Kenneth Glad
Death remains one of the most carefully avoided subjects in everyday life. It is softened, postponed, or pushed aside — until it can’t be. In clinical settings, however, a different reality often unfolds. Those approaching the end of life may begin to acknowledge it in ways that are quiet, indirect, but hard to ignore.
This gap between patients and families is frequently observed in end-of-life care. Clinical reports and hospice practitioners have long noted that while patients may be ready to talk, relatives often resist such conversations.
Aleksandra Tomaszek, a Polish psychologist working with terminally ill patients, described this tension in an interview with Medonet. She pointed out that attempts to discuss death are often interrupted or dismissed, even when they are calm and practical.
These conversations are not always about dying itself. As she explained, they are often about putting things in order — decisions, wishes, small details that matter.
Avoiding them can have unintended consequences. Silence fills the space where clarity might have been.
Making Sense Of The End
Most of the people Tomaszek works with already understand the seriousness of their condition. Within that awareness, something shifts — not always dramatically, but noticeably.
“From my experience, it happens quite often: people know they are leaving,” she said, reflecting on patterns she has seen over time.
That awareness rarely comes as a single declaration. More often, it surfaces in fragments: A sense of readiness, references to going somewhere, or mentions of those who have already died.
“I’ve heard more than once: ‘I am ready’,” she told the Polish outlet.
Medication can influence perception, but it does not fully explain these moments. Psychologically, people seem to search for a way to place what is happening into a frame they can grasp — something that gives shape to the unknown.
Not clarity, exactly. But orientation.
What Still Matters
Another pattern, Tomaszek noted, is the return of unresolved emotions. Near the end of life, relationships — especially strained or unfinished ones — can take on renewed importance.
Sometimes there is time to address them. Sometimes there isn’t.
What makes a difference, she suggests, is whether space exists for honesty. When patients are able to speak openly, even difficult conversations can bring a sense of relief rather than distress.
This applies to children as well. Clear, simple language helps them understand loss, while softened expressions can leave them confused or even afraid.
Her observations echo a broader principle seen across palliative care: acknowledging death does not hasten it. If anything, it allows people to meet it with a little more steadiness.
And perhaps that is the quiet paradox — that those closest to death often face it more directly than those who remain.
Source: Medonet
