Talking to the person you care for

There may be a number of triggers that start a conversation about death with the person you care for. It may be a personal need or a family situation that has arisen, but most commonly it is in response to a terminal diagnosis being given and death is in the forefront of everyone’s mind.

You may find the opportunity to talk about death crops up at the most unexpected moment, for example when you are walking in the park or sitting down having a meal together. But often you or another trusted family member may need to start the conversation and guide it. Crucially, it is important to remember there is no right or wrong way to have a conversation as everyone is different. Do what feels right for you. 

1. Have the conversation as soon as possible and before it is too late. The person you care for may lose their ability to express their wishes unexpectedly. Spot the signs of declining mental capacity. Visit the Alzheimer’s Society for advice on how to best communicate with someone with declining capacity. 
2. Think in advance about what you want to achieve – this will help you to manage your anxiety and give you confidence. See What does planning ahead involve? for the sorts of questions to ask.
3. Don’t rush the conversation – it’s a process and may involve a number of shorter conversations. Little and often may work best.
4. Give some warning to the person you care for that you want to talk about end of life decisions so it doesn’t come as a complete shock. This could be some hints or ideas thrown into normal conversation.
5. Find the right moment and place when you have plenty of time. Create an open and welcoming environment.
6. LISTEN as well as talk! Don’t feel you have to fill in pauses or silences and let the person set the pace. For further information on how to listen well go to Hospice UK  
7. Think about how best to carry out the conversation. Sometimes the person you care for may feel less under pressure if you are not facing each other e.g. in the car together, or walking the dog. You can also write a letter or talk over the phone if this is easier. 
8. Consider using some conversation cards or games. ​​
9. Starting the conversation can be the hardest part. Relate the conversation to familiar topics e.g. talking about a shared friend or something you came across in the news. Look at some family photos to kick start a conversation.

For further guidance and advice on how to have a conversation with the person you care see Having the Care Conversation Toolkit (PDF).

If the person you care for doesn’t want to talk about death, further advice can be found – How to talk with someone who doesn’t want to talk.