A life-limiting illness is one of life’s most stressful experiences imaginable. The person who is ill may feel nobody can really understand what he is going through even when friends or family are trying to support him. Family and friends may feel frustrated that their efforts to care are not more appreciated. Ultimately you cannot control how your friend approaches his dying. However, you can decide how you want to continue your friendship with him.

Living with serious illness usually brings intense thoughts and feelings that fluctuate from day to day, even moment to moment; the experience is often described as a “roller-coaster of emotions”. A life-limiting illness brings the loss of many things, for example: independence, capacity to enjoy familiar activities, and ability to carry out usual roles. Your friend may be experiencing grief for these losses, and this grief may include a deep sadness, a sense that life has become meaningless, and a desire to get it over with. Your friend is likely struggling in uncharted territory with how to live when so much has changed and death looms.

Witnessing the struggles of someone you care about can leave you feeling helpless and anxious, and you want to find a way to relieve the suffering. You just want your friend to enjoy his remaining life as much as possible and to be at peace. We encourage you to browse through these and other articles about emotional and spiritual health. They can help you to further understand your friend’s struggles and offer ways to respond to them:
Living with Limited Time: Exploring Feelings
Finding Meaning and Purpose During a Health Crisis

You and others close to your friend can be supportive by letting him know it is safe to be open about his struggles and to vent the thoughts and feelings that go with them. If he seems uninterested in your company, don’t take it personally. See it as an expression of the dark place he is in. Let him know he is important to you, and that his experiences during this period of life matter to you. Open up conversation about how life is changing for him and how your relationship is changing because of this.

Be real and honest in your conversations with him. Let him know how you feel when he talks about ending his life and what you imagine the impact of his suicide would be on you and others who love him. Talk to him about why he has been important to you in the past and about the ways he continues to be important to you. There is no script for such conversations. It is usually best just to say what is on your heart and mind, and to do what fits for you.

Ask him how you can share time during his illness in a meaningful way. Share your own ideas with him. Ask him what he needs from you as a friend. For example, would he like you to call him at a certain time each day to check in? Would he like you spend certain periods of time with him? Are there practical errands or chores you can help with? Is there some aspect of his care that you can help with? Take your cues from him. Give him a sense of what you can contribute to the companionship and support he wants and needs as he grows weaker. It is important to be realistic about what and how much you can commit to. Be honest with yourself and with him.

As a serious illness progresses, and health problems increase, a person often worries about what lies ahead. Your friend may wonder how he will cope with pain, increased weakness, or reliance on others. He also may question whether he can be cared for at home and where he will die. Ask him about his concerns and encourage him to discuss them with a member of his health care team. He may cope better if he has information about managing his symptoms, available support, and options for receiving care. You can also suggest contacting the local hospice palliative care program to explore how others in the community might help your friend. You may wish to gather information and explore sources of support for yourself. Learn more about services available in your area and how to get connected with this cross-Canada directory:
Programs and Services

If your friend continues to have thoughts about ending his life or talks about a plan for doing this, encourage him to seek professional help. It is important for him to have phone numbers he can call for help. These can include numbers for his local palliative care program, mental health program, local or provincial crisis line and his health care team. These resources can help you locate the nearest crisis support services:
Canadian Crisis Response Services list
The Canadian Association of Suicide Prevention