When someone tells you they’re moving a relative into hospice it can be hard to know what to say. You wan to say the right thing and not something clumsy.
Starting hospice isn’t the same as someone dying tomorrow. But it is a frightening moment for the family and the words we use can cause hurt or have a positive impact depending on what we say.
If you just found out someone is starting hospice and you’re not sure what to say then these messages are a good place to start.
- I heard ______ is starting hospice. I’m so sorry. I’m here and I’m not going anywhere
- This must be such a hard decision to sit with. However you’re feeling about it, I’m right here with you
- I don’t have the perfect words but I want you to know I’m thinking of you and ______ every single day
- You’ve done everything you possibly could for ______. Please don’t carry this alone. Lean on me
- I can’t imagine how you’re feeling right now. I just wanted you to know I’m here, day or night
- I’m so sorry you’re facing this. Whatever you need over the coming weeks, I want to help
- Thinking of you and your whole family. There’s no right way to feel about this, and I’m here for all of it
- I love you and I love ______. I’ll be here through every part of this
For a more in depth guide on why the usual responses don’t work, what to avoid and what to write in a card then keep reading.
Understand What Starting Hospice Means
Before you say anything it’s a good idea to understand what your friend or family member has decided. Hospice isn’t giving up and it isn’t the same as being told there are days left.
It’s a move from trying to cure an illness to keeping someone comfortable, calm and surrounded by the people they love. In the US it’s usually an option when a doctor believes someone likely has six months or less, though many people are in hospice care for longer than that.
Why does this matter for what you say? Because a lot of us hear the word hospice and use language and words about fighting and beating it and not giving up.
To a family that has just made a deeply loving and brave choice to stop chasing a cure and focus on comfort using language like the can feel like you’re judging then. Understanding the decision lets you be more respectful.
Follow Their Lead
You don’t need a speech. Really you don’t need much at all other than showing up and paying attention.
Some people will want to talk through every detail. Others will want to talk about anything but hospice.
Take your cue from them. If they want to sit in silence, sit with them. If they crack a dark joke, laugh. Following someone’s lead lets you just be with them without trying to fix anything.
The worst thing you can do is disappear because you’re scared of saying the wrong thing. Being there for them but doing so clumsily is always going to be better than not being there at all.
Acknowledge the Decision Without Second Guessing It
Choosing hospice comes with a huge amount of guilt for a lot of families. They wonder if they gave up too soon. They’ll go through every appointment over and over again.
So when you respond be careful not to make the doubt they’re feeling any worse. Now is not the time to ask if they’ve considered one more treatment or a different specialist. Even when it comes from love it plants a seed that will only make them second guess themselves more or feel worse about what they’re doing.
Instead tell them plainly that this was a loving choice. Something as simple as “choosing comfort for someone you love is one of the hardest and kindest things a person can do” is going to make them feel much better.
Offer Specific Help
“Let me know if you need anything” is kind but it puts the work back on the person who is dealing with such a difficult time. They don’t want to being thinking up which jobs they need or want doing. So offer something specific instead.
Think about what takes up a lot of a caregiver’s day. You could drop off a meal on Tuesday. You could take their kids for the afternoon. You could handle a grocery run, walk the dog, sit with their loved one for an hour so they can shower or sleep or have a bit of time off to themselves. Small offers are far easier to accept than a vague open door.
If your friend is doing the caregiving themselves remember they’re carrying so much on their back. A note that simply says “I see how much you’re doing” can mean the world to them.
And if you want to thank a nurse or aide who’s been a rock for the family our guide to writing a thank you note to a caregiver has wording you can use.
Keep Showing Up
The messages usually arrive right at the start and then go quiet. But hospice can last weeks or months and the loneliness often gets worse as time goes on.
Set a reminder in your phone if you have to. A short text every few days, no reply expected, is something they will treasure.
“Thinking of you today, no need to write back” asks nothing and gives a lot. Staying present through the whole tine, not just the first week, is the most meaningful thing you can do without fail.
What to Say to the Person Entering Hospice
Most of this guide is about supporting the family because that’s usually who breaks the news to you. But you might also want to speak to the person going into hospice themselves. And that comes with its own worry that you’ll say something wrong.
But you don’t need big or special words. What people remember is how warm and kind you were, not if you were very eloquent.
You can talk about ordinary things. You can reminisce. You can tell them you love them and what they’ve meant to you. That last one is something far too many of us save until it’s too late anyway.
A few openers:
- I’ve been thinking about the time we ______. That memory always makes me smile
- I love you. I just wanted to say it out loud today
- You’ve made such a difference in my life. I don’t think I’ve ever told you properly
- I’m so grateful for you. Is there anything you’d like to talk about, or shall we just sit a while?
If you’re visiting or writing to them directly we go into this much more in our guides on what to say to someone in hospice and what to say to someone who is dying. And if you’re getting yourself ready for a final visit, how to say goodbye to someone who is dying may help you prepare.
What NOT to Say to Someone Starting Hospice
Knowing what to avoid is just as helpful as knowing what to say. The following are well meaning but can cause offence or upset.
‘Don’t Give Up’ or ‘Keep Fighting’
I know it comes from a good place. You want to be hopeful. But choosing hospice is not giving up and framing it as a fight they’re supposed to keep winning makes a peaceful decision something more like a failure.
‘Have You Tried…’
Please resist the urge to suggest one more treatment, diet, specialist or clinic. By the time a family reaches hospice they have almost certainly explored the options with people who know the case far better than any of us.
‘How Long Do They Have?’
It’s natural to wonder but asking puts the family in the awful position of saying a number out loud. Nobody knows for sure anyway. Let them share it if and when they want to.
‘Everything Happens for a Reason’
There’s no reason that makes this okay and trying to find one can feel dismissive of what they’re going through.
What to Write to Someone Starting Hospice
If a conversation feels too hard or the family lives far away a card or a text is fine. Keep it simple.
- I heard the news about ______ and I’ve been holding you all close in my heart. I’m here for whatever comes
- There aren’t words big enough for this, so I’ll just say I love you and I’m not going anywhere
- Thinking of you and ______ every day. Please don’t feel you have to reply. I just wanted you to feel less alone
- You have carried so much with such grace. Lean on me whenever you need to. I mean it
- Sending you all my love as you walk through this. I’ll check in soon, and I’ll keep checking in
- Whatever you’re feeling right now is allowed. I’m here to listen with zero judgment, always
If you’re supporting the same family in the weeks and months that follow our guides on what to say to someone who is grieving and grief support can help you keep being there for them when it counts.
Final Thoughts
There’s no way to make this easy. But you don’t need one. What someone starting hospice and their family really need is to know they’re loved, that the decision they made was a brave and kind one and that you’ll still be there next week and the week after.
