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TODAY
updated 5/18/2004 11:02:07 PM ET 2004-05-19T03:02:07

How do you talk or care for someone who is seriously ill? The most important thing to remember when someone you care about is  that they are in pain — physical and/or emotional — and that your attention should be focused on what they need. Dale Atkins, Ph.D., a psychologist and author of “I’m Ok, You're My Parents,” gives advice on how to say the right thing to ease their pain.

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"Let’s think together how I can be helpful and if there is something I can do that would make you feel better," is an excellent way to open a discussion, although it may difficult for your friend or relative to answer. After all, most of us are taught not to burden others with our problems. It may surprise you to learn that, most often, what the person needs is for someone to listen sympathetically, thereby sharing the burden of their suffering.

When someone is ill and cut off from their daily life, a visit or call or note from someone reminds them they are remembered, part of a community and are cared for. Dealing with friends or relatives who are very sick — or fear they might be — can be a challenge. They and their condition are always changing and often they do not know what is ahead of them. Most people want to know what to say to them. Do you try to cheer them up? Reassure them that things will be all right? Pray with them? Tell them about your own experiences with something similar? Ask if they would like to be in touch with someone you know who had the same illness? Help them to see that they may grow even stronger through experiencing the illness? Should you ask them for details of their condition? Is it okay to ask questions? How can you be a good listener? Is it better to ignore the whole matter and act as if nothing serious has happened?

What is important is that the person who is ill not lose his or her dignity. Illness carries with it a whole gamut of feelings: fear, anger, disappointment, hopelessness, sadness, grief, perhaps guilt or even shame. Recently, after receiving a questionable and confusing diagnosis, a dear friend said to me, "I’m furious. I'm scared. I try to keep laughing." People who are ill often feel dependent and often resentful about that dependence. When you are conscious of these issues, you will more likely respond in a sensitive way. If the person who is ill feels alone, they will likely feel more despondent. Healing the body is linked with healing the soul and it is the soul that also suffers when people do not treat them as viable, important parts of the family or community. Someone who can be a loving witness to all of the feelings a person who is ill has will be greatly appreciated. If you're curious about details of their situation, ask them if they feel like talking about it, rather than proceeding with twenty questions.

What if you're not a particularly good listener or you find the expression of deep emotions somewhat uncomfortable? A professional therapist is trained in precisely these areas, and may be of great help. But the contribution you can make is avoiding the mistake of ignoring the situation, glossing over or changing the subject. Few things in life disappoint us more than when someone we love "isn't there for us" when we really need them. And there are few times in life when we need our loved ones more than when we're sick.

Very often people don't know what to do. They think they should be able to make the person feel better or do something to relieve their suffering. They feel guilty if they cannot do it or sometimes feel guilty as well as relieved that they, themselves, are well. For the person who is ill, the emotional pain is often worse than the physical pain — which can be awful too — and feeling isolated or ostracized — which is different from wanting to be alone — can make an illness worse.

Visiting a person in the hospital or someone ill and homebound for a short period of time can lift someone's spirits but not if they have to "entertain" you or "fix themselves up in anticipation of your visit" which uses up much of their needed, and often, diminished energy. Be sure when you visit someone that you are "in tune" with how they are reacting to your visit. Better to leave while your friend has energy than to exhaust them so that they need to recover from your visit.

Physical and emotional touch can bring great comfort. Whenever it seems appropriate, give a hug or extend a hand, touch someone's arm, if they like, gently apply body cream or scented oil to the person's hands, arms or feet. For many people who are ill, they wonder whose body they are in. They feel unattractive and wonder if they are still desirable. By touching someone  — if appropriate — you can help a person to feel acceptable.

Generally, people who are ill need one or two items from the store and the effort it takes to get them usually isn't worth it or they may not be able to get whatever they need. Picking up groceries at the market and saying, "I’m going to the market for milk and eggs, can I pick some up for you? What else would you like? Not saying, "call me if there is anything I can do for you." that puts the onus on the person who is ill and that is what you don't want to do. But "I’m coming by your house and would like to drop off the groceries after I go to Costco," is really helpful. Bringing over a "hot pink" nail polish and all the fixings for a manicure or pedicure that you lovingly give to your friend can also lift her spirits and create an "easy" atmosphere for talking and listening.

