How Do I Talk About Death?

July 9th, 2025

Talking about death and dying can be challenging and uncomfortable for many people. In Western society, discussions about mortality are often considered taboo or unsettling, leading to a culture of avoidance and silence around the topic. When we do talk about death, we use euphemisms and vague language. Instead of saying “died,” we use phrases like “passed away,” “no longer with us,” or “lost.” This can soften the impact of the reality of death, but at the same time, it reinforces the avoidance of a subject that everyone must eventually confront. 

Many people also harbor an almost superstitious fear that talking about death will somehow magnify their mortality — that saying the word out loud somehow makes them more vulnerable to illness and death. This irrational fear almost certainly stems from the fact that talking about death does make it seem more “real.” But rather than making us more vulnerable, acknowledging the reality of death is empowering. It allows us to examine how we want to live through the end of our lives, and likewise, have frank discussions that are necessary with the people who are important to us.

The Impacts of Avoidance

Avoiding discussions about death can have negative impacts both on individuals and society as a whole. Despite numerous accounts of “near-death experiences,” no one has ever come back from being fully dead to describe what it was like. So thinking about death triggers a fundamental human fear — fear of the unknown. From an evolutionary standpoint, this fear makes perfect sense. Avoiding unpredictable situations kept our early ancestors safe from all sorts of dangers and predators. Even today, moving cautiously into the unknown is generally more prudent than rushing headlong into a situation we know nothing about. 

But avoiding the things we fear can also be self-defeating — keeping us stuck and unable to move forward with our lives. Similarly, by not exploring what it is that frightens us about death we run the risk of being stuck in avoidant thought patterns and behaviors that numb us to the fact that we are all going to die. And that avoidance leaves many of us totally unprepared when we come face to face with death — our own or that of someone we love. 

Developing “Death Literacy”

Death literacy is a term used to describe the knowledge, tools and resources necessary to successfully navigate end-of-life options and care. First introduced in a 2022 Lancet Commission report from a worldwide consortium of experts in end-of-life, it is based on the conclusion that, in our society, healthcare providers have “medicalized” death to the point where it is no longer viewed as a natural and normal part of life. Trained to fight death to the end, healthcare professionals often fail to provide individuals with frank information about when to shift their focus from curative to comfort care. They are often slow to introduce palliative care, which can begin at diagnosis, and far too slow to recommend hospice care for individuals who are clearly at the end of their lives. As a result, our society is enculturated to think of illness and frailty as battles that we can win. Death doesn’t enter into the conversation until the very end, when the opportunity for exploration and meaningful conversations about the end of life is all but lost.

Developing death literacy is essential to both individuals and communities. Individuals cannot make truly informed choices about how they wish to live at the end of their lives unless they understand the full range of options, including the potential benefits and limitations of aggressive, life-prolonging medical care. It is crucial to recognize that for some, particularly those from groups historically denied care, a “full court press” is a deeply valued choice. Conversely, communities and society can face challenges when the healthcare system defaults to expensive, aggressive treatments without ensuring patients and families fully understand the potential outcomes. As Michael Connelly, former CEO of Ohio’s Mercy Health, said in an interview with Hospice News, “No dying person should be in the ICU.” This perspective highlights a concern that many are not offered alternatives, yet our ICUs are filled with people who are dying. Twenty to 30% of individuals admitted to the ICU never go home, underscoring the importance of ensuring all options, from aggressive intervention to comfort care, are understood and accessible.

Developing death literacy, therefore, begins with an understanding of the reality that life is finite and modern medicine, no matter how sophisticated it becomes, cannot extend life indefinitely. It also includes adopting a new healthcare paradigm that acknowledges the reality that the “more is better” approach to care at the end of life is deeply flawed. While eighty percent of Americans say they want to die at home, only 25% actually do. This discrepancy is not just a matter of ignored wishes; for many, it is not medically, physically, or financially possible. This gap cannot be closed unless we begin to talk about death and how we wish to live—both now and at the end of our lives—while also advocating for systems that make those wishes achievable. 

Talking About Death

Talking about death is challenging, especially with the ones we love. But framing the discussion in terms of how we want to live through the end of our lives can be far less daunting and offers opportunities for honest communication about values and goals. By sharing our vision for the rest of our lives with our loved ones, we create a bridge to discussions about how we want the end of our lives to unfold. 

Before we can even start a conversation, however, it is essential that we take inventory within ourselves. In ancient times, this process was outlined in a body of religious literature titled “Ars Moriendi,”  or “the art of dying,” which was written in the aftermath of the bubonic plague. The plague killed an estimated 50 to 200 million people between 1346 and 1353 — nearly two-thirds of Europe’s population at the time. In its wake, the clergy felt compelled to warn parishioners that the time to prepare for dying wasn’t some time in the future, but now. And the way to do so was to learn to live well so that they could die in a state of repentance and grace.

