When They Won’t Get Better

What (and if) to write to the dying and their loved ones.

It’s part of the privilege of being human
that we have our moment
when we have to say goodbye.
—Patti Smith

I don’t have any answers for this one. Just want to get that right up front. I didn’t put “How to” in the headline or the deck because that would imply that I know what to do, and I don’t.

But I read. And I experience things. So, I can learn what others have done and speak from my heart about what I’ve felt in my own experiences.

I’ve addressed variations on this topic before (Sympathy Cards, Pet Sympathy Cards). My little analytics thingy tells me that quantitatively they were received pretty well; that is, a higher number of people opened and (presumably) read them. Qualitatively I think the topics hit home, too, based on the number of comments I received.

Although I have gone through distinct kinds of sorrow with each human and non-human animal lost through illness or old age, the personal impact was always the same: It was awful. The only substantive difference I can cite between the losses of my early adulthood and those of the past decade has been the gradual realization that I would go through this again until the day I die, and I probably would survive—until the day I don’t. Of course, I have no way of knowing how I will respond when I am the one dying, having not had that experience yet. All any of us can do is theorize.

The other commonality in my experience of loss is that almost without exception I have appreciated the efforts of those brave enough to say something or write something. There have been exceptions, but they are few.

So, I suggest this general bit of guidance: Think about what you would like said to you, and do that. If it is offered after a thoughtful consideration of your loved one’s personal circumstances, your condolences probably will be valued—even cherished.

Much of the following advice I found is geared to in-person communication, but it can be extrapolated for written messages, too.

From this Denver hospice (and who better to know this stuff?) comes good advice, including encouraging people to assure the loved one that they have lived a good life, that you will remember them, and that it’s okay for them to let go when ready.

I am reassured to hear this, because it’s something I told a close loved one when he had reached, and really had gone beyond, his imminent death—a circumstance as agonizing for his nurse and his family as it was for him. As someone close to him but not nearly as close as were his other family members, I assured him it would be OK. Perhaps my slight distance allowed him to believe it in a way he couldn’t, coming from those closest to him? Who knows what effect it had? But he died a few moments later, to the relief of everyone in the room.

A resource cited in the above article illustrates another great option available to you wherever you live: your preferred funeral home. Suggestions of good phrases are offered by the Renaissance Funeral Home and Crematory in Raleigh, NC. Among them:

• “I love you, always.”
• “I’m here for you, no matter what.”
• “You’re not alone; we’re in this together.”
• “I’m just a phone call away.”
• “You mean the world to me.”
• “I’m thinking of you every day.”
• “If you want to talk, I’m all ears.”
• “You’re important to me, and I care about you deeply.”

Sage advice and lots of other useful stuff can also be found at grief support site Ever Loved.

Hallmark, that Cadillac of modern-day sympathy gurus (albeit a commercial one), offers great advice on a topic its writers know in their bones. This article by one of them feels to me as if she is talking to me one-on-one as a friend.

She begins with a confession: “I’m a longtime Hallmark writer, and I still felt stumped when asked about writing this kind of message. Luckily, I work with thoughtful people who have direct experience as caregivers and family members of someone in hospice.”

The hospice nurse she contacted advises that “by the time a person has entered hospice care, they’ve accepted the fact that they’re dying, and it’s helpful for them to know that family and friends have accepted this, too. They’re tired of pain, tired of suffering, tired of fighting. You can keep praying for a miracle, but the person who’s dying needs you to affirm that it’s okay to stop fighting and to focus on peace and comfort instead.”

Examples:

“I know this wasn’t an easy decision to make. Just want you to know I support you and I’m glad you’re making the most of this time with the people you love.”

“I don’t like this, but we’re going to do our best with this time.”

“I’m sad, of course, but I’m also glad you’re in a place where you don’t have to fight so hard anymore.”

“I’m praying for you to feel at peace and to know how much you’re loved.”

