Being diagnosed with a terminal illness is traumatic. But sometimes, what people say in an effort to offer comfort is equally distressing. The truth is, many of us just don’t know what to say to a loved one who is facing their mortality.

“Most of the time I really liked when people said nothing,” notes Michelle Colon-Johnson, who has been diagnosed with stage four cancer five times and survived. “If I wanted to discuss my diagnosis, it felt good to know I had people I could talk to, but I never wanted to be treated differently.”

Anticipatory grief is a difficult process experienced by friends and relatives as well as the dying individual. Experts who assist patients in their final days say the best thing to do for someone who has received news of their prognosis is to allow them to guide your conversations and actions.

“They might not want to talk,” explains social worker Edie McCaddin-Bower, vice president of support services at Beacon Hospice. McCaddin-Bower says it’s important to respect the patient’s wishes, but let them know you’re willing hear their thoughts, wishes and fears whenever they are ready. Meredith Cinman, a social worker and ancillary services coordinator at Amedisys Hospice in Valencia, CA, adds that loved ones should try not to worry about saying the “right thing” and focus on spending more time truly listening to the patient instead.

What NOT to Say to Someone Who Is Dying

“Avoid clichés or platitudes,” notes psychiatrist and author Marcia Sirota, M.D. “Saying things like, ‘Everything happens for a reason,’ and ‘It’s God’s will,’ can make the person feel like their illness is their fault.”

Saying things like “You’re strong” and “You’ll get through this” is equally problematic. Although it can be tempting to reassure a patient that they’ll be okay, this approach can be hurtful because it does not acknowledge the patient’s feelings and concerns. “Maybe they don’t feel strong right now and need to feel like they can be afraid,” Dr. Sirota adds. “You need to give them the space they need to share their fears and come to terms with them.”

Gestures Speak As Loud As Words

Dr. Sirota’s advice to family members and friends is to give your loved one as much emotional support as they need, and be aware that this doesn’t always have to come in a verbal format. Use actions to make their remaining days as easy and comfortable as possible. “In this respect,” Dr. Sirota says, “don't wait for the patient to ask for help because they might be too overwhelmed to do so.”

Be thoughtful about gestures that would be both practical and meaningful to them, and then see these things through. Prepare and deliver dinner, offer to clean the house, run errands or drive to doctor’s appointments. If you say you’re going to do something, follow through and do it. If you aren’t sure you will be able to deliver, it’s best not to make any commitments.

“The greatest gift you can give is your time and attention,” stresses Nancy Sherman, director of bereavement at Bertolon Center for Grief and Healing at Hospice of North Shore and Greater Boston. “If you live close enough, you have the opportunity to demonstrate your support by being there.” During visits, rent a movie and make popcorn, play games, or just sit quietly with them. If faith is important to the patient, consider praying or reading the Bible together. “These actions say, ‘I’m willing to walk this difficult road with you, regardless of what that entails.’ ”

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If you're unable to visit in person, stay in touch through emails, phone calls, video chats, notes and cards. “Use this time to tell your friend or relative how much you love them,” Sherman adds. That could be recalling funny stories or important moments in your relationship. The goal is to make sure nothing is left unsaid. Keep in mind that they may not always feel like talking, though. In these cases, notes and emails are helpful for communicating your feelings and messages of support without your loved one feeling pressure to chat or respond immediately. Let them know they are in your thoughts and that you are available to talk whenever they feel the need.

Facing the Reality of a Loved One’s Final Days

If you are close enough with this person to discuss end-of-life care and final arrangements, it is important to broach these topics. The conversation may be uncomfortable initially, but talking out details and preferences will assure your loved one that their wishes will be carried out and provide you with clear instructions to follow before and after their passing. End-of-life discussions can also help both parties come to terms with the situation and segue to other poignant conversations.

When Mercia Tapping’s husband was diagnosed with terminal brain cancer, they talked openly about his impending death. “We faced his disease head on,” she recalls. After a two-year battle, her husband passed away at home, as he had requested. “We had discussed all aspects of his burial and funeral. He wanted me to deliver his eulogy, and I did. Because we faced this so openly together, I have no regrets. Nothing was left unsaid or undone, which makes his death painful but complete.”

Katrina Kritz is dealing with a similar situation as she watches her mother's congestive heart failure progress. “In a situation like this, there is nothing to say except ‘I love you,’ ” says Kritz. “I tell my mother all the things that I never had the time to tell her before. I hold her hand and stroke her hair and massage her feet. I can’t imagine what she feels or what her thoughts are, so I just love her by being beside her and comforting her the best way I know how.”

Letting someone know how much they are loved, listening to them and offering a hand to hold are perhaps the three greatest gifts to give during this time. “We must talk about our fears, wishes, joys, and regrets and be able to accept and forgive before we end our time on this planet,” offers Paula Shaw, who has been a grief counselor for 21 years. “Anyone who helps us do this is a gift.”