As healthcare workers, we deal with death on a regular basis. Whether it’s an unexpected tragedy, or the end to a long road of suffering, we are there as the Family endures their loss. While we may understand the medical facts behind the death, it’s often the comforting words for the family that elude us. What should we say? How should we say it? Should we hug them? What do we do? Unsure of what to do or say, conversational narcissism often steps in and leaves us feeling comforted. But, does it comfort the family?

Simply put, conversational narcissism is the tendency to steer a conversation to your chosen topic, focus on yourself, and/or do most of the talking. While we all know people who are obvious and over the top in their attempts to do this, most don’t ever realize it’s happening. Have you ever comforted someone who lost a loved one by stating, “I understand; when I lost my mother…?” By wanting to share your experience, in what felt like a moment of bonding, you inadvertently redirected the attention onto yourself. Certainly it was not out of malice, but it was not the right time. Even if you don’t talk about yourself, feeling the need to take over the conversation and avoid the awkward Silence by filling the space with insignificant information takes you down the same road. So, what DO you say?

First and foremost, get comfortable with silence. This is probably the most difficult thing for anyone to get past. Sitting with family members as they furiously process their thoughts and feelings in silence can feel like absolute torture! As you sit and wait, you become anxious. You’re thinking about all the things you should be doing. It feels like you’re trapped in a perpetual moment of nothingness. However, it’s the most supportive thing you can do! The person you’re sitting with probably feels like everything is happening too fast. It’s up to you to help him/her slow things down. This is NOT the time to talk incessantly or share your own experiences. Avoid the tendency to fill this space or steer the focus.

Tip: If you struggle with this, practice with colleagues. Choose a location and sit in silence together. Don’t read a book or watch TV. Simply sit in silence for increasing intervals of time until you’re comfortable with the act.

Once you’ve mastered the art of sitting in silence, you’ll still need to find the right words to say. Sure, it’s easy to explain the medical rationale for what has happened. Explaining what happens next is a cinch too! When all of the easy stuff is out of the way, you’ll need to have a comforting word handy. There are tons of options, but the most important thing is to consider whom you’re talking to. Do you know them well? Do they share a belief system with you? What kind of death did their loved one succumb to? Consider the answers to these questions before choosing your words. Here are some example phrases…

• I’m sorry for your loss.
• I’m so sorry for what you’re going through.
• I’m sorry that your mom/dad/uncle/etc. has died.
• I’ll pray for you and your family during this difficult time. (only if you’re sure that you share a belief system)
• He/She touched so many lives.
• He/She will be greatly missed.
• Please accept my condolences.
• Would you like me to pray with you? (only if you’re sure that you share a belief system)

It’s important to consider the things that you should NOT say as well. While these words are spoken with the best of intentions, they steer the focus away from the person who has suffered a loss or even attempt to downplay what has happened. Consider them. Have you ever used them? Put them in your mind and purpose to leave them out of your repertoire.

• Well, he/she is in a better place now.
• It’s for the best.
• I’ve also lost a son/daughter/etc. I understand.
• I’ll miss him/her too.
• When I lost my mother/father/etc.
• I believe that when we die…

Once you’ve mastered sitting in silence with the family and finding the right words say, the next thing you need to prepare for is physical touch. If you’re not a person who enjoys a good hug, it’s ok to forgo any physical touch at all. But, if you’re a “touchy feely” type and you want to comfort family with a pat on the shoulder or a hug, there are a few things to keep in mind. First, hugging without asking is a form of passive narcissism where hugging others leaves you feeling as if you’ve helped and comforted. You may walk away feeling like you’ve done a great service, but the family may not agree.  Secondly, always ask before giving a hug. While this person may have hugged you in the past, not all people enjoy a hug when they’re in distress. Offering a hug for comfort is wonderful, but be ok with hearing, “no.” Thirdly, a touch on the shoulder is still touch. While many of us see it as unassuming, there is an equal amount of people who feel that it is too much. Always, always ask first.

Death is an unavoidable. Whether you experience it at work or at home, you’ll need to be ready for how you’ll react. Practice. Memorize. Prepare yourself. When the time comes, you’ll be a great comfort to the family of your patient and know that you’ve done the right thing.