If your uncle is dying of cancer, you probably don't need somebody telling you to find the perfect words or “stay strong.” You may need something much simpler.
Ask what he wants. Listen to the answer. Offer help that is actually useful. Respect his decisions, even when they are hard for you to understand. Keep being his niece, nephew or family member rather than turning every conversation into one about cancer.
And if you feel awkward, frightened or completely useless, you're not unusual.
I know the awkward part particularly well.
My uncle was dying of cancer, and I started disappearing
Did you know that your friends and family are all secret magicians? That they can disappear or materialize at the incantation of one single word?
The magic word?
It's not abracadabra.
It's cancer.
I'll admit I was one of those so-called magicians.
Last summer, my Uncle Kenny received the news that no one expected: his chemo pill was no longer working. He could either choose intravenous chemo or let the disease take its course.
He chose the latter.
I might not have done a complete disappearing act, but once I heard that my uncle had cancer, I discovered I could suddenly make excuses appear at the drop of a hat.
I couldn't come to visit because I had to work. Exaggeration.
I'd try to make it up to visit as soon as possible. Probably not.
The truth was harder to admit: I didn't know how to be around someone I loved when I knew he was dying.
I had never been very good at knowing what to say to my uncle
This wasn't the first bout of awkwardness I'd experienced with Uncle Kenny.
A helicopter engineer in the Army, he'd been deployed for more than his fair share of Thanksgivings and Christmases. I remember dreading my turn to talk to him when the phone was passed around at holiday celebrations.
My civilian brain never knew the right thing to say.
I'd wish him a Merry Christmas, and he'd remind me it wasn't very merry for him.
I'd tell him I was looking forward to his visit home at New Year's, and he'd bark at me for revealing classified information on an unsecured line.
So maybe eloquent emotional conversation had never really been our thing.
After his cancer diagnosis, though, the silences felt different. I knew even less of what to say.
Eventually I realised something that should have been obvious.
It was okay.
Cancer is awkward and angry and weird and unfair. You don't make that disappear by finding a sufficiently beautiful sentence.
Current guidance for families and friends of people with a terminal illness makes much the same point: you don't have to know exactly what to say. Listen, be honest when you're lost for words, and let the person who is ill lead conversations about their illness and dying. Marie Curie's guidance on supporting someone with a terminal illness recommends taking your lead from the person rather than assuming what they want to discuss.
Sometimes being there without trying to repair the situation is enough.
His decision about treatment was his
One of the hardest things about Uncle Kenny's situation was knowing that another treatment option existed and that he didn't want it.
His chemo pill had stopped working. Intravenous chemotherapy was an option.
He decided against it.
When someone you love makes a decision about treatment or end-of-life care, you may have your own opinions about what they should do. You may desperately want more time. Other relatives may disagree with each other.
But supporting someone doesn't mean taking control of their decisions.
A person's choices about their care belong to them, in discussion with their healthcare team. Family members can ask questions, help them get information and support them if invited. We don't get to make someone's remaining life into a referendum on what would make us feel better.
That can be brutal when you're frightened of losing them.
It's still their life.
Showing up matters, but ask what showing up should look like
Luckily, I realised some of this in enough time to spend the final week of my uncle's life with him.
I don't have a manual for how to get through visits with someone you love who is dying. One family cannot provide a set of rules for another.
But I do know that avoiding someone because you're frightened of getting the interaction wrong can cost you time you don't get back.
Showing up doesn't necessarily mean spending hours beside a hospital bed.
Your uncle may want company. He may want twenty minutes of company. He may be exhausted and not want visitors that day at all.
Ask.
“Would you like me to come over?”
“Are you up for company today?”
“Do you want to talk, watch something or just sit for a while?”
A terminal illness can take away a lot of control. Support shouldn't take away more of it.
Respecting someone's wishes also means accepting that what they want can change. A visit that was welcome last week might be too much today.
Don't disappear because you don't know what to do.
But don't make your presence another obligation either.
You don't need the perfect thing to say to an uncle who is dying of cancer
When someone is dying, ordinary sentences can suddenly feel hopelessly inadequate.
Maybe they are.
There probably isn't a sentence big enough for what is happening.
You can still say something.
“I don't really know what to say.”
“I love you.”
“I'm here.”
“Do you want to talk about it?”
“Do you want to talk about absolutely anything else?”
And then listen.
If your uncle wants to talk about dying, don't immediately shut the conversation down because it scares you. If he doesn't want to talk about dying, don't force some grand final conversation because you think you're supposed to have one.
Silence is also allowed.
For more specific help with cards, texts and written messages, URevolution has a separate guide to what to write to a cancer patient. If the difficulty is the conversation itself, see how to talk to someone with cancer.
Offer practical help without taking over
When someone you love is very ill, “Let me know if you need anything” can feel like the obvious thing to say.
It can also give them another job.
They have to decide what they need, work out what you're willing to do, ask for it and coordinate it.
Try being specific.
“I can pick up groceries this afternoon. Do you need anything?”
“I can drive you on Thursday if you want me to.”
“I can bring dinner over. Would that help?”
“I've got a couple of hours free this weekend. Is there anything around the house you'd like done?”
The answer may be no.
