Talking to tackle taboos with Macmillan: Starting conversations about death, with a loved one who has cancer

Our series of guides will take you through how to have difficult conversations about cancer and death with loved ones, and why they can be so important to have.

At Farewill, our mission is to change the way the world deals with death. We’re working hard to help people through some of life’s toughest times. A big part of that is helping people have often difficult conversations with their families about death.

Research from our recent Death & Us report, which looked at trends in attitudes to death in 2021, showed that people wanted to speak more openly about death, but still don’t know how. We’re scared of saying the wrong thing, so we sometimes don’t say anything at all. Especially when it comes to talking about something like cancer.

We worked closely with Sian Robinson, one of Macmillan’s incredible Support Line Service Knowledge Specialists to put together a series of three guides. Sian works on Macmillan’s support line, helping people who are going through cancer or supporting the loved ones who are caring for them. Our guides will help take you through how to have these difficult conversations with loved ones and why they can be so important to have.

  • If you're wondering how to explain a loved one’s cancer diagnosis to children or your own diagnosis, have a look at this guide

  • And if you’ve been diagnosed with cancer and you’re looking for tips on how to talk about it with your loved ones, this guide is for you

  • If someone you love has been diagnosed with cancer and you’re supporting them through it, keep reading the guide below

Starting conversations with a loved one

Starting conversations with a loved one who has been diagnosed with cancer can be overwhelming too and there can be a lot to think about. Conversations around this can be particularly hard because you may be worried about upsetting the person with the cancer diagnosis, especially when they’re trying to keep positive and not think about ‘the worst’ happening.

It’s often at these times where we see talking about death become such a taboo subject. But as Sian says “it’s important to remember that talking about dying does not bring death any closer”. In fact, we’ve seen how it can often bring a feeling of relief to the person who has been diagnosed with cancer, and their loved ones.

Some practical advice

Sian has outlined a few important things to think about when you’re starting to have these conversations with a loved one going through cancer:

  • Try not have any pre-existing assumptions

As Sian says, sometimes when people hear ‘cancer’ they think ‘death sentence’. This is often not the case - some people can live a long time with a diagnosis and some cancers may be curable. Try not to jump to conclusions until you know what the situation is exactly

  • Try get your timing right

Getting told you have cancer comes with a thousand things to think about. Try to get your timing right and try not to rush it. If the early days of the diagnosis aren’t the right time, wait until there’s a gap in all the information the person is being told and wait for the dust to settle a little.

  • Think about the practical parts of the conversation

Sian suggests thinking about things like where you want to be when you start this conversation. Also have a think about if you’ll have enough time for the conversation, and the person you’re speaking to won’t be rushing off to attend an appointment. Make sure you won’t be disturbed by a phone call and try to be somewhere quiet where you can listen actively. Walking side-by-side can help sometimes as it can feel more natural. 

It can also be important to plan for the conversation. Do you know what you want to cover? It can be helpful to write these down beforehand, especially if you think you may get upset or become flustered in the moment.

  • Listening is crucial

Making sure you are really listening to your loved one is crucial. As Sian says, you do not have to fill silences, always be positive, give your opinion or experience.

Turning your body towards them in person or showing verbal nods like ‘I see’, ‘uh-huh’, ‘OK’. You could try something like ‘I hear what you’re saying’ if you’re talking to someone over the phone. Sian suggests trying to avoid things like ‘I understand’.

  • Think about how you say it

This is a really difficult conversation to have, and one we’re not used to having with our family and friends. Try to think about the pace you set for the conversation; it can be helpful to introduce the conversation slowly.

We also tend to use a lot of euphemisms for dying and death, because of the taboo around having these conversations. For example, ‘passing away’ or ‘going to the angels’ are often used to talk about dying. But using these words can be confusing and sometimes it’s best to be clear about what you mean, instead of having to clear up any confusion or misunderstanding later. It can be helpful to mirror what the person you’re speaking to uses and feels comfortable with.

Sian’s conversation starters

‘You might not feel ready to talk about this in detail yet, but do you think we should talk about….?’

‘I know that talking about these things is never easy….’ 

‘Have you ever wondered what would happen…?’

‘I was looking at information from Macmillan and one of their booklets focuses on future planning and it got me thinking….’

Helpful resources for further guidance

You can find useful information on the Macmillan website and in the Macmillan booklet ‘Talking with Someone who has Cancer’.

Contact the Macmillan Support Line

Don’t forget, there’s no ‘right’ way to have these conversations because everyone goes through hard and emotional experiences like cancer in very different ways. Ultimately, you know the person you’re supporting best, so you’re the expert when it comes to offering them the support they need. 

Conversations and their impact

The impact of having these conversations with family and friends can be mixed. Some people feel relieved, now that their loved one’s wishes are known and that the practical side of end of life planning has been sorted. Others may feel upset and angry that their loved one is thinking about dying, when they should be focusing on living and getting better.

Some people won’t want to have the conversation at all whereas others may start to think and reflect on their own end of life plans. 

Although the impact of these conversations may be different depending on who is having them, at Farewill we’ve seen how important they can be.

Talking early with our loved ones about what we’d like to happen when we or they die, can help with planning a funeral that really honours the wishes of the person who has died. This can often be a big comfort to their family and friends who are grieving.

And having these conversations with a loved one who has cancer can even feel empowering; you’re coming together to protect their last and final wishes. And it can make you feel less alone too. 

Don’t forget, whether you’re the person who has cancer or if you’re supporting someone through it, being kind to yourself is important. Reach out to family, friends and support networks to ask for help. Macmillan’s free and confidential Support Line is open 8am-8pm, 7 days a week, for you to talk about how you’re feeling to one of their trained advisors. 

Find out how your support means Macmillan can continue to be there for people living with cancer.

Article reviewed

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