Sometimes visiting is not helpful and offering not to come in for a visit is exactly what the person who is ill need, but they would appreciate an offer to water their outdoor plants outdoors or bring in the mail, an offer to clean their house, or chauffeur them to an appointment, can be very helpful. As can walking their dog, delivering dinner for their family, sorting the mail, doing the laundry. What do these things do? They help to give the person who is ill a feeling of being cared for and less overwhelmed. Doing a load of wash may take an enormous effort for someone who is ill, who cannot lift or bend, or who just cannot get out of bed. Offering to bring their child to religious school, their swim meet or on a fun outing as a distraction and also to make the child feel as if he or she is still important and can still have fun. This can do wonders for the person who is ill, because so many of their thoughts and worries are not just about their own well-being but about not being there for those around them.

Many people shy away from anything religious or spiritual yet when someone is ill, they often pray or ask for strength from a higher being. Your friend or family member may appreciate praying with you. Sharing an inspirational poem, passage or prayer can be extremely soothing, as can a tape or CD of relaxing music, chimes or nature sounds. Offer to go to the library to pick up some "books on tape." These can help the person who is ill pass long days of being in bed especially if reading or holding a book is too taxing.

Allow yourself to be available to the desire of the person who is ill. Be open. When someone is not well, the hours can drag but long visits with other people can be draining. Short, more frequent visits are often more welcome and establish a comfort zone so the person can say, "I’m not up to a visit but would love for you to drop off the baked chicken if you don't mind." it requires strength and wisdom to enter someone's space and not have an agenda. You may find that your visit is one where you sit and hold the person's hand. There are talking cures and silence cures. Being with someone can be extremely healing. Knowing when to talk and what to say...that is the key.

As long as you remain present, patient and extend unconditional support, offer yourself as a non-judgmental listener, you will likely do well.

Always sit down when you visit a person who is ill. Because they are feeling poorly, you do not want to emphasize the difference in "status" by standing "over" them. Try to be at eye-level.

If you want to talk, be sure the person who is ill wants to talk. Their treatment regimen or just the recovery process may be very taxing and exhausting. Or, they may not feel like talking. It doesn't matter that you drove an hour and only have a short time to stay. This is about what they need. It is important that you make the person feel it is okay that even though you traveled to see them, that if they are tired, you do not have to visit. This is the time you may leave or help them with something like clean up the kitchen, play with the kids, water the plants.

Don't force the individual to reveal feelings he or she is not able or ready to share. Be understanding without claiming to "know" what the other person is feeling.

Listen with sensitivity. Do your best not to interrupt and try not to anticipate what the person is about to say. This is not a time to finish their sentences. Listen with your body, your face, your heart.

If the person seems to be interested in talking, encourage them with phrases such as: "tell me more" or "I see..." nodding, reflect back what you heard by paraphrasing.

Share your own experience but do not dwell on it. Use it only to "level the playing field" and let this person know that you, too, have experienced a time in your life when you felt scared or threatened or incapacitated... and what you found helpful.

Respect silence if that is what is called for. Sometimes people stop talking to deal with their emotional response to what is or has been said. Use that silence to reflect yourself.

Specifically if someone is dying: if you find it difficult to talk about matters — such as if the person is dying — tell them you are having a hard time speaking about it. Describe your feelings because it is helpful for the person to know that you, too, find it difficult.

Do not change the subject. Follow the lead of the person who is ill or dying. He or she may go into areas that are difficult to hear but do your best to stay present. You are helping this person on their journey. Allow the person to express their feelings, including anger and bitterness, as they make their way through their own process.

Be careful with advice. Most people who are ill do not want advice, they want to talk things out to come to their own decisions. Sometimes, giving advice inhibits conversation.

Be generous with reminiscing, especially with people who are dying. Everyone wants to feel that he or she had an impact while they were here on earth. Telling stories about one's life is a way to do that and it is a great way to come to a feeling of closure.

Even if someone is very ill or dying, do not be afraid to use appropriate humor. Funny stories, jokes, sharing incidents where people said the wrong thing that you can now laugh about, lightens the scene and there is much therapeutic effect in laughter.

© 2013 MSNBC Interactive.  Reprints

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