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What to Say to Someone Who's Dying

Make sure your last conversation is one you won't regret (Photo credit: Getty Images)[/caption]

By Jill Smolowe for Next Avenue

My friend’s distress was acute. For weeks she’d been running herself ragged, attending to her ailing octogenarian father.

Daily visits to the hospital had given way to frantic efforts to turn his apartment into a home hospice after he made clear that he wanted to return to his apartment. Now, with a hospital bed and 24/7 nursing care in place, the countdown had begun. There was no “if” about his imminent demise. The only question was: How much longer does he have?

Well, that, and this: How best to use the time that remained?

Now that the practical matters had been addressed, my friend told me that she wanted to “deepen” their conversation. To encourage more meaningful dialogue, she wondered if she should air some old grievances with her dad. Perhaps that would afford her father the opportunity to explain why he had been absent from so many parts of her life. Perhaps if he got those things out in the open, they would both rest easier.

Airing Grievances

My friend’s desire to air old injuries from a father-daughter narrative that had unspooled, unaddressed, for decades was entirely understandable. And entirely human. According to author Kate Roiphe, who explores the final days of six celebrated writers in her new book, The Violet Hour: Great Writers at the End, the desire to right old wrongs, clear up old confusions and set the record straight is almost universal.

“Nearly everyone has a fantasy of a ‘last conversation’ with someone they love,” she wrote recently in The New York Times. “It is the fantasy of resolving all conflicts, of emotional catharsis, that rarely ever comes to pass.”

My own experience with the demise and death of loved ones has left me inclined to favor a different direction when approaching final conversations, though.

Over the course of the two-and-a-half years that my late husband, Joe, was battling leukemia and the side effects of a stem cell transplant, I discovered what most sustained me was the keen feeling of appreciation that flowed between us.

I felt a constant appreciation for Joe’s tenacity, optimism and determination, even on days when he was in considerable pain. He, in turn, never lost sight of my efforts to be by his side daily, even as I juggled a job, our daughter, his phone calls and e-mails and the mountain of hospital bills that dwarfed the usual stack of household bills.

Near the end (though we didn’t know that at the time), he recounted a conversation he’d had a day earlier with a cousin who had visited him in the hospital. As he told her about our marriage, she said she hadn’t realized we’d been married so long, and expressed surprise at the length and quality of our union. Joe told her, “We’ve made it 24 years because of Jill. She gets all the credit.”

His cousin responded, “Have you told her that?”

Giving Credit

The following day he shared their conversation with me. It meant so much in the moment. After he was gone, it meant oh, so much more.

My last conversation with Joe was on a June morning in 2009. While he ate breakfast, I stood on the opposite side of the kitchen counter, updating him about two friends who, like him, were dealing with cancer fallout. A week earlier, Joe had been hospitalized and in frightening shape. Now, energetic and seemingly on the mend, he appeared sufficiently strong to hear about about an email I’d received from one of those friends.

“The opening sentence was, ‘My cancer is back.’” I cocked my head quizzically. “In all the time you’ve been dealing with cancer I’ve never once heard you refer to leukemia that way. Do you ever think of it as ‘my cancer?’”

“No,” Joe said.

“Me neither.” I grinned. “I’m so proud of you that you’ve never let cancer define who you are.”

Joe’s head gave a modest wag. I laughed, touched his hand and went off to blow dry my hair. A few minutes later, I heard a muffled noise. His chair had tipped backward. He was gone.

Healing Words

Later, when the fog of early grief lifted, I would think how fortunate I was — dumb luck, really — that my last words to this man I loved so much had been words of praise. Words that conveyed appreciation. Words that left no room for regret.

In coming months as my mother and sister simultaneously went into decline, the healing power of expressions of appreciation was very much on my mind. With my sister, I made a single attempt to discuss a period in our relationship that I’d never understood, one where I felt she’d deliberately distanced herself from me. “It’s all in your head,” she said. I chose to let it go.

Instead, I turned my attention to creating a photo book for her that celebrated our sororal relationship. Though the words were few and my target audience was just one, I knew this was the most important book I would ever write. I arranged the photos and lighthearted captions to segue from the many shared groupings in our lives —  two parents, two brothers, a deep stash of nieces and nephews — to my message: Ann was singular in my life. My only sister. Unique. Irreplaceable.

I sat by her side as she unwrapped and read My One and Only for the first time. We laughed. We cried. Together, we read the final pages: “You are … my one and only … I will love you forever.” Turning to me, Ann said, with a catch in her voice, “This is the most loving gift I’ve ever gotten.” I still mist up when I think of her words. It comforts me to know that Ann understood how much I loved her.

Cut to the Core

Same with my mother. Ours had been a rocky relationship, the two of us repeatedly trying and failing and trying again to find common ground. I harbored no illusion we could talk through our differences to some point of mutual agreement. I didn’t even try. Instead, for her, I fashioned a letter that gave expression to the many reasons I liked, as well as loved, her.

She, in turn, offered words near the end that cut to the core of her strongest beliefs, leaving no doubt how she felt in her deepest heart about our relationship. “I must have done something very right,” she said, “to have you as my daughter in this incarnation.”

Now, as my friend pondered what to say to her father, I gently encouraged her to consider whether rehashing old grievances was likely to leave her feeling any better. Perhaps instead of giving voice to old hurts, I suggested, she might find a deeper level of satisfaction and eventual solace in telling her dad what she most appreciated about him.

She thought it over and later would tell me, “That felt much more comfortable and kinder.”

My friend not only took my words to heart, she made the exercise into something remarkable. Plumbing the deep influence her father had on her life, she offered him words of love and gratitude. When he closed his eyes for the final time, he knew precisely what he’d meant to her — and so, finally, did she.

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