Coping with Emotions as You Near the End of Life

Finding out that your cancer can no longer be controlled can cause many different feelings. Some people might feel shock or fear. Others might worry about being a burden and how their death will affect loved ones. It can be hard to talk about these feelings, but know they are normal.

When you find out your cancer can no longer be controlled, you might have many different feelings. Know that your feelings are completely normal. It is important to let yourself feel these emotions and grieve for what you are losing. You might feel some or all of the following emotions:  

• Grief
• Anger
• Resentment
• Fear
• Regret
• Sadness
• Feeling alone
• Relief
• Calm
• Acceptance

You may also experience anxiety or depression when you have advanced cancer. While these feelings are normal, your health care 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 prescribe medicine to help. Many people also find that talking about their feelings and concerns with family, friends, and caregivers is comforting. Learn more about grief and loss.

Grief

It’s normal to feel intense grief during the last stage of your life. You’re 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 the interest in doing 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. Being able to connect spiritually to something might help you and your loved ones heal after you are gone.

Talking with someone about these feelings – a partner, a dear friend, someone you trust – 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 they will likely have someone you can talk to about your grief.  

Anger

Anger is often a part of the grieving process and is normal to feel angry.  Very few people feel ready to die. It’s normal to be angry if your cancer cannot be controlled. You can use your anger as fuel to solve problems or to get your needs met.  But if you feel like your anger is affecting your relationships or keeping you from what you want to do, ask your cancer, palliative or hospice care team if there is a counselor you can talk to.

Fear

Many people are afraid to die. But it might help to figure out what it is about death that you’re afraid of.

• Are you worried about where you might die?
• Are you afraid of being alone when you die?
• Are you afraid of suffering or pain?
• Are you afraid of what happens after death?  
• Are you afraid that your life had no purpose or meaning?
• Are you afraid of how your loved ones will cope after you die?

These are just some of the fears people have about death.  Sharing your fears with loved ones and your health care team lets them help you find ways to cope and ease some of your fears. Many fears can be lessened by preparing a plan for how you’d like to spend your time as you near death.

Regret

Some people regret or feel guilty about things they have done or not done or said. You can’t change the past, but there are things you might be able to do today. Think about apologizing for the things you regret. Maybe you can ask for forgiveness or forgive others and yourself. It may be best to try to let go of the things that can’t be changed.

This is 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. Strengthen your relationships with loved ones. You may want to write letters to the people you love, record messages for them, or make videos they can watch to help them remember their time with you.

Anxiety and depression

Many people feel anxious or depressed as they near the end of their life. It might help to talk to someone close to you, a counselor or a spiritual advisor. If  anxiety or depression is interfering with your quality of life or keeping you from doing things you enjoy, there are medicines that might help. Don’t be afraid to ask for help. You want to feel the best you can so you can enjoy your time.

Feeling alone

When someone knows they’ve reached their last stage of life, there can be a loneliness that’s different from any other. It’s a loneliness that happens even when you have people around you. Loneliness is common in people with cancer at the end of their life. Loneliness can affect your mental health and might make your symptoms worse.

Loneliness happens most often when someone doesn’t have people around them that they feel comfortable talking with about how they feel. Loneliness can also happen when the person stops engaging in social activities that they enjoy.

Sometimes people pull back from their social networks because they are embarrassed or uncomfortable having others see how they look or feel. They might not want to burden their friends and loved ones with how they are feeling about dying or they might be having a hard time handling the reactions of their grieving loved ones.

Other times, family and friends avoid the person with cancer because they are uncomfortable seeing the changes that happen as cancer gets worse. This can make the person feel like they’ve been abandoned at the end of their life.

To deal with loneliness, share your feelings  with your close loved ones. Or you may find that you need help from outside those close to you, such as a counselor or spiritual counselor. Your cancer care team can also provide you with support and help you get any other support you need.

Also, try to maintain your favorite social activities as long as you can. This might include letting people come and visit you. Even if you are afraid of how they will react, give people a chance. You can still set limits on what you talk about and do.  

Reflecting on your life

Consider taking time to think back over your life. You can celebrate goals you have met, people you have loved, and events that made you who you are. You may find yourself looking for meaning in your life and death. It might be helpful to talk with someone about your feelings about death, how you lived your life, and how you would like to prepare for the end. If you don’t have a family member or close friend who is comfortable talking about death, talk to your cancer care, palliative care or hospice team.  This may help you find some answers or improve your well-being.  

Finding spiritual peace

Some people find that spiritual peace is as important as physical and emotional comfort. If you value religion or spirituality, your faith or spiritual community may be a source of comfort now. You may want to spend some time with a faith leader, such as a chaplain, to talk about your life, faith, and what lies ahead.

You might also find spiritual comfort through nature or outside of a traditional faith community. Think about where you might find peace. For example, maybe you want to spend some time in nature at a favorite park. Ask friends or family to help you.

Spiritual experiences can bring you comfort, meaning, and peace. They can also give you a sense that your life is complete. Many people who get spiritual support have 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.