My elderly neighbor in my prior town developed pancreatic cancer. He asked me to come over through one of his sons, who approached me with some misgivings. His son coached me as we walked over that he was very near-term critical, and they were only saying positive things to him.
He called me into his room, and he looked gaunt. We talked about the weather, the plants, the things we always talked about when we ran into each other. Then he looked at me in a different way. He said, "you kow I'm dying." I said yes, I understood that was the case. "They won't even let me talk about it and it drives me crazy."
I said that they were afraid of losing him, and it was tough on him, but easier for them that way. He agreed, and said that he wasn't unhappy, he'd had a good life. I asked if he was afraid, and he said no. By then, his son was listening at the door. We talked a bit more and then he said, "you've been a good neighbor," and shook my hand. I said that he had been as well. He had a big smile on his face and looked greatly relieved. It was time to go.
His son bum's-rushed me out, obviously unhappy about our choice of conversation. He said that he had told me that they were trying to say only positive things around him. I replied that he knew he was dying, and that he needed to say goodbye, so I had to do that for him. That's why he had asked for me: he needed to be able to say goodbye to someone on open terms, even if it was just with a neighbor.
The son was still annoyed, so I went home. Charlie died later that evening. A week later, his son came over and said, "I finally understand what you were doing." We were able to talk about it and I went through some stories I had of his dad. He thanked me for being there for his father.
I'm not saying to open up the subject, and I'm not saying the person you're visiting would need what Charlie needed. I'm not saying that anyone will ever thank you for it. But I am saying to be willing to get tossed out on your ear to do the right thing if it becomes apparent, for your neighbor, your friend, your relative.
Often, the family will not discuss the reality of the situation with the patient. They know they are dying. They need closure. They need to express their fears. They need to say goodbye.
So, if nothing else, please let them look you in the eye and say goodbye.
Best wishes,