This was probably it—my last chance to talk with my mom before she died. Over a thousand miles away from me, my mom was lying in a hospice bed after a prolonged illness and serious injuries after a fall. Although she wanted to keep connecting and communicating with her loved ones, her body was simply shutting down. Circumstances prevented me from being physically present—but thanks to an idea from my older sister, I was at least able to call. Yet when the nurse held the phone to my mom’s ear, I was flooded with anxiety. Here I was, faced with what would in all likelihood be my last conversation with my mama, the one who brought me into the world. What could I possibly say? 

Many of you have been in this situation—perhaps on the phone like I was, or at the bedside of a loved one who is dying.You might be one of the fortunate ones who manages to say something eloquent. For many of us, though, words ultimately fail. Nothing seems to quite capture what we feel. We may not even be sure that we are being heard or understood—or that the conversation will be remembered by our loved one.

But it feels so important. And in psychological terms, it turns out that it often is.

Several years ago my colleagues and I did a research study on these final conversations between family members and their dying loved ones in hospice care. This study was carried out with my collaborators Maryjo Prince-Paul, Briana Root, Karen Peereboom, and Everett Worthington and was published in the Journal of Palliative Medicine. We found that if family members reported that they had something important to say to their loved one but had not been able to do so, they reported higher depression scores.

What types of things did these family members really want to say? Following up on ideas from books such as Ira Byock’s Dying Well, we wanted to find out what types of messages family members saw as being especially important to share with their loved ones who were dying.  

Overwhelmingly, our participants reported that saying “I love you” was most important. Nothing else even came close.

Many people also wanted to offer words of thanks or affirmation, expressing gratitude and praise to their loved ones. 

When unresolved offenses still hung in the air, both seeking and receiving forgiveness were identified as important goals as well.

Some family members wanted to talk about the afterlife. Others wanted to reassure their family members that everything—and everyone--would be OK. In some cases, being able to release the loved one (“It’s OK to go”) was an important priority.

An interesting finding was that at least in our study, most people did not express a strong need to come right out and say goodbye. I found this myself, too, when I was on the phone with my mom. I realized that this would probably be our last chance to talk, but I wasn’t sure. And there was something about saying goodbye that I couldn’t bring myself to do. It seemed too final. Instead, I heard myself saying things like, “I hope that we’ll get to talk again, but just in case we don’t, I wanted you to know...” And then I did my best to muddle through what I wanted to say.

To tell you the truth, I don’t remember exactly what I said. I know that I joked a little. I did my best to express my love and appreciation. I said what I could.

I wish that I could say that the words flowed smoothly and easily, but they did not. It was downright awkward, although it feels odd to admit that.

But mattered. That conversation was a precious opportunity for us to connect, one last time, here in this world. Imperfect and fumbling though it was, I’m grateful that we got to talk together one last time.

I love you, mama.

About the Author

Julie Exline, Ph.D.

Julie Exline, Ph.D., is a Professor in the Department of Psychological Sciences at Case Western Reserve University. She is a licensed psychologist and a certified spiritual director.

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