Coping with the news that you’re dying

Learning that you may not have long to live is shocking news. Even if you are aware that the cancer is progressing, hearing that you are dying can be devastating.

We all know that death is a natural part of life and that it will happen to us all one day, but most of us hope that we won’t die anytime soon. Realising that death is close can be frightening and hard to believe. For some people, however, it may be a relief.

You may have questions straightaway, or you might need time to absorb the news and come to terms with the prognosis.

After the initial shock, feelings of fear, denial, anger, despair, helplessness and anxiety are common. You may also worry about being a burden to family and friends – emotionally, physically, socially and financially.

You probably will have more than one emotion at a time. These feelings are likely to change, sometimes from day to day or even from hour to hour. This is often part of the process of making sense of what is happening. You may find it hard to think clearly. It’s natural to cry, so don’t feel like you have to put on a brave face.

Many people compare these feelings to waves at the beach. The first waves may knock you off your feet, then your footing becomes a little stronger. But, at any time, a large wave can suddenly come back and knock you off your feet again.

The waves of emotions may not hit in any particular order, but people often say that their fears are stronger when they’re lying in bed at night, and that they rarely share them with others.

These feelings probably won’t go away altogether, but they may change over time. You may work out strategies that help you cope. Find someone you can talk to, perhaps a family member or friend.

You could also consider seeking professional help through a palliative care specialist, general practitioner (GP), counsellor, psychologist, psychiatrist or spiritual adviser. Other people who are nearing the end of life offer a unique perspective, so you may want to consider joining a support group.

People share the news in different ways. There is no easy way to start this conversation, but you may find it helps to prepare.

• When you feel ready, decide who to tell and what you want to say. Think of answers to possible questions, but only respond if you feel comfortable. You don’t have to share every detail.
• Choose a quiet time and place.
• Accept that people may react in a number of ways. They may be uncomfortable and perhaps not know what to say. If they get upset, you may find yourself comforting them, even though you are the one dying. Another common reaction is denial – they may be convinced that the doctors are wrong. Some people may find it difficult to be around you, and you may feel abandoned by people you thought would be supportive.
• Call Cancer Council 13 11 20 if you need help telling people. They can help you find the words that feel right for you. Another option is to ask your doctor or nurse to help you share the news.

For ways to talk to people (including children) about dying, read about emotional and spiritual concerns.

Sometimes family members learn the cancer is terminal before the person who is dying. They may think the person is too young or too old to be told the truth. Some cultures may also think it’s best that the person is not told.

Usually people who are dying know what is happening. Keeping it a secret from them may mean they feel isolated at a time when they most need support. Ask the person if they would want to know and follow their wishes.

The health care team can help you with this conversation and also with an approach for complex situations, such as when the person dying has dementia.