My friend is far away, dying of ALS. I am at a loss as to what to say to him. Any suggestions?

You've gotten some very good advice here. After going thru the expected but sudden dying process of my husband two years ago...I have some advise of what I would try NOT to do. Don't change! I would try to have a normal relationship with your friend. That may sound so simple (yet difficult)...but from experience, I regret how a diagnosis changed the relationship with my dying husband. It wasn't intentional or preventable as he went quicker than anticipated. Keep your conversations as they were, as they would have been prior to the diagnosis or dying process. Secondly, don't wait. With terminal illnesses it can often be an estimation of how much time they've got, not an exact science of determining a timeframe. Send cards, letters and communicate as normal as possible...as he will appreciate hearing from the friend he knows. (Not the one that may be created via shock & sadness.) I wish your friend and you...peace.

Let your friend express his or her concerns and give them all the time they need and let them know that you are really listening to them! Personally, having been a nurse and worked with the elderly, I realized, that even if the person thought themselves very "religious", they were very afraid of death! If someone ever expresses this concern to you, you really must think of how you will address this. People who have this real fear, will have a harder time passing over as they will try to fight it. I find it very sad that people are so afraid of death, because of what they were taught or not taught in their religion! My advice is to contact your nearest Hospice, as they have very good reading material about this and they describe the stages of death that people go through.

One of the most beautiful statements I ever heard pertaining to this, was in a movie where a child of about 12, who is dying of heart problems, asks his doctor, "Why is God taking me", to that the doctor's response was, "God is not taking you, he is receiving you". I thought that was one of the most beautiful ways of answering that question. My godmother, who is 88 years old and just got diagnosed with early dementia, and whom I am taking care of, was watching the movie with me, and she even commented how beautiful that was. She, also went to church faithfully since she was young, but told me she too wonders what will happen to her after she passes. I gave her the poem "The Rose Beyond The Wall", which has a beautiful way of describing death. In matter of fact, this poem was used on Hallmark sympathy cards for awhile, and even now I will print it out and enclose it with any sympathy card I give. It describes how the rose grew strong and beautiful by this wall, until one day it sees a bright light shining through a hole in the wall. The rose follows the light and goes through the hole to see what is on the other side, and there it finds that everything is still the same, but even better and there it decides to stay and keeps growing stronger and more beautiful then before. My godmother loves that poem and she also had a friend who had a life/death experience and she told my godmother that the poem is true, that your soul and spirit continue to live on and that you do see your loved ones and yes, also pets that have passed on before you. She is a lot calmer now since we have been talking openly about it and now deep down truly believes she will see her loved ones again on the other side!!

How are you doing?

Redhead -The last time i saw Mom in the hospital dying of cancer, she asked me to cut her toenails. I asked the nurse for sizzors, I told her the reason,. but she denied me.So I had to tell my mother, I couldn't do it. We sat silent all the time, until she told me I should go. before I missed my train home. She died soon after.

i cannot really add to even put a sparkle on the advise from others above. first, i'd say ... listen. Your friend has a story that needs to be heard. i'm disabled [spinal cord, disabled 30+years] , and so many people DO NOT want to listen. Yes, mine is progressively increasingly disabling [if that's even possible, but oh i am grateful for the pills and paraphernalia that let me be ambulatory a short time!]. Now i need back surgery, and more neck surgery. Even my sibs do not want to hear a word about it! i mentioned "i need surgery on my back.." only to be interrupted with "you told me that before." [Yes, i now recall it was about a month ago - i regret my lapse in judgement that i asked for help: i can't lift more than 8 lbs, and there was a flood in the basement and workers are coming out in early Sep to finish the tile work -- the floor needs to be barren! Arrgh how could i be so stupid! So that's why i say, please ... listen. Ask your friend if he has some bits of wisdom, that you're collecting them -- and let your friend express any fears or joys that no one else will listen to. Can your friend use the phone? Schedule a phone call ~ even if he needs to arrange for someone to set the phone up in a handier spot [i use a speaker phone]. Best ~ perhaps hint at the idea of visiting your friend, if possible. You'd certainly be sure to be there for a funeral: being their for life is so much nicer. Ask your friend where he'd like to go ... [park, forrest, beach ... see a sunrise/sunset ... ] and see if you can make it happen. i got a card once from a vet when my dog died. It said: "We remember moments, not years." Oh how true. Perhaps you can share some golden moments that will be tucked in your heart of forever gems. Both you and your friend are so very blessed ~ neither are alone. Blessings ~

