On Dying and (not) Hearing

listenNear death, hearing is possibly our last form of active connection with the world around us.

Sight, smell, taste, touch, and hearing usually fade with age. However, regardless of our accumulated birthdays, diseases (or the treatments for them) often limit our ability to sense anything other than sounds. Chatting, joking, or arguing while a loved one is lying motionless in a hospital bed are likely heard by everyone in the room.

I’ve witnessed doctors coaching siblings to continue sharing essential information with a seemingly comatose parent. And I’ve also witnessed nurses warning friends or family members to be careful with all conversations. The patient may hear the argument. The patient may comprehend that an adult child is berating a mother or father for not “pulling the plug.” I’ve been in rooms when individuals have joked about trivial things, completely ignoring their “loved one.” I’ve also been with people who stood on opposite sides of a hospital bed while debating money, cremation vs. burial, or where they’d have dinner later that night.

What is the last thing you want your loved one to hear?

Will you refer to him in the third person, as if he weren’t present in the room?

Will she overhear a casual cruel comment?

Will you criticize colleagues at work or whine about incompetent teachers at your kid’s school?

Talk to your loved one, not over them.

Talk with them, not about them.

Be kind. Be gentle. Be honest. Be hopeful. Be present.

Do we know with 100% certainty that people hear in life’s final stages? No . . . and we can’t do post-death interviews. Furthermore, I’ve read enough research to understand that thoughtful professionals will contradict each other’s views on hearing acuity and the dying. Let the experts keep debating. For me, I’ll always encourage friends and family to assume their loved ones can hear what they say and how they say it.

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Hearing may also be the first of our senses to go.

But now I’m not pondering those who are dying. I’m referring to the living, breathing loved ones surrounding the bed. And, actually, I’m not referring to hearing as much as listening.

Will you be able to truly listen to the doctors?

It is difficult for anyone to hear that physician in the white lab coat say that you, or a loved one, has six months or less to live. You want a second opinion. Please, get that different perspective. But try to pay attention to everything said, even by the physicians who have explained choices you’d rather not hear. Ask the hard questions to help you better understand if certain treatments provide a slightly longer span of life, but that the quality of that life will be compromised. It requires an immense effort to understand a beloved’s devastating illness . . . and that his or her life will be counted in days rather than years.

Will you be able to truly listen while ignoring your fears?

No one wants to take morphine. It is addictive. It can make you dopey. When a hospice nurse asks about your loved one’s, or your, pain level, what do you “hear” them ask? Do you “hear” that the nurse just wants to “knock you out” so you can’t talk to the kids or grandkids? Do you “hear” that you’re close to death and that this rotten drug will “kill you quicker?” Used properly, morphine (and other serious narcotics) is for your benefit. Morphine does not kill you. The disease is “killing you” . . . and many diseases are accompanied by ever-increasing, relentless pain.

When a nurse says he wants to help you, he does. When a nurse asks about your pain level, tell her the truth.

Our lack of listening is more than about drugs, but is nearly always about 1) things we are afraid of, 2) ignorant about, or simply 3) don’t want to discuss. When a loved one is dying, there should be no debate about discussion. Talk early. Talk often. Talk now. And, yes, listen! Learn!

Will you be able to truly listen to the person you love so much?

I love food, whether fine cuisine or junk food. What about something to drink? If it’s darn hot outside, a glass or three of lemonade will be swell! With a nice meal—say, grilled salmon accompanied by my friend Juanita’s always-perfect pilaf—pour me a glass of nice (no, exquisite) red wine!

However, many hospice patients arrive at a point in the disease process when they have no interest in food or liquid. As a grim, unfair illness “shuts down” a body, nutrition no longer matters. That doesn’t stop some families from demanding that an IV is attached to deliver nutrients.

Please, have more chicken soup. Please, eat a cracker or sip water. Please . . . anything!

This is difficult. But in the final stages of most cancers—and certainly other illnesses—the dying becomes even worse if “nutrition” is forced on them. (Yes, I intentionally used “forced.”) When a nurse or doctor explains that nutrients will do more harm than good to a dying patient, listen to the information they share. Please understand what your loved one’s current needs really are.

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I hope you are always careful with what you say around a loved one who is dying. Hearing is likely the last of the senses that we have when dying.

I hope you are always careful with how you listen as a loved one faces death. Hearing, too often, is one of the first of the senses to be ignored by the living.


(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. Several years ago a dear friend called to say her grandmother was dying and asked me to come with her to her grandmother’s home to support her. I’d known the dying woman for many years and my friend expressed concerns about how the famly would handle this change in the family dynamic.

    She had stopped talking, eating and for the most part was quiet and her family attended to her with reverence and love. It was almost a dance as people moved in and out of rooms tending to the grandmother and each other.

    After a few hours of people coming in to her room saying their piece and then leaving, one of the cousins arrived and began ordering people around and clearly taking charge. My friend left her grandmother’s side to follow some silly request of the cousin. I sent her back to her grandmother so she could return to her grandmother’s side and was chastised by the cousin for taking over the task for my friend. Trying to keep the peace was on everyone’s mind. People left the house just to avoid the cousin’s orders. After about an hour of this, the cousin began criticizing some of the family. There were tears and some words exchanged that change relationships forever.

    The grandmother suddenly raised her arm and slowly spread her long slender fingers, She turned her head toward the cousin, pointed her index finger the cousin’s direction and said, Leave, you are not helping. The cousin left swearing she would never offer to help again. Everyone heaved a joint sigh of relief and the dance resumed. The grandmother held on for a few more days before passing on.

    I was so honored to have been witness to this event.

    Thank you for your words of wisdom Larry!

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