I think one thing we seem to do in the United States is deny that we or our loved ones are aging. We feel young at heart and do everything we can to look, act and feel young. So if a loved one looks ill I might try to focus on the positive and act like they look ok or that things will be better soon. Also most people don’t get a clear prognosis even from doctors because some people do bounce back and live longer than expected. So that time to accept that someone is dying and provide some support is in the frantic last few days of life, when things are chaotic. We don’t want it to be the time to say goodbye so we act like it isn’t the time. Most people are only in hospice a few short days before they die. We are in fighting mode up until the very end many times.


Joan comments:  Thank you for raising this very important topic, Mary.  Our denial of this reality stems from love – we don’t want even to imagine that our loved one will die.  We suffer from “magical thinking” – we think by not mentioning the word “death” we somehow keep it from entering the sickroom.  So everyone dances around the topic, the doctors, family, and friends. If the sick person can’t talk about what they see coming towards them, they are tragically lonely.  Moreover, they can’t do the important end-of-life work that can be done if death comes slowly rather than suddenly. If this is the case for your loved one, and you want to change things, consider enlisting the help of someone trained in opening and facilitating these difficult conversations.  A palliative care chaplain might be the best place to start.