Dos and Don’ts of Talking to Someone Who is Seriously Ill

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It can be difficult to know the right thing to say or do when you’re around a friend or family member who is seriously ill. Whether they’re going through cancer treatment or have just come out of major surgery, we often struggle to find the right words or actions to convey our concern. But don’t let that hesitation turn into avoidance. A study in Psycho-Oncology found that while people with breast cancer went to nurses and doctors for informational and decision-making support, they leaned most on their family and friends for emotional support.

Here’s what to keep in mind to maximize the support you provide—while minimizing awkward moments or misunderstandings.

Do let your loved one lead the conversation

It’s hard to know in advance whether your best friend with breast cancer will want to discuss the nitty-gritty of her treatment or be distracted from it entirely, says Jill Cohen, a New York-based counselor specializing in grief. So rather than guess, follow her lead.

If she mentions a hopeful test result, ask her if she’d like to share more. But if she asks about work, fill her in on your funny coworker’s latest antics. “People like an opportunity to laugh and to hear what’s going on in the outside world,” says Cohen. They might be grateful for a chance to hear what’s happening in your life.

Don’t make them discuss their prognosis

Talking through potential outcomes—especially the risk of death—can be a painful conversation for any person with a serious illness. And rehashing this information with every visitor or friend can bring it front and center again and again, says Cohen.

It’s best to avoid questions about things like the odds of recovery, potential long-term limitations, or how many treatments or procedures loom on the horizon. Again, follow your loved one’s lead: If she wants to talk through her frustration about medication side effects or her fear of the future, let her talk. But don’t push or probe.

Do offer help—but make it concrete

“Let me know if there’s anything I can do” is a common refrain when people visit someone with a serious illness. But offering help in that manner actually puts the onus on the sick friend to speak up about what they need and when. Instead of speaking in generalities, offer specific help, says Cohen. That means things like: “I’d like to make dinner for your family on Wednesday night. How about chili and cornbread?” or “I’m headed to the grocery store in a few hours. Will you send me your grocery list, so I can pick up things for you?”

Don’t compare outcomes

Odds are high that whatever your loved one is facing, you’ve known or heard about someone else who once had a similar diagnosis. But while you might think it’s uplifting to hear other people’s recovery stories, your ill loved may not, says Cohen. “No one person’s situation is exactly the same as that of another,” she says.

Hearing other people’s health stories may make your loved one question if he or she is doing the right thing or all they can to get better. Or your loved one may bristle at the implication that all illness narratives are essentially the same. Remember: To them, this illness is deeply personal and theirs alone.

Do share the occasional high five

Being ill is a hard pill for anyone to swallow, and it’s ok to tell your loved one you’re impressed by their grit or patience or stamina, says Cohen. Still, don’t let those compliments turn into predictions, such as saying your friend is so determined, you’re sure he’ll beat his cancer. The truth is, none of us can really know the future, and forcing an optimistic outlook on a loved one’s current situation can make it harder for him to share his own doubts, frustrations or fears.

Do keep it brief

Even if you and your sister used to gab for hours on the phone, if she’s now seriously ill, talking for more than 15 or 20 minutes might be taxing. And even if you’ve never called before popping over for a visit, now is probably the time to start. “People can feel very physically and emotionally exposed at this time,” says Cohen, so you’ll want to be mindful about checking in before showing up, and keep conversations as brief as your loved one’s health allows.

Don’t be tone-deaf

Chatting about your upcoming summer vacation or that fabulous restaurant you visited last night might not normally stoke your loved one’s envy. But if the serious illness has curtailed his or her ability to travel or enjoy meals out, those stories can sting, says Cohen. Be mindful of your friend’s limitations when sharing stories—even holding back on certain topics unless your loved one encourages those types of details.

Do stay in touch

When a major diagnosis hits, people can be flooded with well wishes and visitors, only to have that communication trail off as time passes. But with a serious illness, your loved one needs ongoing support. If you can’t fit frequent visits into your schedule, mark the phone calls on your calendar to keep them a priority. Even a quick text message can brighten a loved one’s day.

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