End of Life Communication

The role of final conversations.

Posted Sep 22, 2020

Today the U.S. reached 200,000 deaths due to COVID-19. Death is difficult under any circumstance, but the particular conditions and uncertainty associated with this pandemic add an additional layer of complexity. That said, understanding the time before someone died is one way we make sense of someone’s end of life.

Maureen Keeley, a professor of communication, has spent her career studying end of life—that is, specifically studying the final communication that a person has with a loved one prior to their death. Termed final conversations, Keeley has written a popular press book on this topic and published numerous research studies.

A study that stands out is one where she interviewed 40 adults in their 40s about a final conversation experience. Individuals predominately described final conversations with parents, but some did discuss loss of a spouse, friend, or other close relationship. In analyzing her data, the predominant theme of love was uncovered. That is, affirmations of love, reconciliations of difficult relationships, and acts of altruistic caring and love were common in her interviews.  

In concluding her study, Keeley wrote: “declarations of love are clearly one of the most important final messages for surviving participants of FC. These messages of love often reconfirm a love that is already known. For others, love is a message that can finally be shared because the impending death tore down previous barriers and helped heal lifelong wounds.” (p. 38).  

In my own conversations with Keeley, she has made the important distinction that these final conversations actually help the surviving person make sense of loss. She argues that such communication, occurring under positive conditions, can be a positive and productive experience for the survivor. Still, we must recognize that grief and loss are never easy or simple. Keeley’s body of research, though, offers one perspective that may help us prepare for one of the most difficult aspects of life.


Keeley, M. (2004). Final conversations: Messages of love. Qualitative Research Reports in Communication, 5, 33-40. doi: 10.3390/bs7020017

Keeley, M. P., & Yingling, J. (2007). Final conversations: Helping the living and dying talk to each other. Acton, MA: VanderWyk & Burnham.