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Emotional Support During the End of Life

Updated: August 11, 2023

There are many feelings and emotions that are a normal part of dying, both for you and your loved ones. The goal of emotional support is not to try to ‘fix’ these feelings, but to support each other while you reveal and learn to deal with these feelings. It will help you cope if you all communicate with each other as honestly and respectfully as possible. The most important aspects of communication are to express love and listen carefully to each other without judgement, argument, or defensiveness.

The fear and apprehension associated with dying can make it difficult for loved ones to start conversations when you are dying, so much so that you may feel alone before they are able to do so. Many loved ones are reluctant to discuss your illness and impending death, so one of the most difficult tasks can be deciding what to talk about.

  • In reality, it is the interaction that is most important and the topic less so. Just being there helps, even if you are just sitting quietly or watching a movie together.
  • Like any conversation, the topic is usually a mutual agreement among those involved.
  • You can begin with whatever is comfortable, even if it is only small talk about sports, movies, or current events.
  • Once you become more comfortable, the conversation can move on to issues about the dying process, your death, and what comes after.
  • Whenever possible, your loved ones should take their cues from you so your needs are met.
  • Your loved ones should avoid false optimism by not implying that things could get better or urging you to keep fighting.

There are other aspects of coping with impending death, many involving practical solutions. One of these practical solutions is to communicate with your palliative care/hospice team so you can take advantage of the services they offer.

  • They can help ease the fears and anxieties associated with concrete end-of-life plans, such as funeral arrangements and estate planning or arranging help to assist in caretaking at home.
  • They will offer other services, such as counseling or clergy, that can help you and your family express your feelings, communicate better, and improve how you experience the end-of-life process.

Planning and processing an imminent death is among the hardest things you and your family will go through. Aside from the reluctance to bring up the uncomfortable subject matter, there may be baggage you must lay aside, such as:

  • Trust issues, fears, anger, inner conflict, unfinished business, or unshared secrets;
  • Troubling family issues, such as estrangement, conflict, resentment, and barriers to communication; and/or
  • Reluctance to atone for or apologize and ask for forgiveness for past deeds.

It is impossible to go through all the complexities of the interactions among your family and all of the overlapping and evolving emotions that will occur during the process here. However, we will go into some of them and focus on the services available to help you and your family cope with your terminal condition.

While it all works together, there are four general areas of support that you and your loved ones may need assistance with, any of which you may request your hospice team to help you with.

  • Support for each other – ways to help each other process your feelings and learn how to say goodbye.
  • Individual support for you – ways to help you experience the dying process and its effect on your loved ones.
  • Support for your loved ones – ways to help them with their feelings and emotions, as well as learning ways to help support you.
  • Grief counseling – support for your loved ones after you have passed. All of this support is available in any combination of individual therapy, group therapy sessions, or support groups. 

Mixed-up Emotions

You will surely have a wide range of emotions that are all mixed together and changing in intensity over time. Your loved ones will be experiencing a similar mingling of emotions, in some cases for different reasons. To complicate things even further, what you are all feeling will probably be out of sync with each other. This means that what each of you needs will vary over time, so the support at any given time must adapt to these changes.

Grief

Grief is a common emotion experienced by anyone affected by death. It is an adaptive and healthy reaction to loss. Grief after someone has died is usually expressed through mourning (expressing grief and loss to others) and bereavement (experiencing sadness about their absence).

Grief is normal when anticipating death. Your family and friends will also be grieving about what you are going through and the impending loss as well. It is a very personal process and there is no right way to do it. Grief can be a long and difficult process full of ups and downs, relapses, confusion, and changing hopes for the future. Your grief can manifest physically, emotionally, and psychologically.

  • Other emotions that can be mixed up with grief include sadness, fear, anger, guilt, and regret.
  • You may resent your situation and envy those who are healthy and still have what you no longer do.
  • It can result in obsessions about death, prolonged anxiety, trouble thinking and concentrating, restlessness, withdrawal, helplessness, depression, and even thoughts of suicide.
  • Physical manifestations of grief are common and may include crying, abdominal pain, loss of appetite, intestinal upsets, weight loss, sleep disturbances, headaches, and extreme fatigue.
Grief and associated emotions are further discussed in Dealing with Grief and Grief Counseling.

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Associated Emotions

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