Saying, Doing, and Being in End-of-Life Care by Dr. Virginia L. Seno

Wednesday, 04 Dec 2013 19:38

Most people wish that they knew what to say and do, and how to be when approaching  dying, death and grief.

Because we’re uncomfortable and unprepared for end-of-life encounters, we either stay away, say and do things that don’t help; or act in ways that are neither becoming nor helpful to the people about whom we care.

What if you did know what to say, what to do and how to be in end-of-life encounters?

Use these three tools to start a conversation with someone, to learn what to do and how to be when approaching death.

The first tool is easy to use.  All you need to do is ask question:

“What is most important to you right now?”

If you want to add something to that, then say, “I’m sorry.”

After those few words you need only to listen quietly. Listen for their answer because it will tell you what to do, or how to help. Frankly, simply listening will help.

Answers about what is most important may vary from needing sleep or a walk to needing someone to weed the garden, needing relief from pain and symptoms or needing to say something to someone.

The second tool is also easy to use. While we seem to be specialists at getting busy doing something, doing anything; that is often an avoiding response, and it may miss entirely what the person or family actually needs us to help them do.

A time ago there was a hospice volunteer coordinator in Beloit, Wisconsin, who taught her volunteers to:

“Do what needs doing.”

She wrote a poem about it.

You can find out what needs doing by asking.

“If there was something you needed done, what would it be?”

Then either do it or get someone to do it, if it’s not something you can do.

Before my husband died, I stayed in the hospital with him for almost a week and then we were at home 7 days before he breathed his last. During all of those two weeks, our lower-level carpet was saturating with water as the summer rains fell long and hard, streaming down the hill to our valley home. There was no way that I could deal with that. But it had to be managed. So, I mentioned it on the care pages that we had running to update friends and family on Josh’s condition. Someone read that and before I knew it, Harry was down stairs, vacuuming up water, placing dehumidifiers and what ever else needed doing. He did it. Ahhhh! To this day, I cannot say my gratitude in words for that and the other things our friend, Harry did.

Do what needs doing. Ask and do.

The third tool is about being. Be quiet and open-minded. Be present. Be available. Be willing to ask and hear and do.

Don’t anticipate what someone’s answer may be to the questions you pose. Just ask and listen and plan on doing if you can.

The best thing that happened to me after Josh died was the arrival of my lifelong friend Mary. She came over every day after her work. I don’t remember what we said at all.  She was being-for me, completely for me. Those first days after his death, I waited the whole day alone in my empty house, anticipating Mary’s visit. She was my lifeline. Mary had other things to do with family, kids and a full time job. But she came to be-with me.

It’s really not difficult to ask someone what’s important to them, to ask them what needs doing or to be present for them with a quiet mind, a smile and a gentle touch. Try any one of those things or all three. You won’t begin to gauge the difference it will make in someone’s living and dying.


Dr. Virginia L. Seno

Founder, Esse Institute LLC

Training for Comfort and Competence in End-of-Life Communication

Access FREE Tips from the Mini-Course Mastering The Listening Self: Personal Growth Through End-of-Life Encounters

Our Book: It's OK to Die

"It's OK to Die" is a ground-breaking book filled with graphic stories straight out of the Emergency Room illustrating how most Americans are completely unprepared for death and dying. In response, the authors have created a unique and comprehensive guide urging EVERYONE to prepare in advance, to assure their own peace and to prevent the suffering of their loved ones.
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4 thoughts on “Saying, Doing, and Being in End-of-Life Care by Dr. Virginia L. Seno

  1. Pingback: Saying, Doing, and Being in End-of-Life Care by Dr. Virginia L. Seno | It’s OK to Die | All Things Palliative - Article Feed

  2. Brian Lynch


    Very well said. I am a retired family physician and a bereaved parent so I know this subject from both sides. From my experience we need love to recover from grief. That we love our patients may not be politically correct to say though I am sure that many of us do, and that allows us to heal, rather than just treat patients, who are people as are we. You are stating a gentle understanding that will give support to loved ones. I think that is part of our job.


    1. Virginia Seno

      Thank you for your personal insight Brian. Yes, the people who helped us in our short 17 days from diagnosis to death and in grief after, were in loving-kindness toward us. Those who were oriented to their tasks as friends and health care professionals were not particularly helpful, and some were downright harmful. But I get that their fears kept them from being open enough to have that love for us show up in their caring. It’s in their potential though. Thank you!

  3. Nancy

    I just spent the weekend with a good friend’s sister who had come to town to be with her sister who is in the end stages of lung cancer. There is much estrangement between the two, and I wish I had read your article before the weekend started. Thank you for the gentle and wise counsel.


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