Let them know how much you have appreciated their friendship. Just contacting them or being there is all you need to do.

Just tell your friend how much you love him/her and if you can do anything to please let you know. It is never easy to say goodbye to those we love.

I'm sorry, I'll miss you, I hope to see you again...Are you scared, do you want to talk about it...and what ever their religious belief, support them in them and ask if there is anything they need, that you can help with and do it.

When my elderly friend (aged 78) & former co-worker was in Hospice last Fall, I was fortunate to visit him there when he was "with it" and we enjoyed 3 hours of reminiscing about the good times we had as co-workers. I treasured that time with him. He wanted to die at home and when he was able, Hospice transferred him back to his home for his final journey. I was again able to visit him at home one more time a couple weeks later but by that time he was really out of it. I'm not sure if he knew I was there or not (I think/hope he did) but I did speak to him as if he could hear me. I reassured him that he was loved and held his hand for about an hour. After I left he passed in less than 48 hours. I am so grateful to have those last moments with him.

Carol's response was excellent. Tell them how much you care for them, recall good times--without telling the person that you will miss them when they die. if you have a mac or ipad and they have the same or family/family member does, you might try facetime with them. You can see them and talk to the person directly and vice versa. If they don't, you could find a used ipad for them for duration of his life. Sometimes if you call an Apple store or authorized reseller where your friend lives, they may help you if you explain your need.
My 94 year old client uses face time when her two adults sons are on travel. They love seeing her and she them.
Your could write recollections about your times together and send them to your friend. If you old photos, you could see them along.
If you have friends in common, then you could ask them to write their own recollections.
Sorry to hear of your sadness.

dmarino: I suggest that you purchase and watch the movie, "The Theory of Everything, " which is the true story of Stephen Hawking, who is 73. It may give you some insight into Lou Gehrig's Disease and thus, be better able to communicate with your friend. Stephen Hawking is brilliant!

If the subject comes up, some people are worried about something they needed to do, should have done, or perhaps a loved one they feel responsible for. I can't say how to bring it up other than, "is there anything I can do for you that you have trouble with now? It might be something as simple as writing a card or letter for them, helping them in making a phone call, or something as big as buying Christmas/birthday presents for children to make sure they have something if the patient passes away before the event or holiday.

Some people worry that a sibling, aunt/uncle, friend may need them after they are gone. Perhaps you can assure that you will do what you can to make sure they are okay... A beloved uncle of mine was in hospice and not able to talk, but was obviously was agitated about something. When we promised that we would take care of his youngest sister (the baby of the family) he calmed down visibly.

Stories--you want to get as many stories as you can about your friend's life, interests, accomplishments, etc. Save the messages you get! Ask what advice he would have for you or a young person just setting out on their life. Learn as much as you can from your friend while he is still here. Ask if he would mind if someone wrote up his story. Let him talk about whatever is going on in his mind, and respond to his thoughts.

I feel sad but the "final" meeting can be important for everyone. When I first started my engineering career I was teamed up with an older engineer who taught me a lot- we were a perfect team. About 15 years ago he was dying of lung cancer (heavy smoker) in a bed in his living room. His wife didn't know if he wanted visitors but agreed I could visit and tell him how much he meant for me in my career. We had a great talk and I still cry when I think about it. It helped him in knowing he left a mark in my world and it was good for me as well.

