Family Communication Help: Talking to dying family members

Many find it difficult communicating with a loved one who is dying. Some fear that if the inevitable is mentioned that somehow what would be said could encourage the loved one to give up hope. Others believe that the depth of such conversations is uncomfortable for both the one who is to remain as well as for the one who is to leave.

However, many who have surmounted such obstacles report much relief that such conversations were made prior to the person's death. They report that the conversations were a great comfort after the loved one passed on. The purpose of this article is to provide tips for how to initiate such dialogue.

Maggie Callanan and Patricia Kelley are two hospice nurses who carefully recorded and organized their experiences with the dying. Their book, "Final Gifts" provides much insight into the needs of both loved ones and those who are facing death. Their book identifies several recurring themes in the language of those who are terminally ill.

Specifically, the messages of the dying fall into two basic categories, according to Calanan and Kelley: attempts by the ill one to describe what it is the dying one is experiencing, and requests for something that a person needs for a peaceful death. Typically, the one in transition attempts to include their loved ones in visions. Some visions are of other loved ones who have moved beyond. Others are descriptions of spiritual beings whom they attest are there to help them with the transition. Interestingly, Calanan and Kelley's experiences report that these encounters leave the ill one with an absence of fear; instead, the dying express concern for those who will be left behind.

Sometimes, the visions include distant, even unknown places. However, attempts to describe these places tend to be impossible for the ill one to describe adequately, unless what they describe is of a place to which they have traveled in the past. What is common in both experiences is a sense of awe and wonderment in the detail and beauty of the places, despite not always being able to describe what it is that was seen.

Calanan and Kelley label these messages as 'Nearing Death Awareness' and report that the definition is different from a 'Near Death Experience.' Although similar, there are important distinctions. In their viewpoint, a near-death experience happens suddenly-as a result of a drowning, heart attack, or traffic accident, for example-while Near Death Awareness develops in people dying slowly of progressive illnesses, such as cancer, AIDS, and lung disease. In Near Death Awareness, the process is gradual, allowing the person to remain inside the body, but at the same time affording him/her with the opportunity to become aware of a dimension that lies beyond.

Ironically, the language of the dying is easily missed by loved ones, as the dying one will use familiar expressions, gestures or even objects as potent metaphors for what it is they are seeing and experiencing. Advanced listening skills are needed. For instance, the authors reported that patients often complained of wanting to go 'home.' However, in pursuing the question further, the authors discovered 'home' was not a current abode but the next transition into death.

Unfortunately, denial runs strong in families who prefer to provide false hope for the loved one. However, it takes too much energy to sustain this fiction-energy that is limited for the one who is ill. Listening with intent can be the gateway to unveil what is actually happening. The loved one and the ill one have a need to ask and to explain what it is each is experiencing. In this manner, both can serve as allies in the process.

Some messages even relate that the ill one is aware of when death will occur. Although not true in every case, some ill persons can be very specific as to the day and time of death. Again, many of these references are veiled and not understood until after the death of the person. Loved ones report a sense of comfort in knowing that the ill one had a sense of when and was not panicked by the death itself.

Some ill persons request for specific things that they need for a peaceful death to occur. For instance, some wish to return to a place in the past or desire to go to a place of which they have dreamed. These places represent symbols of happiness for the ill one of which they want one more, or one last, look.

Other ill persons desire to reconcile a relationship that has been difficult up until now. They might request a meeting with the person, even if the other has not been in contact for many years. For many, this reconciliation will occur in close proximity of the death, leaving loved ones with the sense that this resolution was what was needed in order for death to happen.

Calanan and Kelley suggest that loved ones pursue with interested questions when the ill one speak. Instead of assuming understanding, they recommend that loved ones ask, "what are you seeing? Tell me more about what you mean." These suggestions can allow the ill one to expound upon the experience. Also, nonverbal pointing or restlessness can also pinpoint a possible 'vision' or experience. If the ill one can no longer talk, ask him/her to blink once for 'yes' and twice for 'no.'

In conclusion, the process of dying can be either a traumatic time or a time of love for both the loved one and the dying one. The determining factor tends to be how open either is to sharing what it is that is felt or experienced. For more information on the subject, read "Final Gifts" and visit a hospice organization in your area. Hospice will be happy to provide much information on what both can expect and what should be shared.