How To Be A Friend To A Friend Who’s Dying: Five Best Practices

(Rev. Linda Bryce is an author, educator, end-of-life doula, and bedside singer who offers emotional and spiritual support to those navigating serious illness and approaching death. Linda’s early experiences with health care for seniors, and later at the bedside of her dying husband, have motivated her professional and end-of-life services.)

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Bluntly put, this is when you discover — or rather your friend discovers — just how good friends the two of you are.

It’s easy when everything is bright and sunny and you’re having fun and getting around. But when one of you has received a challenging diagnosis, indeed, a terminal one, that challenges the relationship big time. We’re not all up for the challenge.

Do you remain bright and sunny? Do you modify how you have fun and get around? Really big question: Do you remain in touch throughout what may be an extended period of increasing inability to manage daily life? Bigger question: Are you able to face death with your friend or do you bail?

We’re not all up for that challenge, either.

When we read reports from folks who are dying, their loudest complaint is how often and soon “friends” disappear. Can’t get to the tennis court anymore? Can’t read through that book for book club? Can’t drive safely to attend activities? Regular or emergency medical appointments interfering with everything? Your friend has not chosen what they are going through. Are you willing to journey with them, despite their increasingly limited participation?

Let’s assume you are a good friend and although uncertain — perhaps even a bit scared — you want to be there for your friend on this last part of life’s journey. Although no situation will be the same as another, these general five best practices taken from my book, The Courage to Care: Being Fully Present with the Dying, are helpful guidelines for your time together.

#1: See the Whole Person

When you walk through the door, you won’t know what you will find. Your friend may be in a completely different emotional state from the last time.  Perhaps today they are upset and angry, yelling at the world and at anyone else, including you. Remember that we experience grief and loss throughout life, and we react in different ways at different times. Remember too that outbursts may be directed at you, but they are not about you. Do not take it personally. Permit yourself to see a friend struggling with coming to terms with the loss of all they know, the loss of their life.

Likewise, your friend’s physical appearance may have declined significantly since the last time. This is not the time to gasp, retreat, or put an “oh, my” look on your face. Maintain your poise, regardless of how you experience the person in front of you.

With this person or any other, see the whole person. See who they are beyond their physical or emotional state. See into and reminisce about their past — with you and before you. Look into their future, too, to fill their days with what matters most to them. See their disappointments and dreams, anxieties, and accomplishments. The person before you represents only this slice of their life; this piece does not show the whole of who they are.

When we intend to offer wholehearted support, we see and accept the person as they are today and each day. Yes, we notice behaviors and speech, but as an observer only. We are neutral about what we see; it is what it is. We see beyond how your friend presents themselves today. You may be the one person to gladden their heart and brighten their day, seeing and accepting them whole — and holy — just as they are.

#2: WAIT before Talking

As a friend, you talk when you get together, but this guideline reminds us to WAIT and ask, Why Am I Talking? Especially when we are nervous or uncomfortable, we may ramble and run at the mouth, as the saying goes. Talking gives us something to do and steers the conversation to safe-for-us topics. Your discomfort with death can make it hard to talk about what is going on with your friend. WAIT encourages you to face what you may be avoiding in conversations.

WAIT also reminds us that even in illness we enjoy laughter and lightness, to “be normal” and set aside our health issues. Your friend is alive; talk and treat them in the ways the two of you typically interact. Jokes? Sass? Silliness? Go for it.

#3: Listen Actively; Don’t Fix

Listening is more than sitting silently as another speaks. Deep listening is focusing on what is said — how it is said, as well as the tone, inflection, and emotions that are released or held back.

Listening actively includes giving cues that indicate you are paying attention. A nod. An “I see.” Perhaps a “please say more” or “tell me about that.” Ask open-ended questions. You may offer language that validates what you are hearing. Examples of neutral responses include, “Yes, I hear you.” “Yes, you are working on it.” “Yes, I am with you.” Your responses are encouraging, supportive, and non-judgmental.

The way in which you listen gives cues as to whether you can be trusted. Are you giving unsolicited advice? Are you avoiding talking about dying and death? Are you brushing off emotions or contradicting feelings? Are you respecting and accepting the decisions, opinions, or desires of the one dying? When your friend trusts you, they will be more willing to share the deeper parts of themselves.

Unexpectedly, Ann shared a deeper part of herself on one of my bedside singing visits. Each visit, she was in a different state but I always greeted her warmly and with a smile. This day, silent, quiet Ann began talking — nonstop for 30 minutes. Because of her dementia I did not understand every word, but it was clear she was speaking of her life. When she finished, she distinctly said, “I thought you would listen.” And I responded, “Thank you for trusting me with your story.” Whatever energetically happened between us on prior visits culminated in her opening in that moment and sharing what was on her heart.

If you feel you must, you might say to your friend, “If you ever want to talk about anything, I’m willing to listen.” But if you make this offer, then mean it — decide that you will be available, that you will change your schedule, if necessary, that you will listen — whenever the call comes. Either be prepared to honor your commitment or do not make the offer. (PS That’s another complaint of the dying — friends who don’t do what they say they will.)

When a friend shares challenges, fears, or frustrations, it does not mean they want a response or advice or feel helpless. It simply and profoundly may mean they trust you — or want to trust you — to be a companion who can hold their pain and confusion and grief at what they are losing too soon. Accept the way they feel. Let your friend figure out what they want to do. It is their life, they are strong, and have their perfect answers inside them. Listen; don’t fix.

#4: Befriend Silence

How do you handle extended silence? When you are uneasy with silence, it is tempting to fill the quiet with talk. Please resist breaking the silence; let your friend do so.

Sit in silence with each other. Likely, your company is appreciated, but your friend may be too tired to talk. Too many visitors and too many worries can sap one’s strength. Silence allows a person to slip into a nap and rest. Perhaps your friend needs quiet right now — for prayer, for space to review life’s choices, or for contemplating death.

Breathe into the shared silence. Honor the deep, unspoken connection between you.

#5: Give them Space — and Stay in Touch

Your presence and staying in touch are the most important. It tells your friend they are not forgotten; that you value them and your relationship to make space in your likely busy life to include them — in person, by phone or Facetime, by greeting card (avoid the “get well” ones; they know they are dying), by letter (remember those?).

And give them space. Visit at a time convenient for them. Schedules can be overwhelming. Caregivers need a respite and some semblance of daily life also needs attention (you might help with some of that). Understand when family wants alone time, precious private time together.

When you are again welcomed in, and words fail, there may be music and song or the simplicity of a shared silence.

For you, the challenge is not the start, but the keep-going phase. Dying is often a marathon, not a sprint.

Your friend and those dying live in a world of shifting landscapes and unwanted change. They see friends change, act differently, and avoid them. They long for steadfast connection. The courage to care includes the commitment to stay in touch for the duration.

That’s the way to be a true friend to a friend who is dying.

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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.

Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.