Talking with People as You Near the End of Life

It is important to share your feelings and desires as you near the end of your life. You might want to take some time to think and talk about your life and how you feel about it. People who care about you will want to know how you are feeling and if there’s anything they can do for you. And they may need a chance to start getting ready for the loss they will face when you die.

It might be helpful to have your family meet with your cancer care team to help them prepare for your last days. They might want to learn about the dying process, what your wishes are as you approach death, and what they can do to help cope with their grief.

Your partner  

Cancer and the end-of-life can be difficult for both the person with cancer and their partner.  Remember that your partner is dealing with their own emotions and probably feels a lot of pressure to be strong and to meet your needs.

The loss of a partner is one of the most stressful events a person can experience. Sometimes partners try to protect each other from the pain they’re both going through. If at all possible, talk with your partner about what each of you is feeling. You may find that you’re both going through the same kinds of emotions. Try to accept what each person says without judgment, argument, or defensiveness. Simply let each person say what they feel.

This is another chance to try to make any past wrongs right and comfort each other. But having cancer doesn’t mean that you won’t get angry and frustrated with each other. Try to focus on the comfort you can give each other and let the little things go. Focus on the good times, happy memories, and the times you have been there for each other.

• Try to spend time enjoying each other’s company. Watch movies or TV. If you’re able to, go for walks. Or just enjoy each other’s company.
• Talk about the good and not so good times. What are you most proud of in your life together? What struggles did you go through together? What are your happiest memories of your time together?
• Take time to share your fears and ask your partner what they fear. Try to be open and supportive, even when the topics make you uncomfortable.
• Make sure that your partner understands and will support your wishes for your end-of-life care. If they don’t feel they can carry out your wishes, let them know that’s okay. Find a friend or family member who can do this for you. Some partners have a difficult time with death and wishes around end of life.

Alone time

It can help to give each other some personal space and private time. Reassure the other person that you still love them, but it’s OK if you both need some time to be alone. This is a common need for anyone facing the end of their life or the loss of a loved one. Make the most of each day, and know each day is a new chance to enjoy each other.

Sex and intimacy

At this stage of your cancer, it may be hard to be as sexually close as you have been in the past. You may be tired, in some pain, or simply not interested in sex.

But you can still have physical contact and intimacy in your relationship. Talk with your partner about your needs and if you feel you can have sex. Each person is different and may have different needs. But it's OK if you want to just touch, hug, or hold hands.

Talk with your health care team if you have questions or concerns about sex and intimacy. Ask them what you might be able to do to maintain sex and intimacy.

Help take care of your partner

Talk to your partner if you’re worried about being a burden because they’re taking care of you. Ask how they are feeling. Your partner might show signs of emotional and physical stress, such as depression, headaches, and trouble sleeping.

Encourage your partner to take care of themselves. Ask a friend or another family member to help out if you think there’s too much for one person to do. If you decide to ask others to help, be sure to tell your partner. That way you can help take care of your partner, too.

Your family

Each member of your family is working through their feelings about losing you. There are things you can do to help them. Talk with your family and friends about times you have spent together. You will be honoring your life together and making new memories for them to cherish.  

You might also want to resolve conflicts, say goodbye to special people, and tell family members how much you love them. If you cannot or prefer not to talk in person, consider writing, calling, video chatting, or sending a message through a family member.

Remember that some people may not respond the way you hope they will. They might not feel comfortable visiting, or they may be afraid of saying the wrong thing. Or they might not be able to let go of old issues.  You can feel comfort that you did your best to heal a relationship or connect with them.Stories can be a gift to the people you leave behind. You might want to write down or record your memories. Or you can ask someone else to write or record as you talk. Sharing your wishes and dreams for loved ones may help ease your concerns about leaving them. It can also help them connect with you at important times in their lives.

Adults

You can help adult family members by being open about your cancer, any news you've been given from your doctor, and any other needs you may have. Explore their thoughts and feelings with them. Tell your family that:

• You’re willing to talk about anything.
• There may be times you don’t feel like talking and you’ll let them know when that is.
• You’d rather not have to pretend you’re happy if you’re feeling tired or down. Explain that this doesn’t mean you’re not OK.
• You’ll be as honest with them as you can be and hope they will do the same

Share with your family what you have learned from your cancer care team about how long you’re expected to live, what changes are likely, and what type of care you might need. This will help them prepare and support you as you get closer to death. It also helps to share the expected signs of the dying process, and how to manage them should they occur.

Also tell you family what decision and plans you’ve made or need to make. Get their input if you want, but know the final decision is yours.  

If you have adult children with their own families, they might be juggling their own children, jobs, and caring for you. It can be very stressful. Open, honest communication will help you support each other through this time.

Children and teens

Many people try to protect children from bad news, including death. But children of all ages need help preparing for the loss of a loved one. Children can usually sense changes or stress in the household and know when something is wrong. What they imagine is often far worse than anything you tell them.

You might also want to create some sort of memento to be given to certain children at some point after you die. You could write a letter, make a recording, create a slide show, make a scrapbook or a memory box of things you want them to know.  These mementos can help the children remember you and know how much you loved them.  

For more on talking with children and teens, see Telling a Child Someone They Love Has Cancer.

Your friends

Knowing that someone close to them is dying can be hard for some people. While some friends can be warm, supportive, and want to spend time with you, others might feel awkward around you. They might not know what to say or how to behave.

Talking with your friends might help. Explain that you’re the same person and you’d like to spend some time with them. But some people will still be uncomfortable and you might suggest other ways they can stay in touch or support you. It might be easier for them to send you cards, small gifts, or quick social media messages.

Religious or spiritual counselor

Spiritual questions are common as a person tries to make sense of both the illness and their life. This may be true not only for the person with cancer, but for loved ones, too.

Here are some suggestions for people who might find spiritual support helpful.

• Be sure your cancer care team is aware of any beliefs that might affect your care decisions.
• A spiritual counselor might be able to help you find comforting answers to hard questions.
• Religious rituals, such as forgiveness or confession, may be reassuring and bring a sense of peace for some people.
• A search for the meaning of suffering can lead to spiritual answers that can be comforting.
• Strength through spiritual support and a community of people who are there to help can also be helpful to the patient and family members.

For those who are interested, a minister, priest, rabbi, other clergy member, or a trained pastoral counselor can help you identify your spiritual needs and find spiritual support.