“Meghan, w-w-w-w-hat are your wishes?” My mother asked, her brain tumor making her speech halting, and, at times, unintelligible. The words that I wanted to say seemed to get stuck in my throat but eventually I was able to cough out “I wish that you could live.” This began one of the many conversations that my mother and I had between the time that she was diagnosed with colon cancer and brain cancer, and the time that she died.
My mother was sick for a long time – six years – before she died. Thus, I had adequate time to think about all of the things I wanted to say to her. As it turned out, my mother had one health crisis after another during those years so I ended up speaking with her a lot. In a perfect world, we would do this in each of our relationships. It would deepen our relationships if we consistently honestly communicated with each other instead of waiting until a moment or two before death. In my mother’s case she was dying a slow death so there was plenty of time to tie up loose ends. In the case of sudden death a lot can be left unsaid unless we have been telling the person all that he or he means to us throughout the relationship.
At any rate, when facing a loved one who we know is likely to die shortly, our own anxiety coupled with the anxiety of the dying person can cause all potential communications to come grinding to a halt. One of the big questions is always: Can we talk with the person about the fact that he or she is dying? We are afraid that we are going to upset the dying person if we speak about his or her death. Often, the dying person finds himself or herself in the same boat. He or she often wonders if relatives know what is happening (i.e. that the person is dying) or whether he or she needs to protect them from this truth. This is an awful bind for a dying person to be in because instead of focusing on what he needs to do for himself during these critical moments, he ends up spending his energy on protecting his loved ones, protecting them from something that they probably already know, that he is dying.
I faced the same dilemma with my mother. One night that I was spending sleeping in the hospice with her she asked me point blank, “Meghan, how is my health?” Not really sure how direct to be, I said, “I am not sure, how are you feeling?” She started screaming, “Oh my God, I am dying” over and over again for what seemed like hours. It felt almost unbearable to sit there and hold her while she screamed out in anguish over the realization of her impending death. At the same time, it was a moment of sadness that we shared. It opened the door to further communications between us. My mother knew that I knew that she was dying and I knew that she was aware of it as well. From that moment on whenever I would leave the hospice in the morning (I would sleep there overnight) as I would lean over to kiss my mother good-bye (which is derived from God be with you) she would say, “I will miss you.” I would tell her that I would miss her too knowing full well that we were not just speaking about the daytime hours during which I would not be with her. I am quite sure that the conversation would have been shut down had I answered her question, “Am I dying?” by saying, “No.” She was testing me to see if we could speak about her death, and by not saying “No” outright I gave her the green light to speak about her fears. This then led to a conversation about our relationship.
People often ask, “What should I say when speaking to a dying loved one?” While we can really speak about anything, some of the things that seem to be most helpful to discuss are providing reassurance to the dying person, asking forgiveness from the dying person (and granting forgiveness to the dying person), telling the person how much you love them, thanking them for various things, reminiscing about the past, and letting them know that you will keep them alive through your memories after their death. As my mother approached death she became preoccupied with a decision she had made that directly affected me. She wanted to reverse that decision but it was impossible. I reassured her repeatedly that it was OK, that I was not angry. I forgave her. She also was worried about me. I was single and she did not want me to be alone as a result of her death. She kept repeating, “Meghan, alone,” “Meghan, alone,” over and over again. I reassured her that I would be okay, that I would not be alone. Neighbors, friends and relatives also reassured her that they would not leave me alone. This seemed to allow her to rest more easily.
A lot of the conversations that loved ones have with the dying are about reassurance, especially when the dying person is leaving young children behind. They need to know that their children are going to get the care and attention that they need. And, while no one can ever fill the role of a beloved deceased parent completely we can work to sew up the gap. My nephew had just been born a year before my mother’s death. At one point she said, “I wish I could see all of the babies.” I said that I wished that she could see all of her grandchildren too. Then, I told her that we would make sure that they knew all about her through us, and through our memories of her. It was in no way acceptable to her or to me that she would not be there to get to know them herself but at least I could reassure her that she would not be forgotten. This seemed to give her some peace. And, it made me feel better that this intense love that I had for my mother did not have to die, but could live on through memories shared with others.
It is best to have these conversations early and often but sometimes that is not possible. It often happens that by the time someone reaches their loved one’s bedside they are in a coma or otherwise seem out of it and unable to communicate. At this point people sometimes feel, why bother saying anything at all, he or she cannot respond anyway. I would urge people to say what they need to anyway. Hearing is believed to be the last sense to go, so often dying people can still hear what people are saying. This theory also applies when you are speaking to others while you are around the dying person’s bed. Do not say anything that you would not want them to hear. My mother seemed to be in a coma for her last ten days of life but I spoke to her anyway. I kept the same routines that I had been keeping prior to that time. I believe that she was aware of my comings and goings, especially because she decided to die shortly after I returned for my evening shift. I believe that her death was something that she wanted to share with me. She knew that I would be able to comfort her and pray with her as she died. She knew that I would tell others about her death. In sharing my experience of her death I would make it meaningful in some way, it was not for nothing. As long as the person is alive, it is never too late to say goodbye.
This blog post has been all about how to “say” goodbye to our dying loved ones. It was sparked by a question from a reader whose brother is dying. While it is important to try to put into words our thoughts and feelings when a loved one is dying it hardly ever feels adequate. Sometimes what is right is to say nothing at all but to simply hold our loved one close as he or she approaches death. Often the work of saying goodbye has to continue after death. We continue to speak with our deceased loved ones. We continue to try to make the ending right in our minds. They continue to be the sparkle in our eye and our lantern for the dark.