This is just the first batch of many more terrific phrases—any of which I know I would appreciate—that can easily be worked into a card or a letter. Further, they  are helpfully organized by topic groupings. Additional topics are

Thank You (“Thinking of the good life you’ve lived, the great times we’ve shared, and feeling so grateful for you”);

I Love You (“It hurts to let you go, but I wouldn’t trade one moment of all we’ve shared. I love you with all my heart”);

We’ll Be OK (“I hope it eases your mind a little to know Spot is going to make his new forever home with Kathy and Tom. They’re happy to have him, and they promise to love him just like you do”);

Life and Legacy  (“I hope you’re proud of the amazing family you’ve raised. Thanks for putting some good humans into the world.”);

Family and Caretakers (“It’s okay not to be okay right now. Remember that, and know that it’s fine to let some balls drop. You’ve got a lot of people who will come and help pick them up—me, for one”).

There’s even Lightheartedness and Humor, which was the approach taken by the two sainted men who sat with my father nearly 24/7 at the end of his life and for whom I would throw my body over the railroad tracks if asked. Still, that category seems tricky to me—I’ve been known to stick my foot in my mouth trying to be funny about topics way less sensitive than this one. But you’ll know when and for whom it’s right. And I like that this nurse recommends it.

The most important category, though, is What Not to Say. Among them: “I’m still hoping/praying for a miracle”; “Keep fighting”; “This is God’s plan/will”; and (yikes) “You look great!”

A lengthy and, I think, particularly moving forum on Quora gives and offers advice from plain old individuals, who I consider experts because they’ve been through it. For example, to a friend who is losing a loved one:

“Tell them it really sucks and it is going to suck for a long time, and that’s okay. Eventually, time will make it suck less but it will always suck a little bit.”

Another notes,

“My friend sent me a stupid dad joke every day. It may not sound like a lot, but it gave me 30 seconds of the day where I wasn’t miserable. As she lived on the other side of the country from my parents, it was something she could do.”

A dear family friend who was gutted by my father’s last journey did a version of this. She sent me postcards that said almost nothing and were stupid. “Today is Tuesday.” “This is a drawing of my front yard.” The postcards were cheap index cards on which she would crayon a child-like tree or a stick dog. I never got anything better. She left us a decade ago, and I still miss her most days.

I’ll share one more rather lengthy insight from another member of that forum thread:

In my many (oh, so many!) years on this earth, I have learned that friends and support systems can tend to drift away as if, after the formalities and services are over, the matter is settled and done, and life will resume as normal. It’s not, and it won’t.

Children of deceased parents (or other loved ones) - whether younger or adult children - are likely, at some point if not immediately, to still want to talk about the one they’ve lost, but a lot of people tend to treat that uncomfortable subject as the elephant in the room and not want to talk, or sometimes even listen, to the bereaved person about their loss once the funeral’s over and the closets cleared out.

So, remember that after the casseroles are eaten and the routine returns to some semblance of normalcy, the pain (and often guilt which is normal although likely not really rational) will be fresh and raw for a long time. The ones left behind may find real comfort in talking about the one they’ve lost.

A kind person will continue to reach out and make contact without forcing or expecting anything at all - be a safe space for your friend, and most of all, listen if they want to talk.

Poet, beagle lover, and friend Anita Skeen sent me fabulous resources after one of my sympathy posts. Fabulous because they are creative as well as therapeutic.

One guess what this poet offered up.

“Kevin Young has edited an anthology called The Art of Losing,” Anita wrote, “after the Elizabeth Bishop poem with the same title, which has many wonderful poems for occasions involving grief.  Sometimes I’ve given the whole book to someone experiencing a loss.”

She also recommended “whole books of poems about the loss of someone—Ed Hirsch’s Gabriel about his son’s suicide, Ellen Bass’ book about her brother’s death, Donald Hall’s Without on the death of Jane Kenyon, his wife, or Carol Muske-Duke’s book Sparrow about the death of her husband. There are many such books out there that folks might find helpful, if they knew where to look.”

She continued, “So, I would say to folks, ‘Look for a poem.’ You can send the whole thing, or quote a few lines.”

Then she ended as I will: with an excerpt from a poem by Emily Dickinson.

This is the Hour of Lead –
Remembered, if outlived,
As Freezing persons, recollect the Snow –
First – Chill – then Stupor – then the letting go –

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Lagniappe: The occupation listed on the passport owned by the late Kris Kristofferson, who died September 28, 2024, was “writer.” In an obituary, he was quoted as saying he wouldn't have gotten anywhere without it.