have a dear friend who's a young widow thanks to cancer. Most of my advice comes from the latter.

I'd really strongly advise that he look into support groups. It may take a couple tries to find one with the right vibe, but this is a situation where advice from others in your boat, who have severely ill or dying spouses, are going to have the most relevant and comforting advice.

From my own experience with my friend and her husband, I'll say that the one advantage to a long slog with cancer is that you do have a lot of time to deal with the eventuality of death -- time to be furious, time to bargain, time to be practical, time for your friend to make peace with losing his wife, and time for him to make peace with the terrible fact that he'll be a little relieved. It's especially hard when there are big ups and downs where recovery seems possible and then impossible. But when death comes, it's a lot of things, and heart-wrenchingly sad, but it's not an unexpected shock.

He doesn't know if he should try to give her hope, or if they should face the inevitable fact. He is despaired, she is more despaired.

It needn't be either-or, but they should figure it out together. It's terrible and strange to accept the possibility of a death as the third player in your relationship, but being able to do so without risk of offending the other person can be a relief.
posted by desuetude at 9:44 AM on June 21

And almost all of these posts will be helpful, now and perhaps later.
posted by B(oYo)BIES at 12:31 PM on June 21

Hospice, hospice, hospice: they are caring people, they have been through many times, they know the words to say and how to help the dying, they know the breaking point of the family members.
posted by francesca too at 2:24 PM on June 21

Yup, hospice. I was a hospice nurse, and we work as a team with doctors, social workers, therapists, volunteers, bereavement counselors, pharmacists, you name it. There is no obligation to sign on as a hospice patient when you call them, they can just have a nurse or social worker come to visit and talk about what the family is going through and about what hospice is and does and one can make up their mind about it then or give it some thought. And it's not scary, if that makes any sense. We work with the probems of the here and now, today, as well as prepare for what will happen down the road. Hospice doesn't mean giving up, hospice means dealing with a fact of life, and it sounds like it's time for everyone to talk honestly about it. It has been my experience that sometimes families sort of lock up when it comes to a terminal diagnosis- no one wants to burden the others with their thoughts and fears but it's best to talk about everything. That's part of love, and this is a time to love without restraint.

Just as an interesting aside, it has been my experience that children cope better than adults with death. My theory is that society hasn't had time to teach them to be afraid of the process. I think it is best to be age- appropriately honest with them about what's going on.

And not least, my best thouhts go out to your friend and his wife.
posted by puddinghead at 3:01 PM on June 21

I also work in the oncology field.. You may find this section from the WINGS Cancer Foundation website on bereavement helpful.

I whole heartedly recommend hospice.

Also as a friend, you can make this time of transition easier by providing acts of service such as meals, outtings for the children, and srvicing as a willing, nonjudgmental listener to all.

Good luck.
posted by peace_love_hope at 4:56 PM on June 21