Caring for a parent who is dying can be emotionally taxing. There are many unknowns about the dying process and chances are neither you nor your parent have all the answers you need. Depending on their predicament, you may be wondering if you should have a deeper conversation about their health — and if so, how much time you have left to decide.
Here are ten tips for how to conduct a caring conversation with someone who is dying — and how to know when to sit in silence too.
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1. Assess for Distress
There’s no perfect time to have a conversation with a parent or loved one who is dying. But Dr. Brian D. Madden, a primary care physician and medical director of palliative care at Providence Saint John’s Health Center in Santa Monica, California, says that some time slots are better than others.
Madden discourages starting conversations when your parent is displaying acute pain, having trouble breathing or is otherwise distracted. Starting a heart-to-heart conversation under those circumstances could take away from treating the person’s symptoms or come off as disingenuous — as it may cause some parents to assume you are only saying kind words to help them get through the immediate pain, Madden explains.
If you notice your parent is in distress, postpone your discussion and see how you can meet their current needs. To help you gauge their level of comfort, Madden recommends tuning into their body language or asking them — kindly and directly — how they are feeling.
2. Ask Open-Ended Questions
Just as you would if catching up with a healthy relative, you’ll want to acknowledge and greet your loved one before diving into more challenging topics or questions. You can tell them how good it is to see them, ask if you can get them anything — like a glass of water — or pose a simple open-ended question.
Not only can open-ended phrases be typical conversation starters, they can also help center you and your loved one in the present moment and give them the power to guide the conversation. However, depending on your loved one’s prognosis, Madden warns the phrase, “how are you?” may come off as trite. He recommends prefacing your open-ended question with a validating statement — for example, “You’ve been through a lot, how are you handling all of this?”
This way, you are offering a “compliment on their fortitude and then asking the open-ended question to let them start talking first,” Madden explains.
What’s important is making it clear that you’re there to support them.
After that? “Just sit back and listen,” he says.
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3. Don’t Rush It
If your loved one is dying, it may feel like time is running out to have a conversation. And this might be true. However, Madden encourages people not to let their fears create hasty conversations.
Taking time to sit with your loved one, listen to them and let them dictate the speed — and direction — of your conversation is important, he adds. If they aren’t giving you a lot of information to go off, ask them if they’d prefer to talk about themselves, hear about you, discuss another topic or simply sit in silence.
“There is no rush,” Madden says — “even if there is.”
4. Let Them Lead the Conversation
Some people who are dying may want to avoid talking about their predicament, whereas others may want it acknowledged more. Perhaps your loved one has already told you their preference, or perhaps now is a good time to ask. Madden recommends checking in with them and respecting their wishes.
“I think it is a fair question for anyone to ask — ‘do you want to talk about your condition?'” Madden says. “If it’s no, there’s freedom to avoid the topic. Let’s face it: They have less time, it’s their agenda.”
5. Use Wish-Worry Phrases
There are many unknowns in life and death, and someone who is dying likely has unanswered questions about both. Especially for relatives outside of the medical community, it’s important not to overpromise on either end — and to avoid making declarative statements about good or bad outcomes in their future.
To stay away from this while still expressing your care for your parent, Madden suggests using “wish” and “worry” phrases to express the good things you want for the person and the bad things you fear.
“Wish-worry is important because it shows your support and desire (wish) with a non-declarative statement (worry) about the potential bad things that can happen,” Madden explains.
For example, rather than telling your parent definitively that their doctors will cure them — or that their doctors inevitably cannot — he recommends voicing a phrase like: “I wish the doctors could do more, but I’m worried about how much more you can take.”
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6. Avoid Platitudes
When talking to a parent or loved one who is dying, you’ll want to avoid obvious platitudes like impersonal compliments and empty promises.
For example, Madden says to stay away from phrases such as:
— “You’re looking great.”
— “You’ll be fine.”
— “Everything will be OK.”
Put simply, he says: “If it isn’t true to say it, don’t.”
He also warns to stay away from “if only” wording as this can place unintentional blame on your loved one for their state of health. For example, “If only you’d gone to the doctor like I told you.”
“We don’t want to make anyone feel regret or beat them up for choices in the past at this point, the consequences are evident enough,” Madden says.
7. Don’t Pretend to Know How It Feels
Dr. Akanksha Sharma, a board-certified neurologist, neuro-oncologist and palliative medicine doctor at the Pacific Neuroscience Institute in Santa Monica, California, says that people often try to show someone sympathy by saying they “understand how that feels.” But while this phrase can come from a place of good intent, it’s unlikely to have a positive impact on a person who is dying.
“This is a situation where we clearly don’t know what it feels (like) because we haven’t been near death before,” Sharma says. “Suggesting that we get it can be invalidating and upsetting.”
Corrie Bly, the director of home health, AIM and hospice at Redlands Community Hospital in Redlands, California, also advises striking “I understand” from your vocabulary, when talking to someone who is dying. “Death and dying is a very personal experience for the patient and family, and it is important to recognize that and not overlay your personal experiences onto theirs,” Bly explains.
Instead, let them tell you how it feels. You may want to revisit some of the questions above — such as asking how they are or how they are handling things — or experiment with phrases like, “I can’t know what this feels (like), but I can only imagine how hard it is,” Sharma says.
However, be mindful not to let any “I know’s” slip into those phrases, either.
Lines such as, “I know this must be hard,” may seem like safe alternatives, but ultimately bring up the same issue: that you simply don’t know, Sharma says.
8. Offer Compliments and Validation
Like the majority of us, many people who are dying appreciate compliments, Madden says. While it’s important to avoid disingenuous flattery, he says giving them credit and validation can have a positive impact.
“They are brave, courageous and dignified, among other accolades,” Madden says. “Feel free to let them know.”
You can validate their experience as well as their individual traits. Sharma suggests using validating statements like, “I’m sorry, this is so unfair,” or “this is really awful,” — phrases that simply accept how terrible the situation is.
[READ: How to Choose and Questions to Ask a Hospice Provider Near You]
9. Be Mindful of Body Language
People who are dying may be vulnerable to how others interact with them nonverbally as well as through conversation. Madden explains that this can be especially important if your parent is in a hospital setting or using medical devices, as they may be particularly aware of how others are responding to their appearance.
Body language that suggests you are uncomfortable or “repulsed” by your parent can be damaging, and should be avoided. Instead, he recommends physically leaning in by moving closer or touching them, if they are OK with that.
Leaning in can send a “very powerful non-verbal message of support and compassion,” Madden says.
10. Show Support in Silence
While there are many ways to care for a loved one through conversations, there are ways to show care without talking, too.
Maybe your loved one receives love through physical touch or acts of service. Think about how you can show them care through these modes — be it giving them a hug, making them a meal or taking them on a day to trip to their favorite beach.
“I think we sometimes don’t realize how much power there is in simply being a witness and being present,” Sharma says. “Conversations aren’t always needed. Just being with someone in silence and not being scared from it can have power.”
The Bottom Line
Caring for a dying parent isn’t easy — for you or for them. Whether you choose to show care through conversations, acts of kindness or spending time together in silence, it’s important to be mindful of your parents’ wants, needs and boundaries. While you may have an agenda of your own, experts recommend letting your loved one guide the content and cadence of your conversation. And don’t forget to give yourself grace if conversations don’t go the way you want them to go, either.
“All anyone can really do is create the space where someone can discuss their mortality if they are willing to do so,” Madden says. “Ask permission first to talk about their illness — in so doing, you are giving them control and demonstrating your compassion in respecting their boundaries.”
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How Do You Comfort a Dying Parent? originally appeared on usnews.com
