What to say to someone who is dieing
June 23, 2005 7:10 AM   Subscribe

What do you say to someone who is in Palliative Care?

My grandmother was put in Palliative care over the weekend with an estimate of 1-3 months to live. This will be my first experience with losing a grandparent as I'm fortunate to still have all 4 living.

I've sent her a large bouquet of flowers and couriered her some photos of her great-grandchildren both of which she was very happy to recieve. I've also passed messages to her via relatives who are in the same city as her and are visting her.

What I haven't been able to do is call her and talk to her. I know it sounds stupid, but I really have no idea what to say and I don't want to get her upset by losing it on the phone.

So, when I do muster up the courage to call her what should I talk about that won't seem ridiculous? Do you broach the subject of death or do you tiptoe around it? Help Please!
posted by smcniven to Human Relations (12 answers total)
Don't wait, get on the phone. Tell her (if it's what you want) that you're coming out to see her, and make it no more than a week away.

You get one shot at this - don't worry about getting emotional. This is the time for getting emotional.
posted by cptnrandy at 7:18 AM on June 23, 2005

Talk to her as you would normally. No doubt she will want to hear of your family. You can ask her if she likes the place where she's staying and if the staff are good to her - this might allow her to elaborate on the present circumstances, if she wants. I personally wouldn't bring up death but it may be that she wants to in which case tell her that you and your family love her and perhaps express the hope that she's comfortable and that she should call on staff if there's any problem. Or if there's anything you can do.

But, take all this with a grain of salt I guess -- it mostly depends on your style of relationship with your grandmother to date. Perhaps remind her of any significant past events or how your family or indiviuals relate particularly to certain events in which she was involved. But tell her that you love her.
posted by peacay at 7:26 AM on June 23, 2005

I'd follow your grandmother's lead as much as possible. If she wants to talk about the weather or the people in the corridor or the quality of the food, talk about these things with her because, well, she'll need as much support as possible. Tell her that you love her and care for her but make sure that your conversations are not all doom and gloom. It's no use pretending that death doesn't exist - you both know that it does - but I'd wait for her to bring it up. This is a scary time and it's important to provide support.

Obviously, this will affect you (and that's okay!). Remember to take care of yourself, as well. Go for walks, find a shoulder to cry on, do what you need to do so that you are able to be there for your grandmother.

One bit of advice - it can be very easy to lapse into the past tense when talking with people in palliative care and this can create terribly awkward situations. The last time I visited someone in palliative care, the conversation turned to dancing. My partner's dad said something along the lines of "Frank - you are a great dancer and you have such a great sense of rhythm" which is far more positive and inclusive than "Frank - you were a great dancer" (which, to be perfectly honest with you, was what I was thinking - Frank had lost the use of his legs and could hardly move when this conversation occured). I learned a lot from that moment.

[on preview - it's a great idea to go and see her if you're able to and if you want to. Make sure that she feels like she's a valuable and important part of your life. Write her a letter, send some photos of what you're up to or where you live accompanied with explanations, etc]
posted by lumiere at 7:32 AM on June 23, 2005

Good Advice above. Definitely tell her you love her: do that today. Also, let her know how her life has impacted yours. Be specific. Thank her for anything she taught you or introduced you to. I was able to do this the last time I saw my Grandfather alive. I almost copped out but as I was leaving his nursing home for the last time I turned and told him how much of an impact he had made on my life, and that I loved him. I'm so thankful I had the opportunity to tell him that.
posted by Fuzzy Monster at 7:42 AM on June 23, 2005

Call her. Call her now. Now now now. If you can, go see her, literally as soon as possible.

Just after Christmas last year my mother phoned me "You're grandmother's in the hospital, I think you should go see her" she'd been declining rapidly and we'd been expecting this. I hopped in the shower. When I got out of the shower, there was a message on the phone, she was gone. It can happen that fast.

I have few regrets in this regard. I'd been going to see her every week, and she'd been with the family at Christmas, but I really wish she hadn't died alone.

