Dear Joseph,
How do you best help a friend that has only days to live? I assume being a good listener is important, but is there anything helpful that I should say?
Signed,
Hoping to Help
Dear Hoping,
For purposes of my response, I’m going to assume this is a close friend, not simply an acquaintance. If your relationship is weak, they may find stress rather than comfort in your presumption of intimacy. But if they feel safe with you, if you’ve earned their trust, you should assume nothing less than that. This is when true friends show up. Here are some thoughts about how to show up.
First, you ask: Can you say anything useful? I don’t know. But what I do know is that they probably want your companionship more than your advice. They are unlikely to want someone who attempts to beguile them from their obvious predicament with magical homilies. Don’t pressure yourself by assuming you need to fix something. What they will want most from you is for you to sit with them in their predicament. Experience it with them. Love them in it.
Second, my experience is that in situations like this, we fault more often on being too tentative than on being too intrusive. It is often the case that more intimate is more appropriate. We often act as though we believe not talking about the fire-breathing dragon in the room is safer/kinder/better than taking a person’s hand, sitting beside them, and staring at the dragon together.
Third, spend less time telling them how you feel about their impending death and more time asking them how they feel. Ask about their beliefs. Ask about fears. Ask about regrets. Ask about their legacy. Ask about their proudest life moments. These are perspective questions—ones that invite connection around larger issues of life. Beginnings and endings are moments of perspective. These are the kinds of thoughts that are naturally occurring to them anyway. So, go there with them. If they inquire, feel free to share your perspective on these questions, but don’t cross the line into coercion. Never take advantage of your psychological advantage of being the healthy one to impose your nostrums.
Finally, relieve their stress. My father taught me once that stress is like arithmetic. Everyone has a certain tolerance threshold. Mine might be 40. Yours might be 45. But we all have a number. The amount of stress we feel at any time is equal to the sum of all the stressors acting on us. Some might be 3s (I have a chip in my windshield that might spread). Some are 5s (my water heater is leaking now). And some are 10s (I’m dying). Thinking about stress this way helps point out two things:
1. Everyone has a tolerance limit. Everyone begins to crumble when the sum of all their current stressors exceeds their tolerance limit. Everyone. Even if your tolerance level is 327. If your stress sum is 600, you will break down.
2. You don’t have to remove the big stressors to help someone get below their limit. If your friend is dying, you can’t fix that. You can’t take away the 10. You may not even be able to do much with their 9s and 8s. But if you take away enough 2s, 3s and 4s, you might help them get back to manageability.
Once I learned this, it changed the way I talk with loved ones who are suffering. I no longer make vague offers like, “Please let me know if there is anything I can do to help.” This is a worthless offer. Basically, it says, “Here’s one more thing for you to think about—think about helping me feel helpful!”
Instead, I teach them about the arithmetic of stress, then I hand them a pen and paper, and I say, “Write down EVERYTHING that’s on your stress list right now.” I sit with them and encourage them to work all the way down to the nit-picky 1s and 2s. When the list seems complete, I go to work. I don’t ask for permission. I take charge of all the fixable things on the list.
I hope these ideas help. And I hope the sacred last moments you share with your friend are filled with the real intimacy.
With love,
Joseph
You should re-title this article to “How to Be There for a Friend in Distress”. This is applicable to anyone facing major issues (health crisis, divorce, death of spouse/parent), not just for someone facing death. Great article, and I love the Arithmetic of Stress 🙂
Completely agree. I’ll be putting this into action for sure.
I agree, Anita. This is how I think about anyone I love who is going through a tough time. Best wishes.
Thank you for the response on how to “be” with a dying friend or loved one. It is another great perspective that may make those final hours for you both more meaningful. I shall remember this.
What a beautiful read. Thank you for sharing.
Hi Joseph – I’ve been reading your posts for quite some time and I’m a fan. Today’s blog was quite touching and practical. Thank you for sharing your perspective.
