One hospice patient I visit lives with her daughter, Sarah. A visit with this patient is a visit with Sarah, as she almost never leaves her mother’s side.
Every time I visit, I see her mother’s decline: her shoulders a little sharper beneath her pajamas (the only clothes she wears now), her cheekbones more prominent, her energy more depleted. But every week, Sarah insists cheerfully that her mother is just having a rough day and will be better tomorrow.
On my most recent visit, Sarah hovered anxiously over her mother, who sat at the dining room table nursing a cup of coffee. Sarah arranged organic fruit on a plate and put it in front of her mother, explaining to me how careful she is to make sure all the food her mother eats is natural and organic even though she has trouble affording the more expensive groceries. The health benefits are worth it, she said.
While Sarah chattered about future plans, her mother’s eyes met mine across the table. She was tired. The contrast between Sarah desperately clinging to optimistic fantasies of recovery, meticulously monitoring every morsel of food, while her mother quietly surrendered to the inevitable was stark. When Sarah left the room for a moment, I asked her mother what she wanted. “I want to make Sarah happy,” she said softly, and then, “But I don’t think I can.”
I wanted to scream at Sarah, “Your mother is dying! All the organic food in the world won’t change what’s happening! She needs your support and love right now, not a special diet. Stop focusing on the food and start focusing on being present with her while you can.”
But I also understand where Sarah is coming from. I inflicted my own toxic positivity on my husband after his stroke and it took conscious effort to change my behavior. Once I started making that effort, I could see that it was what we both needed. Our conversations became more authentic and vulnerable when I accepted that sometimes things just sucked. I think it was a relief to him when I acknowledged that and let him grieve what he lost with the stroke.
When you visit with someone who is dying, it’s natural to want to find something positive to say. Maybe you’ll be tempted to talk about new treatments on the horizon, or remind them how many people beat the odds, or suggest they just need to stay positive. Please don’t.
Dying people don’t need our forced optimism. They need our presence, our willingness to sit with hard truths, and our acceptance of their reality.
Toxic positivity—the pressure to maintain a positive outlook at all times—can be especially harmful to someone facing death. When we respond to their dying process with “Stay positive!” or “Don’t give up hope!” we’re essentially telling them their feelings about dying are wrong. We’re asking them to perform optimism for our comfort.
Sarah tells me her mother loves my visits and I think I know why. When I show up, her mother can talk about her fears and sadness without being interrupted with a reminder to smile and be grateful. With me, she can discuss practical end-of-life planning without being admonished to “keep fighting.”
It’s ironic that Sarah wants to be closer to her mother in these last days or weeks or months, but by trying to force positivity into every conversation, she’s shutting down authentic communication. When we make space for someone to express their full range of emotions about dying—including fear, anger, and sadness—we often create moments of genuine joy and connection.
Being with someone who’s dying requires us to examine our own relationship with death and our own emotional limitations. If you find yourself constantly redirecting conversations toward the positive, ask yourself: Who is this serving? Am I trying to make them feel better, or am I trying to make myself more comfortable?
I’ve found these phrases to be particularly helpful for conversation that doesn’t hinge on the assumption of positivity:
- “I’m here to listen, whatever you want to talk about.”
- “What do you need right now?”
- “It’s okay to feel however you’re feeling about this.”
- “Tell me more about what you’re experiencing.”
Dying is a normal part of life. When someone shares their dying process with you, they’re inviting you into one of life’s most profound experiences. They don’t need you to fix it or brighten it or reframe it. They need you to witness it, to acknowledge it, and to accept it alongside them.
Elizabeth Kleinfeld is a disabled widow who blogs about grief, disability, Buddhist life, and joy. Sign up for her free monthly newsletter here.