What I'm saying is that it is not really important what you say when you talk to her, but it is really really important that you talk to her. There are no second chances with something like this.
posted by Capn at 8:11 AM on June 23, 2005

I found that active listening techniques really helped. I had a natural tendency to prattle on about myself, trying to "cheer up" my mom when she was in the hospital, but the times we actually connected were those times when I just let her be scared, and sad, without trying to jolly her out of it (because, really, all that's doing is saying "What you feel isn't important").

That's not the best link, but basically responding to any complaints with "That must be hard" rather than "That doesn't sound so bad" (for example) can help validate her feelings and give her the space to open up.

If she wants to. She may not, and that's fine, too.
posted by occhiblu at 8:39 AM on June 23, 2005 [1 favorite]

My dad was in palliative care for two months before he died. I initially felt terrified of how I'd approach the situation - if he'd seem like a foreign person to me, if I'd be strong enough to handle it all, etc. But once I committed to sharing his caretaking duties with my mother, it wasn't the soul-destroying event I though it would be.

Occhiblu's comment about not having to be so cheery was very true in my situation. Sometimes, my dad wanted to talk about the physical changes he was going through, sometimes he just wanted someone sitting quietly in the room with him. Usually, he just wanted to know what my friends and I were up to that day. Do everything you can to visit your grandma in person. (Your presence will also lend support to any family in the area who is taking care of her.)

The most frustrating part of the situation is you can't say, "things will get better," nor can you fully empathize with what your loved one is going through. All you can do is validate their feelings and remind them you love them.

Yes, follow your grandmother's lead in conversations. She may find a lot of comfort in knowing that life continues to go on -- especially wrt you and the great-grandchildren. Pay special attention if she's wanting to talk about her life and/or her concerns for those she is leaving behind. The latter can be a very difficult subject for people to discuss. I had to broach it myself and assure my father that my mother and sister would be taken are of.

Be aware that some days your grandmother may not want to talk, or could become very agitated. She might even withdraw near the end. This is part of the process; do not take it personally. Just tell her you love her.

Overall, the biggest help for me was how I ended every conversation/visit. It was always "Good night, I love you, I'll will see you in the morning." You may only be able to call every few days or so, but it gives your grandmother something to look forward to and acknowledges that she is still loved, and won't be forgotten.
posted by Sangre Azul at 11:19 AM on June 23, 2005

Consider these all marked as best answer. And thanks a bunch for making me cry at work every time I read this page. :(
posted by smcniven at 12:18 PM on June 23, 2005

One thing very important to the dying is the knowledge that they will be remembered after they are gone. If you could bring up some memories that you cherish-- they don't have to be earthshaking or even particularily important-- it will let her know that she won't be forgotten.

"Hey Grandma, do you remember that time when.....I think about that a lot. It always makes me smile."
posted by Secret Life of Gravy at 12:52 PM on June 23, 2005

I went through 6 months of palliative care with my mom, and all of the above are good. Just as you don;t know what to do/say, neither does your Grandma. IMHO, and experience, the best thing you can do is tell her you love her and listen. There is no right/wrong way to go about it, just come from a place of love and compassion.
posted by gregariousrecluse at 1:36 PM on June 23, 2005

I l ike Secret Life of Gravy's answer best.

I know that's what I would most want to hear.
posted by marsha56 at 4:08 PM on June 23, 2005

Also remember that often people who are sick -- and I don't know your grandmother's situation obviously -- often aren't up for long chats but regular contact is often appreciated. When my grandmother got older, I'd call her more frequently, but often we'd just chat for five or ten minutes and I could always say "okay, I'll call you on Sunday, bye!" or whenever.

There's not a lot to look forward to in a palliative care environment, and there are likely a lot of people who don't know what to say or do. Assuming you like and enjoy your grandmother's company, set up a regular time to call [or ask if it would be appreciated] and then talk to her regularly, and just give her updates and, of course, talk about whatever she's feeling like talking about. With my grandmother it was talking about what she saw on the news, what she thought about it, what I thought about it. With yours it might be different, but you can probably follow her lead.

Above all, keep in mind that a phone call doesn't have to be long and emotional for it to be useful for both of you, and making the call that you're dreading is going to be the hardest part of talking to her, the rest will likely come naturally. If it doesn't, tell her about the kids, tell her you think about her all the time and feel okay about keeping it short.
posted by jessamyn at 4:56 PM on June 23, 2005

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