5 Steps to Having End-of-Life Conversations With Loved Ones

Have you ever lost someone close to you?

Or do you worry about the people you love dying?

Death and dying have been on my mind a lot because I recently lost a close friend of mine. Knowing that she was going to die brought up a desire to explore and talk about death and dying.

Whether you’re actively dealing with this or anticipating it, I hope sharing my experience and what I’ve learned will help you feel more prepared.

https://youtu.be/8R4PANd3wPY

Prefer the audio? Listen here.

Last January, my friend of 25 years, Linda Laundra (whom I met while we were both teaching at NYU), was diagnosed with liver cancer. She had had health challenges throughout her life, but this was different. And I knew it.

Her diagnosis and my fear of losing her inspired me to face my fears and do research on death and dying. This brought me to Julie McFadden, also known as Hospice Nurse Julie, on social media (a beautiful expert on death and dying), and I interviewed her on my podcast, where she answered my questions and reassured me about what was next.

For most people (even a seasoned therapist!), talking about death and dying with loved ones can be complicated and messy. Julie offers a five-step process we can walk through to make those conversations less awkward and more graceful.

5 Tips to Navigate Death and Dying With Loved Ones

In case you’re new to her work, Hospice Nurse Julie has over 2 million followers across her social platforms. She was an ICU nurse before she transitioned into hospice work. Julie believes that the more we know about death, the better prepared we are for it, the better we live, and the more peacefully we die.

Her passion is helping others understand the dying process before we go through it. From her ICU and hospice nurse work, she learned the importance of discussing death and dying with loved ones sooner rather than later.

These are her five tips for broaching end-of-life conversations with family: ¹

Set the Stage: Be proactive by planning to have the conversation. Don’t just spring it on the person.Ask For Help: Frame the conversation as being helpful for you. For example, “Hey mom, can you help me with something? I know you’re okay right now, but if something were to happen in the future, getting plans in place will make it easier to know how to best care for you.”Make and Share Your Own Plan: If we want others to plan, we have to start with ourselves, even if we’re nowhere near death. Not only is it an easy way to start the conversation, but having a plan in place so our loved ones don’t have to figure things out while grieving is a loving thing to do.Bring in Experts: There are a lot of decisions to make when someone is unwell, and it can help to bring in experts like estate planners and funeral advisors, especially for more complex situations.Listen and Be Respectful: Once we begin the conversation, a lot will come up: funeral home planning, advanced directives, and obituary writing, to name a few. Your job is to listen fully to the other person and respect what they want.

It’s important to have these conversations early on because we want our loved ones to have some semblance of control in the death and dying process. Leaving it too late can jeopardize their ability to have a say.

Don’t pressure yourself to do it perfectly. These conversations will likely be a bit awkward, and that’s okay. The important thing is starting it. Doing so lets your loved one know you’re open to it when they’re ready.

If someone you love is dying, download the guide for resources, such as places you can go and people you can call, because this can be an overwhelming experience. The guide also has tips for end-of-life conversations.

Our Bodies Know How to Die

When I had Hospice Nurse Julie on the podcast, she explained that our bodies know how to die, which felt reassuring.

In Psychology Today, Megan Shen, PhD, says, “Those who are dying are immersed in their own world, guided by the archaic intelligence of death. The best thing you can do is respect their journey.”

This coincides with what Julie said during our interview, which is that when people aren’t educated about the death and dying process, they often panic and try to force a loved one to eat or drink. But the body knows what to do. Eating and drinking less and sleeping more is how it prepares for death.

If you want to educate yourself further on this process, Julie covers it all in her book, Nothing to Fear: Demystifying Death to Live More Fully, which I highly recommend.

An Excerpt From I’m Not a Mourning Person, by Kris Carr

My pal Kris Carr wrote a beautiful book, I’m Not a Mourning Person, about the death of her father, Ken, and I wanted to share this excerpt with you: ²

“Only cry in the shower. No one will see you, and you won’t wreck your mascara.”

This bit of wisdom was given to me by a family friend when my father was dying.

At the time, overwhelmed by emotion and desperately trying to maintain some semblance of control, I thought it was a brilliant tip. Not only did I attempt to follow this guideline, I also added a few of my own. Things like: Stuff yourself into the nearest closet and scream into a pillow (or any dense fabric that muffles agony). Dig your nails into your palms so the physical pain overrides your emotional distress. Think gruesome thoughts to distract yourself from your grueling feelings. These strategies worked for a while until my pent-up sorrow took on a life of its own, refusing to abide by any rules.

