What do you say when someone tells you they’re going to die?

One mention of the “D word” and you imagine conversation grinding to a halt. You worry you’ll upset someone, say the wrong thing, or maybe just make things a bit awkward.

And when it’s about someone you love who's found out they're terminally ill? You might have no idea where to start. How do you start a conversation with someone you love about their terminal cancer or having six months to live?

Glyn Thomas is no stranger to talking about death. As a Senior Social Worker at the Marie Curie Hospice, Hampstead, he’s an expert at guiding people through difficult conversations and has plenty of experience in what to say to someone who's living with a terminal illness.

Who better to answer these pressing questions about how to talk about death?

Generally, I’d say that avoiding the subject is not good. It’s better to offer someone the opportunity to discuss things with you, without pushing them to say more if they don’t want to.

Often, the person will want to talk about their illness. Start by asking open questions like ‘How are you feeling today?’ This will perhaps give you an idea of how open they want to be.

If your friend or family member is a private person and you know they tend not to discuss very private matters, be led by this.

Illness can make people feel very institutionalised and removed from everyday life. So it’s often a good thing to discuss what’s happening in the real world as it can make someone feel a part of things.

If someone is dying, it doesn't mean they necessarily only want to think and talk about their illness. When everything is turned upside down, it can be reassuring to hear that the world is going on as it always does. 

But again, be led by the individual and share something only if you feel it’s appropriate. Asking open questions about how someone is feeling that day can be a good starting point for a supportive conversation, if you’re worried you’re talking too much about yourself.

Be open about what you can and can’t offer to help with, and again be led by the person’s situation. 

It may be that you can offer some practical help; for example, cooking a meal or driving them to a hospital appointment.

It can be tempting to reach for profound or comforting words for people with a terminal illness. But sometimes it's those practical suggestions of things that could make their life easier that are most helpful.

Living with a terminal illness is a very unpredictable thing.

It might be that the person was particularly unwell when you visited. When you’re ill, how you feel and what you’re able to do changes throughout the day, as well as from day to day.

If you get the sense that the person didn’t want to see you because they were having a bad day or feeling particularly unwell, try not to let this stop you visiting in future and stay as flexible as you can about when you visit.

My advice is to respond to the individual and your knowledge of who they are. 

Some people are open to talking about difficult subjects –  particularly if they’re terminally ill – which perhaps they wouldn’t have talked about when they were well.

Be sensitive to them, and if you do say something that you think may have upset them, just apologise and move on.

If the person you care about has a friend or family member looking after them, it may be helpful to chat with them first. They can give you a good idea of how the person is doing and can help you if you’re not sure what to talk about.

If your ill friend has a carer, my main advice is to offer the carer help and support if you can. Carers are often overlooked in these situations, and they need support as much as the person they’re caring for.