Managing Fears of Death and Dying
For most people in our culture, the thought of dying is frightening. Thinking about talking with others about this subject can also be very scary and stressful. Many people avoid the topic all together and, at a time when connection to others is so important, you can be left feeling alone and afraid.
In reality, all of us have thought about dying. Having these important conversations with friends, family, and your healthcare team can lessen your anxiety and reduce the isolation. Many of your fears about death and dying can be addressed by using three steps: acknowledge your fears, share your concerns with others who will listen, and focus on your quality of life.
Acknowledging Your Specific Fears
While many fear death, each of us has our own specific fears and concerns. You may find it helpful to try and identify your specific fears rather than remaining stuck with a generalized sense of fear. Sometimes there may be no specific answers or solutions but sharing your fears with your loved ones, healthcare team, members of a faith community, mental health professionals, or others can be very useful in helping you to feel less afraid and less alone. Some also find talking to others who have cancer, such as in a support group at the Cancer Support Community, to be vey helpful in reducing fear. Below are some of the most common fears that people have about death and dying.
Sharing Your Fears with Others
- Fear of the Unknown – It is normal to be afraid of the things we can’t imagine. If you have been involved in a faith community or other spiritual involvement, you may find some answers there that will be helpful to you.
- Fear of Pain and Suffering - Many people fear that pain and suffering at the end of life cannot be avoided. Talking with your healthcare team about your concerns is very important. Your healthcare team will help you to understand the advances in medicine that can minimize pain and lessen anxiety and depression.
- Fear of Punishment – People from every religious point of view and those with no religion at all may fear that they will be punished for what they did or did not do. Each of us has things we would do differently if we could go back in time. Sharing these regrets openly with those close to you or someone from a faith community can help you to feel less burdened.
- Worry about What Will Happen to Loved Ones – One of the most common fears is what will happen to those who are dependant on us. Making plans in advance for guardianship and financial planning can help lessen these kinds of worries.
- Loss of Control - It is our nature to want to be in control over our lives but recognizing what is out of our control can help to focus attention on the things we can control.
- Isolation – Being open about what you are really thinking and feeling with those close to you will help them feel more comfortable being around you. Let them know that you still want to know what is happening in their lives and that it is okay to joke and talk about trivial things as well as some of the more serious things on their minds.
- Fear of Non-Existence - Many people, including those who are not religious, believe in an afterlife. When facing one’s death it is not unusual to question this belief. We cannot know for sure what will happen, but speaking with others in a faith community or loved ones may help to reassure us.
Opening up the lines of communication can be challenging. Concerns about upsetting others, not knowing how to begin, fearing that you will feel helpless, and the thinking that if you say it out loud you will cause it to happen are just some of the reasons we struggle to have these conversations. While these concerns are valid, having the chance to share your feelings or ask practical questions can help lessen anxiety and the isolation that many people experience at the end of life. Some people find it helpful to talk with other cancer survivors about how they started these conversations. Here are some tips for opening up the lines of communication that we have learned from members of the Cancer Support Community:
Focusing on Quality of Life
- Find an example from when someone in your own family was dying. For example: “Do you remember when grandma was dying and in the hospital? I wish I hadn’t been afraid to tell her how much I love and would miss her.”
- Find an example from the news. For example: “Wasn’t that a sad story about that professor who died? I really admired the way he was able to speak publically about his experience. It seemed to mean a lot to him and his family.”
- Use popular cultural references such as TV shows, movies or books. For example: “Doctor, on TV the other night I saw a show and the character who was dying was suffering so much. Was that just for TV or does that happen in real life?
No matter what the future may hold, it is important to remember that you can live fully in the moment. Focusing on the here-and-now can help shift your thinking, even if temporarily, away from fears and worries. Focusing on the emotional, social and spiritual aspects of your life should not be overlooked. Try to do the things you normally do that bring you pleasure even if adjustments need to be made. Make plans for the future that are meaningful for you. Playing with a grandchild, listening to a favorite piece of music, taking a walk or sharing a special meal with a friend can help you to remember to enjoy life today.