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5 Things to Say (and Not to Say) to a Sick Friend

A guide to the best — and worst — things to say to someone who's ailing or grieving

En español l Anyone who has been seriously ill or had a loved one with a health crisis knows that friends and family can say just the right thing — and just the wrong one, too.

Women holding hands while sitting across from each other at a table,  What to say to a friend who is sick

How do you console a friend who is ailing or grieving? — Paul Bradbury/Getty Images

After my mother suddenly became ill and passed away last year, a woman she considered a close friend came up to my father right before the funeral service and said, "I've been having trouble downloading books on my Kindle. Do you think you could look at it later and help me?" (I am not making this up.)

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And I still remember the shock I felt several years ago after my 8-year-old daughter was diagnosed with leukemia and a friend actually said to me, "Well, everything happens for a reason." (Really? This is supposed to make me feel better?)

My coworker has an even better one: On her mother's second day in hospice, an acquaintance from church came to visit, plopped herself in a chair next to the bed and announced to her mother, "Well, you've had a great life. You've done wonderful things. Now it's time to let go and be with God."

None of this surprises Letty Cottin Pogrebin, 73, author of How to Be a Friend to a Friend Who's Sick.

The veteran journalist and author has heard it all, mostly thanks to her own stint as a breast cancer patient in 2009. During the long stretches in the hospital waiting room, she began talking to other patients, swapping anecdotes and eventually soliciting their advice about what to say — and what not to say — to someone who's seriously ill.

The don't-say-this examples in her book range from flinch-worthy reactions to a diagnosis — "Wow! A girl in my office just died of that!" — to empty platitudes like "Maybe it happened for the best" and "God only gives you what you can handle."

Pogrebin casts a wide net in her book, offering suggestions for a number of tough situations, including how to remember which friend has what health problem — an increasingly common occurrence for those in her seventysomething age group. She writes about how to show compassion to someone with Alzheimer's, to those with a terminal illness, and — in a chapter titled "As Bad as It Gets" — to parents who've lost a child to a disease.

She also offers some alternatives to that knee-jerk phrase, "Let me know if there's anything I can do," which puts the burden on the patient or the family to ask for needed assistance, something they may be embarrassed to do.

"It's OK to say, 'What can I do to help?' as long as you follow it with something like, 'I'm not just saying it, I really mean it,'" Pogrebin says. "Then suggest a few things you think might be helpful that you are actually willing to do."

So why do people find it so hard to know what to say to the sick or dying (or to their family)? Pogrebin says so many of us are awkward around those who are ailing "because they arouse our own sense of vulnerability and mortality."

We fall back on clichés like "I'm sure you'll be fine," because they let us distance ourselves from our discomfort. To the sick person, though, it merely sounds dismissive.

Illness and death are also reminders of how little control we have over the things in life that are the most precious to us — our health and the health of those we love, says Phyllis Kosminsky, Ph.D., a clinical social worker who specializes in helping people deal with difficult issues like life-threatening illness and grief.

Kosminsky, who counsels patients at the Center for Hope in Darien, Conn., agrees with Pogrebin that often a simple, heartfelt "I'm so sorry" is the best way to express your sympathy without demeaning what the other person is going through.

The social worker also acknowledges that, especially as we age, "it can sometimes feel like life is a never-ending series of losses and we just can't face one more."

If you feel as if you've reached your emotional limit, don't feel bad about taking some time to recharge, she says. Offer to do what you can "in ways that feel manageable to you," such as picking up groceries, taking the dog for a walk or stopping by just once a week to say hello.

And if visiting a hospital or hospice makes you uncomfortable, find other ways to express your concern. For my coworker, an offer to take her children to the movies or to dinner so she could stay with her mother would have been much more meaningful than an awkward sickroom visit.

We asked Pogrebin to tell us five things to say — and five things never to say — to someone who's ailing.

What to say:

1. I'm so glad to see you.

2. I'm so sorry you have to go through this.

3. Tell me what's helpful and what's not.

4. Tell me when you want to be alone, and when you want company.

5. Tell me what to bring and when to leave.

What not to say:

1. Is it terminal?

2. It could be worse.

3. Maybe it's in your head.

4. What do you think you did to cause it?

5. (To a mourner) God must have wanted him/her.

Candy Sagon is a senior associate editor for health for AARP.

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