End-of-life care (6)
- End of life: Caring for your dying loved one
- Hospice care: An option when confronting terminal illness
- Terminal illness: Interacting with a terminally ill loved one
- see all in End-of-life care
Grief (8)
- Grief: Coping with reminders after a loss
- Survivors of suicide: Healing after a loved one's suicide
- Infant death: Grief and the path to loving remembrance
- see all in Grief
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Terminal illness: Interacting with a terminally ill loved one
A Mayo Clinic chaplain offers her advice on supporting and comforting a loved one with a terminal illness.
By Mayo Clinic staff
Mary E. Johnson has been a chaplain at Mayo Clinic, Rochester, Minn., for 28 years. Her areas of special interest include ministry to women with gynecologic cancers and spiritual research.
Here she discusses what you might say to a loved one who has a terminal illness, how you might act around him or her, and how to deal with negative thoughts after your loved one dies.
How might your relationship with a loved one change once he or she is diagnosed with a terminal illness?
Each person is unique, and each person's journey with a terminal illness is very individual. Relationships usually don't change when people are faced with bad news. It's important to build on the strengths of the relationship that were in place before the terminal illness came about. It's also important to be open to possibilities during this dynamic time. Sometimes people experience healing in their relationships and find this time to be some of the richest of their lives.
How do you know if you should ask questions or prompt a person with a terminal illness to open up?
Based on your relationship, you may be the best judge of how your loved one copes. If you're by the bedside of someone you love, let that person know that you're willing to listen — to hear his or her concerns. It's important, though, that loved ones be loved ones and not try to be counselors. Never underestimate the value of your presence. Even if it feels as though you are not doing anything, being present sends the message, "I am here. I will not abandon you."
Is there a typical emotional process that a person with a terminal illness goes through?
Numerous theories about grief and the experience of grieving have been developed and published. Having a clearer understanding of a process can make it seem less intimidating and can even give us a sense that we are more in control of it. But dying is not a science. Don't assume that your loved one with a terminal illness is going to go through a methodical process of coming to terms with death, such as denial, anger, and so on. It may not happen that way. Sometimes well-meaning people try to push the one with a terminal illness through these stages of death and dying. That's not helpful.
Many theories on grief include the notion of acceptance as the most desirable outcome of a grief process. A better description might be accommodation — learning to live as fully as possible, while accommodating to the presence of this terminal illness in your life. But do you have to accept that you have a terminal illness? Do you have to accept that you're going to die before you thought you would? No, you don't.
How do you deal with a loved one who's in denial about his or her impending death?
Denial is an important coping mechanism and has been described as a form of terror management. We deny because the reality is too frightening, too overwhelming or too much of a threat to our sense of control. Denial is a form of natural protection that allows us to let reality in bit by bit. It allows us to continue living as we contemplate death.
The person who's dying may be afraid of the pain that might be ahead. Or perhaps the person is afraid of losing control of his or her bodily functions, mind or autonomy. The person may also fear abandonment or becoming a burden to others.
To provide emotional and spiritual support for people in denial, I invite them to talk about their fears. Sometimes it's easier for the dying person to share what he or she is afraid of and explore it with someone other than a family member. In my role as a chaplain, I can often help reduce the intensity of fear, whereas the person who's dying may feel the need to protect his or her spouse or child from this type of discussion. If your loved one knows you're willing to talk about these concerns, however, your discussion can provide a wonderful opportunity for mutual support.
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