Finding out that you are near the end of life

How you might feel

You may have many strong emotions. After the initial shock, it’s common to have feelings of fear, denial, anger, despair, helplessness, anxiety and depression. Your emotions might change, sometimes from day to day or even from hour to hour. This is part of the process of making sense of what is happening.

How you respond to these feelings will vary. You may find it hard to think clearly at times. It’s natural to cry or feel completely overwhelmed; you don’t need to put on a brave face. Other times you may feel quiet and reflective — you may avoid people and not want to talk. You might get a burst of energy or anxiety and start making plans.

Some 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. There may also be calm periods between these waves. But, at any time, a large wave can suddenly come back and knock you off your feet again. Your emotions may go up and down and may not hit in any particular order. People often say their fears are stronger when it’s quieter at night, and that they don’t always share how they’re feeling.

It may help to talk – You may have your own ways to respond to these emotions. At first you may not feel able to share your feelings. But as you start to process things it may help to talk and find a path forward.

You may decide to talk to a trusted family member or friend. Or you could consider seeking professional help through a palliative care specialist or nurse, general practitioner (GP), counsellor, psychologist, psychiatrist or spiritual adviser. Other people in a similar situation offer a unique perspective, so you may want to consider joining a support group.

Telling people

There is no easy way to start this conversation, but you may find it helps to practise what you are going to say.

• 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.
• People react in different ways. They may be uncomfortable or not know what to say. If they get upset, you may end up comforting them, even though you are the one dying. Denial is a common reaction – they may be convinced there’s a cure or that the doctors are wrong.
• If you’d like help telling people, call Cancer Council 13 11 20. 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.

Do people who are dying need to be told?

Sometimes family members learn cancer is terminal before the person who is dying. They may think the person is too young, old or sick to be told the truth. They may worry about the health or emotional impact if the person knows they are dying. People who are dying usually have a sense of what is happening. Trying to keep it a secret may mean they feel alone when they most need support. Ask the person if they would want to know and follow their wishes. Knowing they are dying gives them time to prepare for death. The health care team can help you have this conversation. They can also suggest ways to explain the situation if the person has dementia, memory problems or issues understanding.