Thank you, Jeff. I’m grateful for our virtual friendship.
Beautiful and actionable.
Grateful, as always, for you, Joseph.
Perhaps this article reinforces making friends and keeping friends and family close; spend less time chasing entertainment.
I am not sure exploring all these things is the best thing to do when death is around the corner. Pay your respects, decide to stay only a few minutes, knowing it can be tiring for this person and there may be more who want to visit in the coming days.
In my experience as a healthcare professional, people try to make up for lost time when a beautiful, heartfelt and simple greeting is best.
Share a smile, hold his/her hand and know it’s OK to be silent. Share a memory, let him/her know your prayers and good thoughts are there and respectfully leave.
Offer to grocery shop for the family, pick up the dry cleaning or run the mail to the post office (something simple and useful). Those efforts will be appreciated.
Lastly, it may not hurt to ask your friend if s/he communicated funeral arrangements; who the rabbi/priest/minister is to contact, from which synagogue/church to be buried, cemetery, etc. I have seen the children who live far away don’t know what to do next. Hopefully, your friend can write down or provide the details for them if those things have been pre-arranged.
Mr. Grenny and anyone concerned,
your suggestion to spend “more time asking them how they feel…about their beliefs… fears… regrets… legacy… proudest life moments” reminds me of that new yorker article “The 36 questions That Lead to Love”, which i’m not going to try linking here but is worth a quick search nonetheless; it was based on the idea that sustained mutually escalating self-disclosure would make people feel more intimate, closer, more connected, etc., in an attempt to get them to work more effectively together, and most of the questions are similar (this Aron/Bator/etc paper: The Experimental Generation of Interpersonal Closeness: a Procedure and Some Preliminary Findings).
thank you also for the stress arithmetic metaphor
Greetings. Thanks for sharing this article. It is a very deep question. Having lost two loved ones recently, it is a tough situation to know exactly what to say. We definite need to “be there” for that person. As well, with my father in law, he asked me to take care of a few things for him once he was gone. I most certainly said I would and this brought some peace for him.
Can I offer some more hope though? In my father in laws case, my wife asked if she could pray for him. He was not a man of faith, but said yes. He was open to his own daughter to share these last few days together praying for him.
There is hope in Jesus. If you are curious, look at the Bible and read John 3:16. As a man of faith, I know that I am not perfect, but Jesus is. When we face this time, and we all will, we need to know what is next. There is hope in Jesus Name!
You miss the point of the article by proselytizing in this forum. When my mom was dying, she was so irritated by my aunt who showed up to visit and didn’t help our family at all – her sole mission was to make sure my mom was “saved.” This is so hurtful and selfish. It’s fine if you want to believe, but please don’t try to convert people in vulnerable times, as it is truly a predatory act.
Perhaps your aunt’s motives seemed selfish to you or your family, but I can assure you it was not selfish in trying to help your mother. I can’t imagine why you would view that as “predatory.”
It is unselfish for a person of any faith to pray privately for the well-being of another without ever mentioning it to them. This is what we do when we Love. It is predatory for one human being to use their own criteria to judge another to be defective and to take overt action to perfect them. Defining the mother as being “unsaved” and launching an unwelcome, irritating, conversion event is what we do when we are controlling and self-centered, not something we do when we are other-centered and God-centered.
Well said. Thank you
Thank you for sharing this article. Ive personally found the arithmetic of stressors to be so very applicable to many different circumstances, and do believe that everyone has a different number they can handle. Being aware of this has helped me to pull people back from the edge many times.
You know, I always like Joseph’s posts. But this one made me like Joseph himself. What a lovely and kind way to talk about this difficult issue. And something I can easily do.
I often find myself in a position to talk with a friend who has someone they love dying. This message will work for them too.
