What to Say — and What NOT to Say — to Someone in Hospice

When dealing with death and dying, it can be confusing to decide what is and is not appropriate to say to patients. Part of the reason is because different people deal with these types of situations differently. However, there are some general rules of thumb to follow that should keep you on safe ground when visiting or talking to hospice patients or their family member. Suncrest Home Health & Hospice operates hospice locations across the U.S., including in Fremont, California.

Getting a Terminal Diagnosis

There is no right or wrong way to feel when you hear you have a terminal diagnosis.  You may experience a range of emotions; anger, denial, sadness, frustration, relief and acceptance.  These feelings can be experienced at different times throughout your diagnosis.  As you navigate the struggles of a terminal diagnosis it is important to continue to talk to someone about your feelings and the next steps.

The Decision to Enter Hospice

The decision to enter hospice often feels like you are giving up, this feeling is normal but is not that a true reflection on hospice.  Hospice focuses on quality of life and enjoy the time you have left by doing what you feel is important.

Choosing hospice means you are not seeking aggressive treatment but focusing on comfort measures.  This means the hospice will continue to treat symptoms related to the terminal diagnosis but one does not seek out aggressive treatment that will cure the terminal diagnosis.

The hospice team will work with the patient and family to develop a plan of care that focuses on the patients goals and how to effectively manage the terminal diagnosis while focusing on the quality of life.

What Not to Say When Visiting Hospice Patients

Now that you understand what hospice patients are going through, you can have a better understanding of what they may be thinking and feeling.

When you visit a hospice patient, you will not know what stage of grief they are in. Even if the patient is your mom or dad, their mood and feelings can change drastically from day or day, or even hour to hour. It’s best to start the visit by gauging how they are feeling. They may be teary, angry or sad. Know that there are no words that will “cheer up” a hospice patient. It’s best to remain open in your communication with them and offer understanding and support.

Among some less-helping things visitors can say to hospice patients are:

• I know how you feel.
• I can imagine how you feel.
• Live for today.
• You’re so brave.
• Everything happens for a reason.
• It’s God’s will.
• God doesn’t give us more than we can handle.
• You are going to a better place.

Although religion can be comforting during difficult times, it is best to assume that declarations about God’s will may not be taken well. Especially if the patient is in the anger stage, words like these can sting. After all, they may wonder why it is God’s will for them to die and not someone else. They may be thinking about how they have more to do, how they wanted to see their grandchildren graduate, get married or have children. Believing it was God’s decision to deprive them of this can be confusing and upsetting.

No one ever knows exactly how another person feels, even if they are in the same exact situation. Two people who both have cancer may look at their situations completely differently. For that reason, it is rarely a good idea to tell someone you know how they feel, whether they are in hospice or not. If you once had cancer, it may be appropriate to share this with cancer patients, but not those in hospice, because it is unlikely they will recover.

Because you don’t always know what a person is thinking — even if you ask — it can be jarring to make pronouncements like, “You’re so brave,” or “You’re so strong.” While these seem like compliments or uplifting comments to make, you may be off base. The patient may feel like you don’t understand them, or you have expectations of them, and the last thing you want is to put pressure on a hospice patient to feel or think any particular way.

Lastly, you will want to avoid using your visit to a hospice patient to unburden yourself about past issues. Asking for forgiveness for past transgressions, wanting to revisit and settle old disagreements or confessing something to them now does them no good and causes unnecessary stress.

Similarly, you may think reliving old, happy times will be fun, but it may only result in making them feel sad. If you are a friend who will not visit the hospice patient every day, say goodbye after your visit carefully. Don’t cry or make allusions to the fact that you may never see them again.

What to Say to a Hospice Patient

There are no universally acceptable words to say to anyone, especially those in hospice. However, there are some subjects we here at Suncrest Home Health and Hospice think are generally safe.

Start out by asking them how they are to help gauge their state of mind. Patients in the anger stage may not react to this question well, but know that as a visitor, you are doing the best you can. Allow them to guide the conversation based on their wishes and mood.

Talking about family members may make them happy, but it may also make them sad, so see what they bring up first and go with that topic. If you want to show them pictures of places you went or people you saw, ask them first if they would like to see them.

Regardless of what stage of life they are in, most people enjoy hearing, “I love you.” You can also say thank you to the person and talk about some things you appreciate about them. Tread lightly with messages such as, “I’ll miss you,” or speaking in the past tense such as saying, “I always loved you.” Hospice patients may live weeks or months and it may be upsetting for them to think about never seeing you again.

When you’re thinking about what to say to a hospice patient, think more about soothing or uplifting words rather than messages of encouragement such as those that might be found on a get-well card, since they are not expected to get well.

What You Can Do During Your Visit to Hospice

Many hospice patients are gravely ill and confined to their beds. Many are also on painkillers and may be groggy or even asleep. Sitting by their bedside and holding their hand can be helpful. Speaking softly to them — even if they don’t answer — can also be soothing.

However, some hospice patients are awake and fairly alert. They may not be mobile, so you might want to ask them if they would like you to take them for a walk in a wheelchair so they can get a change of scenery.

Before you leave, ask if they need anything you could bring them. They may not be able to think of anything or feel uncomfortable asking for anything, so be prepared to offer suggestions, such as their favorite snack or drink.

At Suncrest Home Health and Hospice of Fremont, our staff of hospice nurses, social workers and certified nursing assistants can help you with any questions you have about hospice patients and how you can help them feel more comfortable in their remaining days. We offer loving, compassionate care to the dying, allowing patients to live our their lives with dignity and in peace.