Life is Good is right. I am a Hospice Volunteer. If the patient wants to talk about it we give them opportunity to do so, but they have to lead the way. Many terminal patients know or have a sense that they are dying. Some will talk, some don't. Just be there for your friend. They need to be surrounded with a sense of love & caring.

I was at the bedside of my dying husband in hospice 24/7 (for 8 days). He was 38. So many friends and family came through that room to say good bye. Many of them pulled me aside before visiting him, crying and asking me what they "should say". I had no idea so I immediately went to the nursing staff and asked. Their answer,
"it would help the process so much for him if you let him know in what ways he has made a difference in your life."

Let your friend do alot of talking and you do alot if listening. Saying the right thing to a dying person is never easy but its a great time to laugh, reminisce and maybe even cry. I pray your last moments together are ones that you will cherish forever!

You listen.
You give permission , "It's OK to go home."

A very good question! I can appreciate the awkwardness you feel; it's like that dead elephant in the middle of the room that everyone is aware of but nobody mentions because it is too unpleasant a topic. It strains communication to the point where one would prefer to avoid the person who is dying altogether. We fear upsetting the person and we fear potential anger and rejection by the person if we say the wrong thing. So we rather not say anything at all. However, news of their impending death has an effect on the survivor as well.

Some very good advice here about normalizing the conversations yet providing an opportunity to discuss difficult feelings and unpleasant realities. My suggestion would be to continue to connect with your friend and not worry about communication errors, as I believe the heaviest burden faced by people who are dying (and people who are grieving) is the isolation imposed on them by survivors who do not know what to say and stay away. I commend you on your compassion and desire to make this right despite feeling a little out of your depth right now.

If you're not familiar with the dying process, it would first be very beneficial if you learn about it. Next, just have normal conversations with your friend as you would if they were not dying. You really don't want to talk about the bad stuff unless they bring it up in a conversation. I strongly agree with anyone who would say to let your friend take the lead in the conversation about the bad stuff, because this is exactly what I would do. Just let them share what they want to and don't pressure them. Just be respectful as you always have, and just be there for them when they need you when it's actually possible for you to be there. Just treat them as any other normal person, and definitely pray for them. I know that some people may not want to hear the next thing that I have to say, but this really is the truth that we will all one day have to face. Before your friend goes, you definitely want to see where they are spiritually because when they die they will stand before our Maker. Definitely make sure they know Jesus if they want to live forever in heaven. I'm sure you'll want to see your friend again on the other side, and Jesus is the only way into heaven. Don't wait because no one is promised tomorrow. One day we will all go through this very same journey and we will all end up on the other side in one place or the other, God promises that. Anytime someone is dying, you definitely want to see where they are spiritually because we all have a spirit that will live on somewhere. I don't know how close your friend is to the end, but now is the time for salvation if they don't already have it. We will all one day return to dust, that is that. However, we can leave this life with the assurance of going to heaven and seeing our loved ones again. The earthly life may end, but that's not the end because there is a spirit realm. Anyone who's had an NDE will even tell you there is a spirit realm and that we do have a maker whose name is God, and we will all one day stand before him when we die. This is an end-of-life fact and many people either fear death for this very reason or they become uncertain of the unknown. The unknown is what they don't know, and it's up to those who do know to share the truth and relieve any fears and uncertainties that our dying loved ones have. Where is fear and uncertainty for a reason because it's within us all to know the truth though it be buried in our subconsciousness. The truth is the truth that we will all face when we die. I know that even my surrogate dad will one day leave this life and even he will stand before God when he dies. No one wants to lose a loved one, but you can rest assured that you will see them again if they go to heaven. Even if you ever had a dream about a departed loved one, that's proof right there that there's a spirit world. I've had such a dream, and that's called a lucid dream as it's called. Lucid dreams are very common, so they're not new or unusual. Depending on how close you are with your friend will depend on whether or not you yourself may have the same dream when your friend is gone. We will all at some point lose a loved one sometime, and the best way we can prepare is to know the truth and prepare our hearts ahead of time. The only thing we can do now is that when we know someone is dying, we really need to tie up any loose ends when possible. This will help give us the best closure possible, so being for paired to make any confessions and apologies as hard as it may be. Seek forgiveness for any mistakes made during your relationship. If you ever borrowed anything that you've not yet returned, quickly return it. Let that friend know that you love and care about them because they really need to hear it, especially now near the end. In case your friend does not go to heaven, the expression of love will be the last kindness they ever experience. If they go to heaven, they can experience kindness again along with the most love anyone can ever experience. Whatever happens, just be sure to shower your friend with as much love and kindness as absolutely possible. You really don't want to neglect them, especially now. No one should die alone, especially without the expression of loving kindness.

