Telling Your Loved One the Truth

By Eunice Lehmacher

Painful realities sometimes become part of caregiving.  When an illness is incurable, progressive or life-limiting, caregivers often wonder if they should tell their loved one the truth–that they know are dying.

Unfortunately, many dying people don’t know that the treatment they are currently undergoing is either not curative or unlikely to be curative. Doctors usually can’t give an exact prediction of when diseases cause death, but they can discuss treatments and how effective treatments can be. Many patients decline uncomfortable treatment when they know the likelihood of success is marginal. Surveyed hospice professionals say 96% of people near death prefer to know the truth about their future, said author Douglas Smith in Caregiving: Hospice-Proven Techniques for Healing Body and Soul.

People in their last years and months have a right to know the truth. Open sharing of the facts allows an atmosphere of trust and teamwork between caregivers, family and patients.  Dying people often say it is easier to die when people around them talk about what is going on even if these same conversations bring sorrow and pain.

Here are some ways to face talking about a worsening prognosis:

  1. Ask about your loved one’s past experiences with death. Past experiences affect current perceptions and can create fears.  Caregivers can also share their grief stories, making observations about how illness and death is different for everyone.
  2. Notice and talk about your loved one’s thoughts. Instead of focusing on “It’s not fair that I got cancer,” help your loved one find more accepting thoughts such as “What do I want to do with my last days?”
  3. Talk about the pain and sadness. The willingness of a caregiver to talk about uncomfortable feelings and difficult decisions can help our loved ones to face and accept hard truths.
  4. Practice stopping irrational thoughts. When thoughts like “There’s nothing I can do” occur, help your loved one catch and stop them.  They can begin simply telling themselves “Stop!”  Develop alternate thoughts together, “Even though I can’t cook dinner, I can enjoy the family visit.”  As caregivers and loved ones share fatalistic thoughts, you can help each other turn limits into possibilities.

Will talking about irrational thoughts, death and pain making dying easy?  No.  But not talking about hard topics can turn pain into suffering.  Your courage in these hard conversations will help both of you to accept the today’s circumstances, to develop hope, and to enjoy the present.  Need some help developing that courage?  Come to a caregiver support group on June 7 at 3 p.m. at the Cottingham Hospice House.

Eunice Lehmacher, a licensed independent social worker, is the bereavement coordinator at Prisma Health Hospice of the Foothills in Seneca. For additional information about the program, visit

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