You've probably heard people say that it's important to talk about death before it's too late. I talk about it quite a bit myself.
But what happens when someone you love is seriously ill, and they want absolutely nothing to do with that conversation? Maybe you've tried bringing up their wishes, only for them to change the subject. Maybe they tell you they're going to be fine, even though their health has been declining. Or maybe they get upset and tell you they don't want to talk about it.
Meanwhile, you're worried about what's coming. You have questions, there are decisions that may need to be made, and you don't want to wait until you're in the middle of a crisis to figure everything out.
So what are you supposed to do? The answer isn't always as simple as sitting down and having an honest conversation. Sometimes the other person just isn't ready, and sometimes they may never want to discuss it.
Not Everyone Wants to Talk About Death
As an end-of-life doula, I believe conversations about death are important. But I also recognize that not everyone feels the same way. Some people are very open about dying. They'll tell you exactly what they want, what they don't want, and how they'd like things handled when the time comes. Others would rather talk about just about anything else.
While it's easy to assume someone is in denial because they won't discuss their death, that may not necessarily be the case. They may understand what's happening and just not want to spend their remaining time talking about it. They may be frightened, overwhelmed, or still processing everything themselves. For some people, their cultural or religious beliefs influence how they approach conversations about death. Others may worry that discussing it will upset the people around them. Sometimes, they just don't want to.
We don't always have to understand someone's reasons to respect how they're feeling.
But What About the Family?
This is where things can get complicated.
While one person may not want to talk about dying, the people caring for them may have a hundred questions. What kind of medical care would they want if their condition gets worse? Would they want to remain at home if possible? Have they thought about funeral arrangements? Who should make decisions if they become unable to speak for themselves?
Then there are the things that have nothing to do with paperwork or medical decisions. Maybe you want to tell them something you've been holding onto for years. Maybe you want to ask about family history, hear certain stories again, or make sure they know how much they mean to you. There's a lot that families may want to talk about.
When those conversations keep getting shut down, it's understandable to feel frustrated, anxious, or even hurt. You may feel like time is running out. But here's something worth considering: You and your loved one may be experiencing the same situation in very different ways. You may be thinking about everything that needs to happen next, while they're trying to get through today. Neither experience is insignificant.
Try Starting Somewhere Smaller
Sometimes it's not necessarily the conversation itself that someone is avoiding. It's how overwhelming the subject feels.
Imagine someone sitting you down and asking you to discuss your medical wishes, funeral arrangements, and what you want to happen when you die. That's a lot to take in, especially if you're already dealing with a serious illness.
Instead of trying to cover everything at once, consider starting with something smaller.
You might ask:
"Have you thought about what would make things more comfortable for you if your health changes?"
Or:
"If there ever comes a time when you can't make your own decisions, is there someone you'd trust to speak for you?".
"There's something I've been wanting to talk to you about. Would you be okay having that conversation, or would you rather wait?"
You could even start by asking permission. Giving someone a choice about when and how they talk can make a difference. And if they say no, respect that answer. You can always leave the door open without bringing it up every time you see them.
Sometimes You Have to Let the Conversation Go
I know this probably isn't what some families want to hear. Especially when there are important things that haven't been discussed. But we can't force someone to talk about dying just because we believe it would be helpful.
If a person understands their situation, has the ability to make their own decisions, and doesn't want to discuss certain things, that choice deserves respect. That doesn't mean the family's concerns disappear. There may still be practical matters that need attention, particularly if medical decisions could become urgent. In those situations, it may help to involve the healthcare team. A physician, social worker, chaplain, or other appropriate professional may be able to explain what decisions need to be addressed and help the family understand their options.
Someone may also be more comfortable speaking privately with a professional than discussing everything with their children or spouse. If their ability to understand or communicate decisions is changing, the healthcare team can help determine what additional support or decision-making arrangements may be needed.
The goal isn't to get someone to agree to everything the family wants. It's to make sure their wishes and rights remain at the center of the conversation.
You Can Still Connect Without Talking About Death
I think this part is especially important.
When someone is seriously ill, it can start to feel like every visit needs to involve an important conversation. Have you discussed your wishes? Is there anything you need to tell me? Are you sure there's nothing you want to talk about?
While those questions may come from a place of love, imagine being on the receiving end of them constantly. Sometimes people want to feel like themselves for a little while. They want to watch their favorite show, complain about something on the news, hear about their grandchildren, or talk about what everyone had for dinner. Not every interaction needs to revolve around their illness.
You can still spend meaningful time together without discussing death. You can listen to their stories, laugh about something ridiculous, or simply enjoy each other's company. If they eventually decide they want to talk about something more serious, you'll be there to listen.
What If They Never Want to Talk About It?
It's possible. Some people never have the conversations their families hope for.
That can be difficult to accept, especially if you're someone who finds comfort in having a plan. You may have to make peace with not knowing every preference or having every question answered. That doesn't mean you can't prepare in other ways.
You can learn about the dying process, understand what support services are available, and ask the healthcare team what to expect as an illness progresses. You can also prepare yourself emotionally and practically for the changes that may come.
If you're responsible for someone's care, it's reasonable to ask for guidance about what to do in an emergency, who to contact after hours, and what resources may be available to help.
When decisions must be made, any known wishes, previously expressed values, existing documents, and applicable legal decision-making arrangements should help guide the process. You may not be able to plan everything together, but you can still find ways to feel more prepared.
How Can an End-of-Life Doula Help?
An end-of-life doula can provide support to both the person who is dying and the people caring for them.
Sometimes that means helping someone explore their wishes and identify what matters most to them. Other times, it means supporting a family that's struggling because their loved one doesn't want to discuss what's happening.
A doula can help families think through questions they'd like to ask, explore ways to approach difficult conversations, and understand what support may be available as an illness progresses…
But there's also value in just being present without an agenda. Not everyone wants to talk about their death. Sometimes they want companionship, someone to listen, or an opportunity to talk about something completely unrelated to their illness. That's okay.
End-of-life doula support is non-medical and doesn't replace the healthcare team, counseling, or legal planning. It's another layer of support that can be shaped around what the individual and family actually need.
You Don't Have to Have Every Conversation
I encourage people to talk about death, make their wishes known, and plan ahead whenever possible.
I think those conversations can make a real difference for families. But I also think we need to recognize that not everyone approaches the end of life the same way. Some people want to talk about every detail. Others want to take things one day at a time. Some people purely aren't interested in discussing death, even when it's approaching.
You can encourage a conversation without forcing it. You can express your concerns while still respecting someone's boundaries. You can continue showing up for someone, even if the conversations you hoped to have never happen.
Sometimes supporting someone at the end of life means meeting them where they are, even when it's different from where we wish they were.
At Blooming Transitions, I provide non-medical end-of-life support to individuals and families throughout the Tampa Bay area, with virtual support available beyond Tampa Bay.
Whether you're trying to start a difficult conversation, navigating changes in a loved one's health, or simply looking for guidance as you care for someone, I'm here to help you work through those questions at your own pace.
About the Author
Brittanny Clervil is an end-of-life doula and Licensed Practical Nurse serving the Tampa Bay area through Blooming Transitions. She provides compassionate, non-medical support for individuals facing serious illness, those at the end of life, and the families caring for them. Through education, guidance, and a calming presence, Brittanny helps individuals and families navigate end-of-life with greater understanding, confidence, and support.
