Pay attention to everything the dying person says. You…

““Pay attention to everything the dying person says. You might want to keep pens and a spiral notebook beside the bed so that anyone can jot down notes about gestures, conversations, or anything out of the ordinary said by the dying person. Talk with one another about these comments and gestures. • Remember that there may be important messages in any communication, however vague or garbled. Not every statement made by a dying person has significance, but heed them all so as not to miss the ones that do. • Watch for key signs: a glassy-eyed look; the appearance of staring through you; distractedness or secretiveness; seemingly inappropriate smiles or gestures, such as pointing, reaching toward someone or something unseen, or waving when no one is there; efforts to pick at the covers or get out of bed for no apparent reason; agitation or distress at your inability to comprehend something the dying person has tried to say. • 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, “That’s wonderful! Can you tell me more about it?” or “I’m so pleased. I can see that it makes you happy,” or “I’m so 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 appreciate your trying to share it with me,” or “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.””

— Maggie Callanan