How to Cope as You Near the End of Life

Learning that your cancer can no longer be controlled can bring up many different emotions. You might feel shock or fear. You might worry about being a burden. And you may wonder how your death will affect loved ones. These feelings can be hard to talk about, but they are normal. You’re not alone.

Common emotions as you near the end of life

When you find out your cancer can no longer be treated, you may have many different feelings. These feelings are completely normal. It’s important to allow yourself time to feel these emotions. It’s OK to grieve in your own way for what you are facing and losing.

You may experience grief, anxiety, or depression when living with advanced cancer. These feelings are common, and your healthcare team can help you cope with them. They may be able to recommend a counselor who has experience working with people with advanced cancer. Or your care team may be able to provide treatment to help. Many people also find comfort in talking about their feelings with family, friends, and caregivers.

Other feelings you might experience can be:

• Anger or resentment
• Fear or regret
• Sadness or feeling alone
• Calm and acceptance

These feelings can change from day to day. Understanding these emotions can help you cope and seek support when it’s needed.

Grief

It’s normal to feel intense grief during the last stage of your life. You might be grieving the loss of the life you expected. Or, you may have lost things already, such as the strength to get around like you used to or do the things you enjoy. You may feel distanced from those who are not coping well with the fact that you are in your last stage of life. Many physical and emotional losses come before the loss of life itself.

The people you love are grieving too. They know they’re about to lose you. Try to talk to your loved ones about the grief and loss you’re all going through.

Talking with someone – a partner, a dear friend, someone you trust – about these feelings can help you work through them. Some people also find it helpful to talk to a counselor or spiritual advisor. If you are receiving palliative or hospice care, that care team will likely have someone you can talk to about your grief.

Anger

Anger is a common part of the grieving process. It’s normal to feel angry about a serious illness. Most people don’t feel ready to die and find this hard to face.
If you feel like anger is impacting your relationships or daily life, ask your cancer care, palliative care, or hospice care team to connect you with a counselor to help you cope.

Fear

If you fear dying, think about what you’re afraid of about death. Are you worried about:

• Being alone or where you might die?
• Suffering or pain?
• What happens after death?
• Your life not having enough purpose or meaning?
• How your loved ones will cope after you die?

These are some of the fears people have about death. Sharing your fears with loved ones and your healthcare team can help them support you and find ways to ease your fears. Many people find that having a plan for how they want to spend time and be cared for can bring a sense of peace and comfort.

Regret

Some people may feel regret or guilt about things they did or did not do or say. While you can’t change the past, there are things you might be able to do now. You might consider apologizing or asking for or offering forgiveness to others. Also, forgive yourself and try to let go of the things that can’t be changed.

This can be a good time to talk with your children about the important things you want them to know. It’s also good to talk to them about how to handle their feelings and the loss they will soon go through. Writing letters, recording messages, or making videos for keepsakes they can keep might help support them as they go through this process. Strengthening these relationships can bring comfort to you and them.

Anxiety and depression

Many people feel anxious or depressed as they near the end of their life. Talking with someone you trust, such as a counselor, a spiritual advisor, or a loved one, can help. If these feelings affect your quality of life or keep you from doing things you enjoy, treatments, such as therapies or medicines, might help. Don’t be afraid to ask for help. You want to feel the best you can. And your care team wants to support you during this time.

Feeling alone

When someone knows they are nearing the end of life, they may feel lonely in a different way. They can feel lonely even when people are around. This feeling is common, but it affects your emotional well-being and might make your physical symptoms feel worse.

Feeling lonely can also happen when a person stops engaging in social activities and connections that they enjoy. Sometimes, people pull back from their social networks because they feel embarrassed or uncomfortable with how they look or feel. They might not want to burden their friends and loved ones with how they are feeling about dying. They might also be having a hard time managing the emotions of their grieving loved ones.

Other times, family and friends might keep their distance because they feel uncomfortable seeing the changes that happen as cancer progresses. When this happens, it can make the person feel abandoned and lonely.

To help cope when feeling lonely, it may help to share your feelings with those you trust and your cancer care team. They can help connect you with support and the resources you need.

Try to stay connected to your favorite social activities as long as you can. This might include letting people come and visit you. Even if you are unsure of how they will respond, give people a chance to help. You can still set limits on what you talk about and do together.

Reflecting on your life

Consider taking time to think back over your life. You may find yourself looking for meaning in your life and death. You can celebrate goals you have met, people you have loved, and events that made you who you are. It can help to talk with someone about your feelings about death, your life, and how you want to prepare for the end. They can listen and help bring comfort to you. This connection might improve your well-being.

Finding spiritual peace

Some people find that spiritual peace is as important as physical and emotional comfort. If religion or spirituality is meaningful to you, your faith or spiritual community may be a source of comfort during this time. You may consider spending time with a faith leader, such as a chaplain. They can talk with you about your life, beliefs, and what lies ahead.

You might also find spiritual comfort outside of a traditional faith community, such as in nature. Think about places that bring you peace. For example, maybe you want to spend some time at a favorite park. Ask friends or family to help you make this possible.

Spiritual experiences can bring you comfort, meaning, and a sense of peace. They can also help you feel that your life is complete. Many people find that spiritual support gives them a better quality of life in their final days. If you need help finding this type of support, ask your cancer care, palliative care, or hospice team. Many of these groups have a chaplain available if you don’t already have a relationship with a faith leader.