I thought this was a great article, especially the part at the end of just removing the stressor 2’s and 3’s and 4’s on the friend, without even asking! But on the Holmes and Rahe Stress Scale for adults, it stops at “Moving violation of the Law” with a stress of 11. Do you have another scale in mind when you think of 2’s, 3’s and 4’s, or are these other, lower stressors that the person would tell you?
Very nice article. Thanks for all the practical advise. These are difficult times and I had to say to say good bye to a very dear cousin. I wish I had seen the article sooner. Thanks anyway
I am the person in distress. Im not sick, but i´m the caregiver of my child who is. I found your article moving and helpful. Thanks for sharing it. Totally agree with the suggestion of changing the title. But the original was catchier for sure.
My sister is presently dealing with a rare form of cancer….and I just love the advice to “write down everything that is stressing you”. Then I can just jump into action when I am with her.
Awesome read!
As a physician, I heard lecturer encouraging us to ask patients what their greatest fear in dying, and then address it. I starting doing this. I was shocked by some patients greatest fears. For one patient with 2 young children, I assumed her greatest fear would be her children growing up without a mom. Instead her greatest fear was pain. I reassured that morphine would handle that and she was relieved. Another patient was afraid her ex would get the house so we talked about getting a Will. They were glad I asked the question.
For my friends suffering with grief, I bring food so they will not have to worry about cooking or food shopping. Sometimes we need to help with the smaller things and just be there to LISTEN
Great article full of humane and practical advice.
This was a fantastic read. I love the arithmetic of stress analogy. I often find myself being that person who says “Let me know if there’s something I can do for you” and I know that is such an empty offer. Thank you for providing actionable steps to be of service to loved ones who are struggling.
Exactly!
Thank you for these words of wisdom!
Thank you Joseph. This is extremely helpful as I’m in that age group that is experiencing loss (siblings, family members, friends). I now have additional skills to create that safe environment to invite others to share.
As the end is near….hearing is the last sense a dying person loses.. Keep talking…reminisce- talk about favorite subjects..talk to the person!
Love this
This advice is well timed and articulated. Thanks.
My baby sister is struggling with a cancer that does not submit to cure. I am grateful for this timely guidance. Thank you.
Thank you, Joseph, for this useful and insightful information. So many times I have been in this situation with no idea what to say or do. I believe the arithmetic would also be useful with the spouse or partner, as they are dealing with just as much stress.
I love the concept of the arithmetic of stress
Thank you for your awesome suggestions. When my mom was dying my siblings and I (6 of the 7 of us) sat together in her room and we talked and laughed about old times. There were stories we’d never heard before about each other and my mother listened and laughed along with us. I think for her dying was a relief and there didn’t seem to be any stress. It was her wish to see each of us one more time and to have most of us together was a happy moment for her.
That is a great Idea, coming at a perfect time.
I thoroughly appreciated this article! Lots of nugests there to put into practice and so well said. This was wisdom I could take and use right now and of course it is applicable to more than a dying friend. I want to reach out to you on a social science situation we are having that is interfering with performance in our company. I will find a way to contact you.
Just lost my dad so this feels fresh. We talked about much of what we shared together in life, both happy and difficult times, but it was mostly a rear view mirror approach. Now, I wish I had focused a bit more on his feelings and thoughts about impending death and if there was anyway I could alleviate those current concerns. He was 90 and really ready to go: there is no going back, so I can’t live in “woulda/shoulda/coulda” now. However, I will certainly use this perspective moving forward. The one thing I am confident about: there will be other opportunities and I will be there for those friends in a better way having read your article.
I absolutely love this. Thank you!
Love this! It was meaningful, useful and insightful. Thank you Joseph.
This is really good – thanks so much. And love the idea of having them write down everything – then my being the one to work on that list – how useful. Thank you.
“Write down EVERYTHING that’s on your stress list right now.”
I love this!
What a wonderful idea! You are correct – asking how you can help will likely be met with zero requests, but even the mere act of writing all of the stressors down on a piece of paper may relieve their mind.
Brilliant!