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End-of-Life Etiquette

At some point in life, people will learn that one of their friends, business associates or relatives is battling a life-threatening illness, and the prospect for their recovery is very poor. They feel like they should reach out to the person somehow. But what’s the appropriate response? How should they interact with someone who’s life expectancy may be a only a matter of months, weeks or even days?

“Because we are not taught how to deal with people who are near the end of life, quite often we’re afraid that we’ll say or do the wrong thing, so we do nothing at all,” says Samira Beckwith, LCSW, FACHE, DHO, president and CEO of HOPE Healthcare Services. “But there are many simple things one can do to bring comfort or brighten the day of someone with a very serious or terminal illness.”

Beckwith offers these tips:

  • Don’t be Afraid to Reach Out – Even if you don’t know what to say, the most important thing is to be there for them in any way possible.
  • Be a Good Listener – Be willing to listen and let the person talk about what they’re experiencing.
  • The Little Things Count – A card, note or phone call is always appreciated.
  • Don’t Speak the Harsh Truth – Keep it light. Instead of saying “I know you’re dying of this horrible disease,” say “You’re in my thoughts.”
  • If you can’t confront seeing your dying loved one, send flowers to show you’re thinking about them.
  • Offer Help – Ask what you can do to help.


As a former cancer patient herself, Beckwith knows what it’s like to be alone in a hospital bed with a serious illness, shunned by friends and associates.  “When I was 24 and had cancer, I actually had somebody call me from the hospital lobby to ask how I was. They said, ‘You don’t want any visitors today, do you?’ I said, ‘Where are you? When can you come by?’ They said, ‘I’m in the lobby.’ I said, ‘Why don’t you want to come up? Are you afraid of what I’m going to look like, or that you don’t know what to say?’”

“I’ve come to realize that people are really afraid when they don’t know what to expect," Beckwith says. “I tell them that it’s okay to feel afraid. But don’t use that as an excuse for not reaching out to someone.”

Most everyone struggles with end-of-life etiquette because it’s not a subject taught in schools or by parents.

“Surprisingly, because they were not taught how to speak with terminally ill patients, some doctors avoid having important conversations with their dying patients,” says Beckwith. “They will give patients needless, painful treatments rather than tell their patients that they’ve exhausted all the treatment options, as their condition is medically incurable, and it’s time to put end-of-life care in place.”

“Thankfully, most medical schools now instruct doctors on how to communicate with their end-of-life patients,” she says.

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