Death Doesn’t Take A Holiday

Ira Byock
4 min readDec 16, 2020

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photo by Evilicio on unsplash.com

What to Say to Someone Who May Be Dying

People often wonder what to say to someone who is dying. I’m asked this question most often in the runup to the holidays. I think the contrast between the festive family celebrations and the hard realities of being sick cause people to worry about inadvertently saying “the wrong thing”. The pandemic-imposed need for physical distance only complicates matters. My main advice is to relax.

The fact that you are reaching out means that you are already doing the right thing. This is a situation for which showing up — even if your visit is by phone or FaceTime or Zoom — is 90 percent of success. Too many people avoid saying anything to someone whose health is declining because of fear — mostly fear of how they themselves will feel. This is a person you care about who’s going through a particularly difficult time. Sure, it’s especially sad that this is all happening now, but Illness and dying don’t take holidays. It’s a terrible situation — and also part of life.

Adopting this perspective will, hopefully, allow you to feel more at ease and able to proceed. I can offer a few simple suggestions that may help. First, be honest. This is no time for sugarcoating or overuse of euphemisms. Secondly, begin by stating what’s obvious. It’s a good way of framing a conversation. Arriving to visit a friend who is dying, I might begin by saying, “It’s really good to see you, but I hate seeing you so sick.” That’s honest and expresses what I feel; that even though these are lousy circumstances, it’s good to be together. Third, don’t be afraid of emotions. You might find yourself tearing up — or say something that brings your friend or relative to tears. That’s OK. Emotions are a way of showing how much we matter to one another. Love and loss are intertwined in life. Sadness comes along with caring. Your relationship is worthy of those feelings. Be real. And don’t be surprised if you and the person you’re visiting break into laughter together. That’s authentic too!

With these few suggestions in mind, you can be present and enjoy the visit. Unless the person is in your bubble, practice physical distancing while being socially intimate. I try to listen more than talk. It’s alright to ask the person about what’s on his or her mind.

Are there things to avoid saying? Yes, but only a few, and once you hear them, they’ll be easy to remember. I avoid implying what the person is feeling — or should feel — or what their attitude should be. The prime example is, “I know how you feel.” Far better to assume you do not know and ask how he or she feels. Dave Isay, founder of StoryCorps, reminds us that “listening is an act of love.”

Other pitfalls to avoid are: “Don’t worry, it will all turn out OK.” Or, “Things will get better soon.” Or, “These things happen for a reason.” Although well-intended, statements like these can sound intrusive. I imagine cringeworthy comebacks to these assertions: “Really? How do you know how things will turn out?” “Maybe, but it’s possible things will remain miserable.” What possible reason is there for me to be so sick and forced to leave everyone I love?!”

Instead of saying “I know how you feel” or “You must feel awful”, consider saying, “I can only imagine how hard this must be.” It’s an honest and empathetic statement, assuming you’ve taken at least a moment to actually imagine how hard this must be. And it doesn’t impose your feelings or expectations on the person.

What happens if you say something that lands with a thud? I speak from authority here, because over the years, I’ve made mistakes too. When I’ve inadvertently put my foot in it, I’ve learned to apologize. Simply and clearly. The guides of being honest, stating the obvious, and expressing feelings have gotten me through. “I think I just stepped in it. I am sorry. You matter to me and the last thing I want to do is upset you.”

If you are at a loss for topics to discuss with the person who is ill, you might think about what would be left unsaid if he or she were to die before you next spoke?

Over many years of accompanying people during the last months and weeks of their lives, I’ve learned from patients and their families that there is value in saying at least four things to one another. Please forgive me. I forgive you. Thank you. And, I love you.

“Please forgive me” and “I forgive you” are important because there’s rarely been a perfect relationship. Human beings are imperfect and so are our relationships. Even the most close and loving relationships between friends, relatives, or lovers may contain history of hurt feelings, misunderstandings and, sometimes, serious transgressions. That’s regrettable, but true. Even the most healthy relationships are imperfect.

When you are talking with a close friend or relation, saying “Thank you” and “I love you” is honest, states the obvious, and expresses tender feelings. People may think that it’s not necessary to say such things because the other person already knows. My response to that is, so what? If there’s ever a time to say things out loud, this is it. What better gift could you give someone for the holidays?

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Ira Byock

palliative care physician, author, and public advocate for improving care through the end of life. He directs the Institute for Human Caring IraByock.org