When terminal illness affects a loved one, it isn't always easy to know how to react. Find out how to offer support and deal with grief.By Mayo Clinic Staff
Knowing how to comfort a loved one with a terminal illness can be challenging. What can you say or do? How can you help the person cope? How will you deal with your grief? Get the facts about supporting a loved one who is terminally ill.
Your relationship might not change. If you're concerned, build on your relationship's strengths. Also, stay open to new possibilities. The diagnosis might improve your relationship.
Remember that this person's needs and desires likely haven't changed. Many people facing a terminal illness want to be treated as normally as possible.
Let the person know that you're willing to listen — and never underestimate the value of your presence. Even if it feels as if you're not doing anything, your presence sends an important message. Don't, however, try to replace a trained counselor.
Don't assume that the person will go through a methodical process of coming to terms with death. The most desirable outcome might be that your loved one learns to live as fully as possible while accepting the presence of a terminal illness. But does your loved one have to accept having a terminal illness? No. There's no right or wrong way to come to terms with death.
Denial is a coping mechanism. Your loved one might be in denial because reality is too frightening, too overwhelming, or too much of a threat to their sense of control. The person might be afraid of pain or losing control of their bodily functions or mind. They might also fear failing family or becoming a burden.
Denial can allow a person to let reality in bit by bit and continue living while contemplating death. As long as denial isn't causing significant harm — such as by causing the person to seek out painful treatments of no therapeutic value — then it isn't necessarily bad.
To provide emotional and spiritual support, invite your loved one to talk about their fears. Sometimes, however, it's easier for a dying person to share fears with a spiritual counselor.
If denial is interfering with a dying person's necessary tasks, you might need to take action. If, for example, a single parent's denial of their illness is getting in the way of planning future care for a child, it might be necessary to intervene. Seek the help of a professional with expertise in the care of the dying, such as a hospice specialist, palliative care nurse, doctor or social worker.
Clergy may also be able to help if religion is important to the person.
Encourage your loved one to talk about their life. You might be amazed at the stories they have to share. Talking about memories can also help affirm that the person's life mattered and that they will be remembered.
Ask your loved one what they want. Most people wish to die with family nearby, but others might prefer to go privately. Keeping a vigil can be a sacred experience and give a dying person strength and comfort. It can also help you ensure that their pain and symptoms are addressed and that they have access to spiritual resources.
Remember, however, that your constant, physical presence isn't required. If you keep a vigil, take breaks, drink plenty of fluids, eat balanced meals and accept support from others. Also, understand that you might not be at your loved one's side when they die. This timing is beyond your control.
Sometimes it might appear that a person is having trouble letting go. If you think the person is hanging on for your sake, it's OK to say that you'll be all right and that they can let go.
Grief is a natural response to loving and feeling loss that often comes in waves. Emotions can feel overwhelming, making even simple tasks difficult. This is normal. It doesn't mean that you won't be able to function for the rest of your life. Grief also doesn't necessarily begin when a person dies. It might start as a person's illness progresses or normal roles change.
If you're concerned that you're unable to stop grieving and it's affecting your ability to function, seek professional help.
After your loved one dies, you might question whether you did enough or said the right things. Guilt is a normal part of grieving but it often gradually fades. If you're having trouble dealing with guilt, talk to someone who can help you work through your feelings.
Nov. 16, 2018
- Providing comfort at the end of life. National Institute on Aging. https://www.nia.nih.gov/health/providing-comfort-end-life. Accessed Oct. 14, 2018.
- Advanced illness: Holding on and letting go. Family Caregiver Alliance. https://www.caregiver.org/advanced-illness-holding-on-letting-go. Accessed Oct. 14, 2018.
- Grief and loss. Family Caregiver Alliance. https://www.caregiver.org/grief-and-loss. Accessed Oct. 14, 2018.
- Rosenblatt L, et al. Psychosocial issues in advanced illness. https://www.uptodate.com/contents/search. Accessed Oct. 14, 2018.
- Comfort care. National Hospice and Palliative Care Organization. http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3333. Accessed Oct. 14, 2018.
- Offering spiritual support for family or friends. National Hospice and Palliative Care Organization. http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3406. Accessed Oct. 14, 2018.
- Baily FA, et al. Palliative care: The last hours and days of life. https://www.uptodate.com/contents/search. Accessed Oct. 14, 2018.
- Kwan CWM, et al. The use of life review to enhance spiritual well-being in patients with terminal illnesses: An integrative review. Journal of Clinical Nursing. 2017;26:4201.
- Stern TA, et al. Psychiatric and ethical aspects of care at the end of life. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Oct. 14, 2018.
- Chen J, et al. The effects of spiritual care on quality of life and spiritual well-being among patients with terminal illness: A systematic review. Palliative Medicine. 2018;32:1167.
- Takahashi PY (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 27, 2018.