The fragility of those nearing death reveals the profound meaning of human dignity. Dr. Marie-Sylvie Richard, a Saveriana sister and director of a palliative care center, draws on her lived experience accompanying the dying: with each person, we must find a way to truly connect. Connection with another always gives our lives meaning and purpose. But when a patient is dying, establishing contact becomes difficult. We stand before a person who is suffering, and it is through listening to that suffering that genuine connection becomes possible.
When Self-Worth Has Been Lost
As the end of life draws near, the sick, disabled, or elderly person finds their capacities slipping away, one by one. This growing dependence makes the relationship with those nearby increasingly painful. Their image is altered. Their mental faculties weaken. They doubt themselves. They no longer esteem themselves: "I'm not who I was before. I don't know if I can still be loved. Others will tire of me."
When this loss of self-worth deepens, it can lead the dying to such despair that they wish for death: "I don't know if they recognize and love me as I am now. It would be better to die than to live like this." In such moments, we must accept what we might call a psychological euthanasia: "It's true. I understand."
Near the end of life, a person lives with constant uncertainty. Everything becomes frightening: "What will happen to me? How will the illness progress? How will death come? Will I be alone?" To the fear of being alone, of losing one's mind, of losing all control, of being unable to speak up, of being completely abandoned in others' hands—to all this may be added a profound doubt that calls everything into question, even one's deepest convictions. And yet, through this suffering of total stripping away, something deeper can be built.
When everything seems to collapse, the sick struggle most to connect with others. At the very same time, they are grateful to find an attentive ear—someone willing to listen to what they feel, to reassure them, to let them know they still matter to someone.
The Helplessness of Those Who Care
Family and friends suffer from watching suffering. It can be unbearable to sit with someone whose physical pain never lets up. The sense of helplessness is immense. It is agonizing for those who know the patient well—a husband or wife, children—to be unable to take their place, to be unable to grasp what they are living through as moral and spiritual anguish. The intensity of our love does not ease their suffering, nor can it prevent them from dying.
Each of us is left in solitude. Those with faith may entrust their loved one to God. Yet we all live with this helplessness, this inability to reach the other in their suffering.
I find myself confronted with my own limits—never an easy thing, especially when we long to do so much for the other and time is running out.
The Difficulty of Communicating
Another source of anguish for those beside the dying is the difficulty of communication, which grows worse with serious illness, advanced age, and the approach of death.
It is vital to tell patients the truth about their illness and how it will progress. They are the first ones directly concerned. Yet how many lies, half-truths, and distortions we tell—not out of cruelty, but to soften a reality that seems too brutal for them and for those around them. "Whatever you do, don't tell them. They shouldn't know." But information must be shared gradually, at the rhythm of their own questions, in an atmosphere of truth and trust. Not to hide something from them, but simply so they can hear it and understand it.
Families need guidance and support in learning to do this.
When a dying person asks us, "Am I going to die soon?" it frightens everyone. In reality, patients rarely ask it directly. Usually the patient themselves signals us in their body that they sense death approaching. They might say, for instance: "Do you think I'll die soon?" In saying "I'll die soon," they are already telling us something—showing us they sense something. Rather than remain frozen in fear of this question, we can learn to reshape it simply: "You say you'll die soon. Why do you say that? What are you feeling?" This way, they will give us the information we need to answer their question. When we practice this small technique in an atmosphere of trust, we lose our fear of words that might hurt us. We can then allow ourselves to stumble, even to say: "You know, your words move me. I don't know what to say back."
Rediscovering Reciprocity
Sometimes verbal communication is no longer possible—the illness has affected brain function or speech, the patient is semi-comatose, or they lack the strength to whisper a word. We must all learn to communicate without words: with the eyes, with a hand, with a smile, and to read every small gesture, every movement, as if it were speech. It is difficult to remain with someone without feeling reciprocity, even though the absence of feeling does not mean reciprocity is not there. Those who have spent time with people with severe disabilities know how profoundly we can be changed by their presence, even when communication appears entirely one-sided.
We must believe in reciprocity even when we cannot feel it. The philosopher Paul Ricoeur said:
"When you sit beside someone at the end of life, someone with whom you cannot truly communicate—do you perhaps leave that room unchanged, as if you had never entered?" No!
Something has happened within us. Something has touched us, transformed us, or is transforming us. The other, in their profound vulnerability—no longer able to communicate with us at all—yet simply because we have found the courage to remain present, to stay attentively with them, this other shakes us and changes us deeply.
by Marie-Sylvie Richard - Ombre e Luci no. 88, 2004