Death anxiety

It’s normal for people to feel a range of emotions when they’re told their illness is progressing and death isn’t far. Commonly people say they feel numb, sad, helpless, disappointed, angry, or afraid. Family members often report similar reactions. There really are no specific words to alleviate the stress of the situation, but there’s a lot you can do to give your mom some comfort.

The best approach generally is to be attentive to your mom. Let her know you’re there to support her. Often people assume their support and intentions are obvious and they don’t need to say it out loud. Yet it can give someone a lot of comfort to hear words along these lines: "I love you and I care about you. I don’t like to see you going through this difficult situation. You’re not alone. I’m here for you whenever you need me".

Listening may be the single most helpful thing you can do. It shows your mom she’s important to you, that you’re attentive to her needs, and that you’re available to her. It’s okay to ask your mom what she wants to talk about, and what she doesn’t want to discuss. Consider asking what she thinks about her situation, and whether she’s afraid. There are some things you may want to avoid saying. For example, people often say, "I know what you’re going through". No doubt it’s said with the best intentions, but it implies that you’ve been through the same things and have felt the same things. This can be interpreted as minimizing the other person's experience, and may give the impression that you just don’t understand, so there’s no point in talking further. You may consider instead something along the lines of, "I don’t know how it feels to be in your situation, but I love you and I’m here to support you".

It’s very hard to watch someone cry or show distress. This may be one of the toughest parts of being with someone who is dying. It’s common to feel helpless, and really, there’s nothing you can say to fix the situation and stop the tears. If your mom cries, this is the time to show your love and support. Hug her and hold her. Let her know you’re there for her. Crying and feeling sadness are very normal in the face of an advanced illness. If your mom’s sadness becomes severe, it’s important to ask the healthcare team for help.

Some people find that illness shatters their sense of meaning and purpose. If your mother considers herself religious, she may wish to maintain or renew her connection with her faith community and its practices as a way to re-build the sense that life is meaningful. Other ways to find meaning include focusing on whatever is good in the present moment. A visit from a close friend, for example, may provide meaning even in the midst of a difficult day.

For many people, relationships are central to their understanding of meaning and purpose. You might want to affirm the meaning you find in your relationship with your mother by:

• reminiscing together;
• enjoying favourite activities, places, or rituals together;
• openly expressing your love, affection, and gratitude;
• working through treatment decisions and changes in roles and needs;
• letting go of old hurts and resentments;
• talking about the way the illness is changing family life or relationships.

Ask your mother if she has specific goals or things she’d like to do. People often find that finishing some task or resolving an old conflict can bring peace. Ask if there’s any way you can help her.

Your mother may also have some thoughts about what kind of legacy she’s leaving. It’s well known that people benefit from believing they’ve passed on something from their lives that may have meaning to others. You may ask your mom if she has stories she wants to pass on to someone, or if she wants to share some family history or advice with children or grandchildren. You may feel awkward starting such a conversation, but you could be pleasantly surprised at what you learn. If you’ve had such conversations throughout your lives, then this may be a chance to reminisce.

Throughout this time, remember that you too, need care and support. You can help your mom by taking good care of yourself. This includes taking time to do the things you enjoy. Obviously. you want to help your mom cope with her advanced illness, but you can’t do this if you get ill or overcome by exhaustion. Consider talking about your feelings and concerns with someone that you trust. Recognize and accept that you can’t meet all your mother’s needs by yourself. Accept help from people who want to be involved.

There may be resources available to you and your family that can support you. For example, there may be a palliative care program or hospice palliative care association in your region. Such organizations are leaders in end-of-life care. They can offer help and point you to resources available to patients and families.

It’s normal to feel lost and confused when you first get news that someone close to you has a terminal illness. You may feel all kinds of emotions and not be able to control them. The first task is to digest the news and make sense of it. It’s difficult and it takes time. Stop and reflect, think about your questions, and look for information before you do anything or make any decisions.

A good way to start is to reach out to people and services related to palliative care. It’s best to know what’s available and make contacts before there’s a crisis or a major change in your dad’s condition. Your father will have a health care team or a palliative care team to help support him and you. These health care providers can help you and the rest of your family deal with the emotions and the changes to come. If you think you’d like to talk to someone about this, don’t hesitate to ask.

It’s normal also to not know what to say. In society generally, there’s discomfort with talk about death and dying. Many people have never faced it nor had to care for someone who is dying. We have so little experience with death that most of us are afraid of saying or doing the wrong thing. Usually we say nothing and try to avoid the whole situation. Open communication helps everyone. You’ll realize that you share similar emotions and questions, and together you can ease fears, find answers to questions and reach out to health care providers for help.

Many people find it difficult to talk about death, dying and their own illness. For some people this kind of discussion is most difficult with family.

You can try several strategies to help your father open up and talk. It’s possible that no matter what you try your dad may be unwilling to talk. This can be hard for you, and if it is, it may help to tell him so. Unless he knows, he may not realize that talking will help you and him.

First, it’s important to acknowledge your father’s illness and even ask questions about it and how he’s doing. If you say nothing it can be awkward for both of you. It’s possible that you both want to say something, but each is afraid that the other is uncomfortable with the subject. Your father may want to protect you, which may be why he isn’t talking about things, or he simply may be uncomfortable. If you make the first move your dad may feel more at ease. By inviting him to talk, you are letting him know that you are open to talking about dying, or whatever else is on his mind. If your father still is silent, it may the way he needs to deal with his illness at this point. If you make it clear, however, that you’re willing to talk, it’s likely to be a comfort and may make it easier for him to open up when he’s ready.

If he does start talking, the best suggestion is to be attentive. Watch and listen for clues that tell you what your dad wants to talk about, what makes him uncomfortable and what’s comfortable. Often people who are dying are afraid of pain and other symptoms at the end of life. As your dad talks, some fears may come up. If this happens you may want to contact a health care provider who can help explain his illness and what to expect.

It’s okay to ask your dad if there are things he wants to talk about. He may have certain memories or experiences he wants to share. If you’re not sure whether your father’s comfortable with the direction of conversation, or if you’re not sure what he means by some comment, just ask. The first discussion is often the hardest. It should get easier as you and your father continue to talk.