When we learn about the terminal diagnosis of a dear friend who lives far away, it’s easy to feel despair, not only about the diagnosis but about our ability to to help. While every friendship is different, there are ways we can help. Perhaps more than any other, this is a time when the Golden Rule is particularly helpful to keep in mind. Remember a time when you were scared or felt sick, and think about what it felt like. How did you want to be treated? What did you want to talk about?
Educate Yourself. Once you become aware of the diagnosis, it is useful to do some reading, not for the purpose of offering advice but for background in your interactions. Try to take notes when talking with the friend or family member since they are in the position of having to tell and update a number of people, and repeating information can be draining. Stay current with any information that is being shared by your friend or family members though blogs, facebook pages, group emails, etc. Having these updates may also a good way to start conversations with your friend.
Words Matter. Don’t be afraid to talk with your friend. It is better to say, “I don’t know what to say” than to avoid communicating out of fear. Acknowledgment is important. People often take comfort from simple words like: “I’m so sorry this is happening to you.” “I’m thinking about you.” “I care about you.” “How can I help?” “If you ever feel like talking, I’m here to listen.” Avoid unhelpful phrases that minimize, teach or solve, like: “Don’t worry.” “I’m sure you’ll be fine.” “I know how you feel.” “I know just what you should do.” “How long do you have?” Don’t say things so full of praise that it sounds as if you are giving a eulogy.
Tone: Allow for sadness and uncomfortable topics, but don’t shy away from laughter and fun stories if it seems appropriate. A small story can make someone’s day. Ask about interests and other topics unrelated to cancer. People going through treatment sometimes need a break from talking about the disease. Try not to let your friend’s condition get in the way of your friendship. As much as possible, treat your friend the same way you always have. Before asking questions or giving advice, ask if it’s welcome and be sure to let them know that it’s fine to say no.
Discuss plans for future communication. You might suggest a time that you will call to check-in, letting your friend know that you are flexible and it’s fine for them not to answer. If you feel that suggesting a regular check-in is too much, you might suggest that they lead the way in the timing of calling or writing. Then make your best effort to answer the phone or return calls and respond to emails, texts and letters promptly. This takes the pressure off your friend of needing to feel “up for” communicating at an agreed-upon time but gives them something to look forward when they are feeling the need to connect with you.
Possible Visit. If you do have an opportunity to visit, be sure to ask permission and let your friend know it’s fine if it doesn’t work for them. Be flexible about the time you go and accommodating schedule changes. Don’t impose by staying with your friend unless they absolutely insist, and then put yourself in the mindset of a being a helper, not a guest. You should prepare yourself for changes in your friend’s appearance (weight changes, fatigue, hair loss) and start your visit by expressing how good it is to see them, rather than commenting on physical changes.
Keep A Calendar. Keep a calendar with dates of important treatments, milestones, etc. Getting in touch by text, email, or a call is a good way to show your support at these times and let your friend know you are thinking about them.
Practical Help. Although you can’t be there to help with daily tasks and chores, be creative about ways you might help. Some things that can be done from a distance:
- Offer to research or gather information they may need.
- Offer to make any difficult phone calls.
- Organize a phone chain and/or support team to update others and/or to check on your friend.
- Think about things that might make life easier or more “normal” for your friend and try to arrange for this long-distance (eg, UberEats meal, housecleaning service, gift card to grocery store).
- Consider participating in a fundraiser for the illness your friend is suffering from.
- Send a surprise (flowers, plants, books, journal, gift certificate, portable hobby kit).
At the end of life, friendship is more important than most anything. Your offering of acknowledgment, love and support is the most important thing you can do.