I’ve only ever been on the receiving side of hearing news that someone I care about has died. I suppose in a way, I’ve been lucky — not having to carry the burden of passing something along that is almost always likely to hurt. Telling someone that their loved one, their friend or even their colleague has passed comes with a heightened responsibility: Do it wrong and it will further exacerbate an already painful event.
Thinking back on my own life, amidst a Persian culture that was so often intimidated by talks of death — which usually resulted in long delays and a string of half truths — I often wondered if there was ever really a good time, or a good way to tell someone that a grandfather, mother or cousin has died. I would watch as a circle of elders would huddle together, their faces heavy with torment, whispering the cost-benefit analysis of delaying reality for their loved ones. This wasn’t subterfuge: It was ritual politeness pushed to its macabre ends.
These days, of course, the delivery of death news has become terrifyingly routine. Every day, more people are dying than at any point in the last several decades. We live in a time of “excess death,” according to scientists — the nationwide data between the months of March and April shows that there were 87,000 more deaths than would have been expected during the two-month period, according to a report from Heart.org. And yet, says Anthony Back, co-director of the University of Washington Center for Excellence in Palliative Care, while delivering the news of someone’s death is never easy, there is a formulaic grace that can help soften, or at the very least not worsen, the blow.
Don’t Assume Anything
Particularly in the case of a sudden death, Back tells me that you should never assume what a person receiving the news already knows. “Make sure you set the stage because very often, things that I assume that they already know, because they’re the family member, they’re the spouse, they’re the cousin, they don’t actually know,” he says. His point is that it’s important to make sure you have some understanding of who the person is, and how the news might affect them psychologically.
To that end, Back says, rather than cater the news to the age of the person on the receiving end, he suggests being more attuned to their overall experience with death. “If I have the knowledge to adjust it more to their experience, people who have been through death with another person that’s close to them, they have a sense of the territory and they will also know how to take care of themselves,” he says. “Whereas people who have not, they just don’t know what it means to take in the death of somebody they’re close to.”
Don’t Wait to Deliver the News
Amy Kelley, associate professor of geriatrics and palliative care at Mount Sinai, says that the safety and wellbeing of the loved one receiving the news should always be considered. “In rare circumstances, if it’s determined to potentially be unsafe for that person to receive the news, then arrangements should be made to meet in person, or arrange for safer, more supportive circumstances prior to delivering the news,” she says.
Back agrees, telling me that you never want someone to find out news at a time when they won’t have support and when they will be in a place where it’s not private or safe for them to receive the news. But he also doesn’t like withholding it. “I’ve seen family members not be told that someone died before they got on a plane for a long flight, and they get to the hospital only to find out that the person had died before they left,” he says. In those cases, people often feel frustrated and angry because, “the presumption is that they couldn’t handle it.” “If you think you want to do that kind of stuff, you have to think about the consequences of the person finding out,” says Back. “This whole thing about us deciding what the other person can handle should really be taken with a grain of salt.”
Don’t Belabor the News
“The second part is when you get to the actual news, you need to be super straightforward and give a headline,” says Back. “When I’m training doctors, I tell them to write a headline for themselves and make sure that when it gets to the time to say the news, they say a headline that says the whole fact and what it means in one sentence. Then they have to stop.”
The reason, explains Back, is that doctors, often due to nerves, will tell a really long, complicated medical story, “like their blood pressure dropped and then we did this and then we did this medicine and then their ventilator changed and we did this and then their kidney function failed.” It invariably has so much detail that the person doesn’t understand what they’re hearing. “By the time you actually get to the news, you’ve lost them,” says Back. “Any intelligent person can only handle so many pieces of information at once. We’re all built with a short-term memory that only holds about seven things. So once you get past seven things, especially that you don’t know, that’s it.” The rest of it, he says, you just lose.
Don’t Try to Control the Reaction
Back says that you have to expect that the person on the receiving end of the news is going to have some kind of reaction and you have to be able to respond to it. “If I tell someone that someone’s died, I don’t know if they’re going to be angry, upset, sad, lashing out or just silent,” he says. “I just have to be prepared that I’m going to be present for some kind of reaction and I have to just be there to receive it, and receive it in a way that’s kind and generous and gives people the benefit of the doubt, because I don’t know where they were coming from.”
That’s especially true if you’re unsure of the relationship between the person who’s died and the person you’re delivering the news to. “I have to also be careful not to try to shape it for them,” he says. “It’s not good for me to say, ‘Well, it was the best possible thing.’”
That’s not to say that you can’t let them know at some later time that the doctors tried everything they could as reassurance. “The whole thing that makes me crazy is when doctors and other well-meaning people are telling other people how to feel,” says Back. “That isn’t helpful. So I need to let them have their feelings and be present for them.”
Be Prepared to Answer Questions But Don’t Expect Them Right Away
“Very often, after that first wave of emotion, people will have lots of questions,” says Back. “I just have to try to answer the questions that they have in as straightforward a way as possible and realize that not everyone is going to have a lot of questions.”
In that regard, Back says it’s probably not helpful “to give long lectures about things.” “Usually when people are really shocked, they need some time to get through that,” he says. “Then they will be able to ask the questions that are most important.” Which, again, is why Back’s goal with these kinds of conversations is to give people the news in a way that they can take it in and start to digest. As he points out, “I have to realize that [their grieving] won’t be done at the end of my phone call.”
If anything, it will have only just begun.
Andrew Fiouzi
Andrew Fiouzi is a staff writer at MEL.