Accept that too.
Practical support should make life easier, not become a polite invasion.
And there is a line between helping your uncle and becoming responsible for his medical care. Questions about symptoms, medicines, treatment and clinical decisions belong with his cancer, palliative-care or hospice team.
You can be family without pretending to be his doctor or nurse.
Let your relationship still be about something other than cancer
When somebody is dying, it's easy for every conversation to become Very Important.
How are you feeling?
How was the appointment?
Are you in pain?
Have you thought about what happens next?
Sometimes those conversations need to happen.
Sometimes your uncle may just want his niece or nephew back.
Talk about family gossip if he likes family gossip. Watch something stupid together. Complain about football. Ask about the story you've heard thirty times.
Although you may want to keep your own stories slightly shorter and sweeter.
Your loved one doesn't actually have until the end of eternity to hear your latest saga about your gripes with the carpool lane.
Terminal illness does not erase someone's personality or their existing relationships.
You are allowed to laugh.
You are allowed to have an ordinary conversation.
You are also allowed to stop talking entirely.
Don't force positivity because the truth feels unbearable
People reach for reassuring phrases when they don't know what else to do.
“Stay positive.”
“You have to keep fighting.”
“Everything happens for a reason.”
“Miracles happen.”
Those words may feel encouraging to the person saying them. They can also make it harder for someone who is frightened, angry, exhausted or simply unwilling to pretend that everything is okay.
You don't need to turn fear into optimism before you can sit with it.
Your uncle may feel hopeful one day and furious the next. He may joke. He may not. He may want reassurance or find it irritating.
Let him have his own response to what is happening.
And resist the urge to arrive with a miracle treatment you found online unless he has actually asked you to research something. A dying person's remaining time should not become an endless sales pitch for somebody else's cure.
Family members won't all respond the same way
Terminal cancer doesn't happen neatly to one person while everybody around them responds sensibly.
One relative becomes intensely practical.
Another cries.
Another avoids the subject.
Someone wants every detail from the doctors.
Someone else cannot bear hearing any of it.
And sometimes people disappear.
Cancer was the magic word that exposed my own talent for that.
Different reactions don't automatically make somebody uncaring. Fear can make people behave strangely.
But the person who is dying should not have to spend their remaining energy managing everybody else's reaction to their death.
Support one another where you can.
Talk to another relative. Share practical tasks. Give the main carer a break if they want one. Find somewhere to put your fear that does not require your uncle to constantly reassure you.
If cancer has exposed serious problems in the family rather than bringing everybody together, our article on coping with unsupportive family during cancer looks at that from the perspective of the person with cancer.
You may start grieving before your uncle dies
One part of having somebody you love dying is that grief doesn't necessarily wait for the death.
You may already be grieving the things that are changing.
The way he used to be.
A holiday you expected him to attend.
A conversation you assumed you'd have next year.
A future that is becoming shorter in front of you.
This is often called anticipatory grief, or grief before a death.
It doesn't happen to everyone, and there isn't a correct amount of it to experience. Grieving before someone dies also doesn't mean you've given up on them, and it doesn't mean you'll have somehow completed your grief by the time they die. Marie Curie's anticipatory grief guidance describes how grief can begin while the person is still alive, while the US National Cancer Institute also recognises grief before death among people supporting someone with advanced cancer.
For me, dealing with my uncle dying from cancer was also a way to connect with my own fears around dying.
That didn't make his death about me.
It meant his death was happening inside a family, and families don't experience terminal illness at a safe emotional distance.
If the grief or anxiety is becoming difficult to cope with, talk to someone outside the immediate situation. That might be another friend or relative, a counsellor, a grief-support service, or someone from the palliative-care or hospice team.
Your feelings deserve somewhere to go too.
What not to do when your uncle is dying of cancer
There isn't a universal etiquette guide for dying. Uncle Kenny certainly didn't hand me one.
But a few things are worth resisting.
Don't turn every visit into an interrogation about his health.
Don't assume he wants to discuss death just because you are ready to.
Don't refuse to discuss death because you aren't ready to.
Don't pressure him to be positive.
Don't insist that he continue treatment because the alternative frightens you.
Don't give medical advice you aren't qualified to give.
Don't treat cancelled visits as a personal rejection.
Don't make him responsible for comforting the whole family.
And don't wait so long for the perfect version of yourself to show up that you disappear instead.
That last one I learned the hard way.
There may be nothing useful left to say
Near the end of my uncle's life, I still didn't discover the magic sentence.
There wasn't one.
What changed was that I stopped believing I needed it.
I could be his niece without solving cancer.
I could sit in an uncomfortable room.
I could love someone whose decision frightened me.
I could feel sad before he died.
I could occasionally say the wrong thing.
And I could stop making excuses long enough to spend that final week with him.
If your uncle is dying of cancer, your relationship will be different from ours. He may want different things. Your family may work completely differently.
So don't copy somebody else's version of a “good death” or a “good family.”
Ask your uncle what matters to him.
Listen.
Help when help is wanted.
Give him space when space is wanted.
And when you don't know what to say, you don't have to perform wisdom.
Sometimes you can simply stay.
Supporting a friend instead? Read how to help a friend dying of cancer.