I remember the exact moment the dam broke. My dad had just received news that his cancer was progressing, and there were no more treatment options. Numb from the arresting prognosis, I walked through the aisles of my local drugstore, having offered to run an errand to pick up more Ensure—the only nourishment he could stomach. I stood frozen, staring at the chocolate-flavored protein drinks, incapable of deciding how many to buy. Will he live long enough for a case, or should I just stick to the four-packs? 

That question hit me hard. An emotional tsunami was about to unleash itself on me and all the innocent shoppers in my immediate vicinity.

Shit! Here come my feelings. And no shower in sight. I blinked heavily through the checkout line, fighting back the deluge of tears that were mere seconds away, until I could rush to the safety of my car and sob uncontrollably. Let me tell you: the parking lot at CVS is no shower stall. My once-compartmentalized grief was now on full display. Hunched over my steering wheel in a teary puddle, I happened to notice an older woman, probably coming to fetch a prescription or buy toilet paper, glancing my way. She could plainly see what I’d been so desperate to hide: I was a full-blown mess.

After the remains of my mascara finished streaming down my face, I felt a sense of relief—similar to when medicine kicks in, giving you a break from a hallucinogenic fever. I’d somehow overlooked how cleansing it could be to let my feelings rip. After this happened a few more times (shout-out to Home Depot and their decision to pipe Michael Bolton’s “How Am I Supposed to Live Without You?” through their stereo system), I’d started to realize that these breaks helped me survive. They made me realize that the only way through my sadness was to allow the waves of big feelings to move through my body—something I’d been hell-bent on avoiding for fear I would drown.

If embracing my intense emotions helped me feel even the slightest bit better, why had I been so determined to avoid them? And given how all-encompassing these hints of catharsis felt, I couldn’t help but wonder, Where else in my life have I been avoiding grief? Did that avoidance have anything to do with the strange existential angst that had been creeping up on me over the last few years, where I sensed that I was not, in fact, living as fully as I could be?

The more I thought about it, the instinct to avoid grief made perfect sense to me. As well-meaning as my family friend’s advice was, Keep that mascara intact, honey was not going to help me heed my soul’s call to grow. For that, I would need to surrender to my grief and other big emotions.”

I really identified with Kris’s experience of trying to avoid the tsunami of feelings I was experiencing while Linda was sick and dying.

I was stuck between wanting to support her husband of 57 years and her friends of 40+ years and my own pain about not wanting to lose her and our friendship.

I felt selfish because while it wasn’t about me, it had to be about me when it came to me. Meaning, I had to take care of and process my feelings. I didn’t need to make Linda’s husband think about me, but I certainly asked my husband to think about me in my grief.

Linda transitioned on January 17, 2025, and I’m still experiencing grief. It’s not a linear process. I’ve accepted that the nature of grief, for me, is like waves.

Something will remind me of her, or I’ll think of something I need to tell her, and the realization that I can’t call her because she’s transitioned slams into me like a truck.

Don’t Forget to Take Care of Yourself + Find Support

When you’re supporting someone who is dying or being a caregiver, you need to receive support yourself. Ask for help where you need it. Bring in other people and take care of yourself to the best of your ability because this is often an emotionally heavy load.

If this isn’t something you’re dealing with right now, and you have siblings, talk to them about what end-of-life care for your parents may look like between all of you. I’ve had too many therapy clients and members of my community share that they got stuck with being the sole caregiver for a parent, and it doesn’t have to be that way, nor should it be.

Being in a community during these situations can be incredibly helpful, too. You don’t need to be alone in whatever you’re experiencing.

If you lack community, I’d love to invite you to join my membership. We meet four times a month to discuss whatever is on our minds and hearts via Q&As that I host on Zoom. When you join, you also get access to my signature courses. You can check out all the details and join here.

Let me know in the comments or on Instagram: What is your relationship to death and dying? Have you been through this experience? Have you processed it? Are you caring for someone who’s dying? Did this episode help you? Remember to download the guide for value packed resources to help you through this situation, and as always, take care of you.

¹https://www.afterall.com/helpful-resources/planning-with-your-parents/hospice-nurse-julie-shares-its-time-for-the-talk-about-end-of-life.html#:~:text=Hospice%20Nurse%20Julie%20Shares%3A%20%27It%27s%20Time%20for%20The,Experts%20…%205%205.%20Listen%20and%20Respect%20

²https://kriscarr.com/never-let-them-see-you-grieve/