If possible, I'd let your friend lead the way. The responses here were terrific - keep it light unless she wants to talk about dying. Much depends on your friend's personality and how close you are. Most people hate to feel "pitied" but appreciate empathy.

It's hard to communicate by phone when someone is this ill, but again, as was suggested, talking about good memories rarely fails. But leave an opening in case she wants to say goodbye. There are people who don't like the fact that people won't talk about death.

It's such an individual matter that you'll have to rely on your instincts and how your friend reacts to what you say. The main thing to remember is that she'll know that you care because you keep trying. You really can't go too wrong if you let your love come through.

Also, write notes. Cheerful memories that can be re-read. It's not as exhausting to read a note or have it read to you as it is to keep up a phone conversation. Notes can be saved and savored. Fun note cards would add to the experience.

Please update us on how your friend - and you - are doing.
Carol

I love you and I am here

I know this sounds simple, but being a retired Hospice Social Worker, sometimes when visiting patients, I would just ask what they wanted to talk about today. It works sometimes. good luck and we are all praying for you during this most difficult time.

I do some hospice companionship volunteering. Most people don't want to talk about their illness or dying but some are comfortable with it. I never initiate such disscusions but if it comes up I will talk about it with them as honestly as I can. Patients may ask about my religious beliefs. I'm honest with them, I'm not religious but I may say that I'm glad they have such strong beliefs as it seems to give them peace in their struggle. You can't Bull S... Someone who's dying.

Take advantage of Facebook. It's great that he can still communicate this way. Follow his lead, talk about what he wants. Old times, old friends and adventures. And talk about regrets and mistakes but remind him everyone has the shoulda, coulda, woulda, feelings.

Let him know he is loved and will be missed and that we all know he did the best he could, that he did more good than harm in this life. May or may not be entirely true in some cases but go with it as much as possible.

And I agree with Geewhiz. Could you make strip to see him? If he doesn't have many people in his life that could be such a huge gift for him. Good luck. Let us know how it goes.

I'm sure your friend appreciates your support more than he can express. ALS is such a devastating, insidious disease.

I honestly don't know what to say to someone dying of this disease, although Geewhiz makes some good suggestions. I would generally try to keep the conversation light and focused on pleasant thoughts, but if/when he does want to discuss his fears, anxieties and thoughts, validate them, compliment him on his courage and just let him know you're there for him. I would think that just having someone to communicate with would be a valuable support tool for someone who must feel as though he's very alone in battling this disease.

I'm wondering if any ALS or muscular degenerative societies have suggestions on their websites?

I traveled the ALS road with a friend for 7 years. She was single, no children, no sibs. If your friend can still speak on the phone an occasional call would be terrific. My friend just wanted to know that others were there for her. Talk about the times you shared and how you value the friendship and the good times. My friend and I would talk about our trips, etc. If you have photos of the two of you post them and recall a memory of that photo. Take your friend on a trip 'down memory lane'. Help him to remember the good times. Typically, ALS patients don't want to be thought of as 'the disease'. Make your friend be as normal as possible. If he follows sports, talk about the latest score. If has kids, ask how they are doing. Is there any possibility you can get in a visit? It would give him something to look forward to and look back on! Good luck. This is a terrible disease.