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How to Help a Friend at the End of Life

09/28/2012 11:50 am ET | Updated Nov 28, 2012

Having been a hospice nurse for the last 12-plus years, I know how to be with someone at the end of life from a clinical perspective. However, last year, a very dear friend of mine died of FBC... the other kind: F-bomb Bladder Cancer. It was awful. Truly horrendous. She had been super healthy (we frequently compared which exercise regimes we were doing or which detox programs we were interested in trying). It was a crazy, confusing and very, very sad time.

If you are in this situation, I'm so f-bomb sad for you. It's a rotten place to be. However, the Silver Lining is that being with a person at the end of life is one of the most sacred and powerful experiences, and there are ways to help you both.

Here's how to help:

Be Present

People who are dying need to feel the presence of loved ones at the end of their lives. Be assured that dying isn't a person's whole identity. They still need to be a real person in your life. They can still talk about other things besides death and sickness. My beloved mother-in-law talked about celebrities until days before her death. It was a great diversion for her.

It's also important to know that not all silence needs to be awkward. A calm physical presence may be all a dying person needs or wants.

Don't Pretend Like Everything Is Okay

Many people believe that talking about someone's illness or impending death will only upset them and therefore pretend like everything is okay. Many people are surprised to find that a dying person wants to talk about what's happening to them. In fact, many dying people are thinking the same thing -- that talking about what's happening to them will only upset their friend or loved one. All of these assumptions are such a waste of precious time. When in doubt, just say: "What would you like to talk about right now? I would like to hear about anything and everything that is on your mind. I am here for you no matter what."

Gestures Speak Louder Than Words

Assure your friend that you are here to help in any way needed. I recommend that you don't wait for your friend to ask for help because she might be overwhelmed or may not want to be a burden. So, go ahead and prepare dinner, offer to clean the house, shop, or go with her to doctor appointments. But be sure to follow through. If you say you're going to do something, do it.

Avoid Clichés

Saying things like, "Everything happens for a reason," and "It's God's will" is NOT the way to roll. Most people know they are dying, whether they admit it or not. Saying things like, "You're strong, you'll get through this, you'll be okay" is an outright fib. Though the emotions surrounding death can be hard for some people to hold, please acknowledge and normalize all feelings and by all means, don't try to talk your friend out of her feelings.

Share Memories

Sharing memories of good times is a wonderful way some people find peace near death. In fact, this can be comforting for everyone (Silver Lining).

It is really, really important to know that hearing is often the last sense to go. So, even if a person is unconscious and cannot communicate directly, believe that it is very likely that your friend can hear you. Therefore, always talk to, not about, the person who is dying. When you come into the room, it is a good idea to identify yourself, saying something like "Hi, John. Hollye's here. I've come to see you today." Know that it is never too late to say how you feel or to talk about delightful memories.

Physical Contact

The simple act of physical contact -- holding hands, a touch, or a gentle massage -- can make a person feel connected to those he or she loves. It can be very soothing and calming. One of my favorite things to when I was a hospice nurse in the hospital was to give afternoon hand massages. Patients absolutely loved it!

Set the Mood

Try to set the kind of mood that is most comforting for the dying person. Think about what she always enjoyed. Was it a party with lots of people? Or was it quiet time with just a few close friends? Try to create the kind of environment that your friend always enjoyed.

When working with patients, I always find that when death is very near, music at low volume and soft lighting are soothing. In fact, near the end of life, music therapy can improve mood, help with relaxation, and often lessen pain. For some people, keeping distracting noises like televisions and radios to a minimum can be soothing.

Offer Assurance

Many people at the end of life feel unprepared for death. Your friend may be worried about who will take care of things when she is gone. As a friend, you can be of great assistance by assuring her that you will help organize and complete unfinished tasks. You can begin by helping to figure out what is most important on the list of things left undone. Then you can actually help complete those things. For example, you can help write letters. You can help make lists about where things like important documents are located. Reminding your friend that her personal affairs are in good hands can also bring comfort.

Be Hopeful

Even when cure is beyond the realm of possibility, there are many opportunities for hope. While you may change what you hope for, hope is actively present. You can hope for pain-free days. You can hope for a peaceful death for your friend. You can hope for the opportunity to do something special with your friend.

Though none of these suggestions take away the pain or sadness of the death of a friend, I hope that they will give you some tools to help in the process (Silver Lining).

To read more about Hollye's holistic and humorous journey over, around, above and below breast cancer, please visit her blog, The Silver Pen (http://www.thesilverpen.com/). You may email her at hollye@TheSilverPen or follow her on Twitter @hollyejacobs.

For more by Hollye Harrington Jacobs, click here.

For more on death and dying, click here.