The four human tasks of dying - communication

The founder of the Hospice movement, Dame Cicely Saunders, identified four important human tasks that people want to complete during the process of dying. They are:
• To say ‘goodbye’ – to people, animals and things that have been important to them
• To say ‘thank you’ – for a life together, for help and care provided, perhaps particularly in this last period when extra care has very often been needed.
• To say ‘sorry’ – perhaps for failings or slights or demands, or especially for being difficult to live with, in the last illness.
• To say ‘I love you’.
How can we help people to carry out these tasks?

Make communication possibler
The first thing is to see that these tasks are about communication, so we have to make sure that communication is possible. One of the most important jobs I and my colleagues do when working with dying people is helping people get in touch with people they have lost contact with. Perhaps they don’t dare – fear of rejection after that family dispute twenty years ago is still powerful. Yet knowing that a sister or brother is dying is often important enough to overcome past family rifts. Every family member can help to make communication possible, by visiting and spending time with someone who is dying.

Be presentr
Another important job is to assist the communication; that means being prepared to be present and to stay with it. I remember the businessman always up and down to go outside to use his cellphone, to have a cup of coffee. He said: ‘What good is it just sitting there?’ but in saying that he was reflecting...his own anxieties, yes; but also his lifestyle, his focus, his motivation. This was what he was; his loved one probably understood that. But he needed to be helped to understand that just presence was worthwhile. Presence could be felt and appreciated by others. And presence requires staying power. He could be helped by seeing staying power as an achievement.

Communicating by doingr
You do not communicate only by speaking. Sometimes it is not clear when someone is dying whether they can hear you. So, as well as being there, holding a hand, a kiss, a hug can communicate just as strongly, even more strongly than talking.

Preparing for communicationr
A lot of people find visiting sick or dying people difficult: ‘I don't know what to say...’ they think. This requires a little preparation. So think through (even write down) a list of topics that you might often talk about. Do you have some good memories of time together? Are there things you loved to do together? Are there interests you share? When visiting a friend I didn’t know well, we often used to talk about the business pages of the newspaper. It kept her in touch with the current world, and got away from the ‘illness talk’ around her.