From Final Gifts

Respond to anything you don't understand with gentle inquiries. "Can you tell me what's happening?" is sometimes a helpful way to initiate this kind of conversation. You might also try saying, "You seem different today. Can you tell me why?"

Pose questions in open-ended, encouraging terms. For example, if a dying person whose mother is long dead says, "My mother's waiting for me," turn that comment into a question: "Mother's waiting for you?" or "I'm so glad she's close to you. Can you tell me about it?"

Accept and validate what the dying person tells you. If he says, "I see a beautiful place!" say, "I'm so pleased. I can see that it makes you happy," or "I'm glad you're telling me this. I really want to understand what's happening to you. Can you tell me more?"

Don't argue or challenge. By saying something like, "You couldn't possibly have seen Mother, she's been dead for ten years," you could increase the dying person's frustration and isolation, and run the risk of putting an end to further attempts at communicating.

Remember that a dying person may employ images from life experiences like work or hobbies. A pilot may talk about getting ready to go for a flight; carry the metaphor forward: "Do you know when it leaves?" or "Is there anyone on the plane you know?" or "Is there anything I can do to help you get ready for takeoff?"

Be honest about having trouble understanding. One way is to say, "I think you're trying to tell me something important and I'm trying very hard, but I'm just not getting it. I'll keep on trying. Please don't give up on me."

Don't push. Let the dying control the breadth and depth of the conversation-they may not be able to put their experiences into words; insisting on more talk may frustrate or overwhelm them.

Avoid instilling a sense of failure in the dying person. If the information is garbled or the delivery impossibly vague, show that you appreciate the effort by saying, "I can see that this is hard for you; I can see you're getting tired/angry/frustrated. Would it be easier if we talked about this later?" or "Don't worry. We'll keep trying and maybe it will come."

If you don't know what to say, don't say anything. Sometimes the best response is simply to touch the dying person's hand, or smile and stroke his or her forehead. Touching gives the very important message, "I'm with you." Or you could say, "That's interesting, let me think about it."

Remember that sometimes the one dying picks an unlikely confidant. Dying people often try to communicate important information to someone who makes them feel safe-who won't get upset or be taken aback by such confidences. If you're an outsider chosen for this role, share the information as gently and completely as possible with the appropriate family members or friends. They may be more familiar with innuendos in a message because they know the person well.

This is a great book for anyone who works with dying people or if you have someone you love suffering from a terminal illness.