There have been many iterations of Ars Moriendi through the centuries, but the concept of living one’s life according to a value system that reflects one’s deepest held beliefs has persisted throughout. As bioethicist and physician Lydia Dugdale explained in an interview with SevenPonds, 

“…The underlying theme was always that one needed to attend to living well to die well.That meant thinking about what kind of character or habits you wanted to cultivate. Were you a person of integrity, of honesty, of solidarity? Did you invest in your community? Then there were the more existential questions: Why are we here? What is this life for? The idea was to think about these things in the context of your community so that you would cultivate a sense of peace throughout life, instead of arriving at the end in spiritual or existential distress.

In other words, the art of dying well is really a matter of living well to the end. Thus, exploring what gives your life meaning today can help you explore and discuss what you would like your life to look like when you are nearing its end. 

Some questions that may help you formulate your thoughts about these important matters are listed below. As you reflect on your answers, consider how they can help you shape your life now and in the future, including as you approach the end of life. 

• What does a good day look like to you? What relationships and activities add pleasure or meaning to your life?  
• What parts of your life do you believe are essential to your well-being? What would you not want to live without?  
• What are the three top values you live by? 
• What or who gives you comfort when you are going through a hard time? 
• Who do you turn to for support and advice? 
• Do you have any regrets? How would you remedy them if you could? 
• What is your purpose in life? What important roles do you fulfill? 
• If you were going to die soon, who would you want to speak with? What would you want to say? 
• What three words would you use to describe how you would like to be remembered after you die? 

Once you have explored these ideas sufficiently, you can share your reflections with your family and loved ones. If you’re not sure how to begin that conversation,  you may want to try saying something like “I just answered some questions about how I want to live the rest of my life and how I want the end to look. I would love to share my answers with you. I’m also wondering what your answers would be. Can we find a time to talk?”

Talking About End-of-Life Care 

Beyond general discussions about values and goals, talking honestly about death should include conversations about specific scenarios that may arise as one nears the end of life. This can be an outgrowth of a values-based conversation or a separate discussion if that seems appropriate. The goal in either case is to try, to the greatest extent possible, to determine what kind of medical care you would or would not want if you were seriously or terminally ill. 

The Conversation Project, a public engagement initiative of the Institute for Healthcare Improvement, offers a number of excellent free tools and resources in multiple languages to help individuals and families start conversations about goals of care. The Conversation Starter Guide, for example, includes a number of questions about how involved you wish to be in planning your care and the level of care you think you would like to receive if you were seriously ill and close to death. It is an excellent resource that can help you and your loved ones to focus on the questions that may arise if you need medical care. It also offers useful suggestions about how to begin the conversation, tips on what to discuss and how to follow up after your talk. Some issues you may want to discuss include:

• How much information do you want your provider to share with you about your diagnosis and treatment?
• How involved in treatment decisions do you want to be? 
• Do you want accurate information about your prognosis or would you rather your healthcare team keep that information to themselves?
• Do you want to know if your illness is terminal? 
• If you were seriously ill and unlikely to recover, how much care do you believe you would want?
• If you had a choice, where would you like to die?
• Who do you want to be with when you are dying? 

The Conversation Project also offers a conversation guide for caregivers of people with dementia who wish to begin a conversation about values and goals of care. There are other guides as well, including a guide to choosing a health care proxy and a guide for caregivers of children who are seriously ill. All of the guides are available to the public at no charge.  

Talking to Children About Death

Children are exposed to death in many ways. In our society, especially, children regularly see depictions of death, both real and dramatized, in movies, television shows, video games and on the news. This is a shift from the past, where children living in multigenerational households or on farms often witnessed the natural cycle of life and death as a more integrated part of daily life. Today, they have “active shooter drills” in school, and far too many of them have witnessed violence and death on the streets where they live. During the COVID-19 pandemic, millions of children across the globe saw their parents, grandparents and other relatives die. And according to recent research, over 1.4 million children in the United States alone lose a family member to drug overdose every year.

When we don’t talk to children about death, these encounters can be frightening or overwhelming. Additionally, they may encourage inaccurate beliefs or fantasies about what death really is. Even very young children may have questions about what they have witnessed or heard but be reluctant to voice them because the prevailing social paradigm is that talking about death is “taboo.” On the other hand,  the more openly the adults in a child’s life talk about death and dying, the more likely it is that the child will feel safe discussing their questions, concerns and fears. 

Talking to a child about death can feel daunting, but it is possible to have a frank conversation if you approach it in a calm, unemotional way. This is far more likely to occur if you bring up the subject before the child is exposed to the death of someone they love — talking to a grieving child about losing a loved one is far more difficult than explaining the concept of death in more abstract terms. 

In either case, conversations with a child about death should be, first and foremost, age-appropriate. To learn more about children’s understanding and behavioral needs at specific developmental stages, see our article “How Can I Talk to My Children About Death”  in the topic Grief and Loss.

Additionally, there are many excellent books about death and dying for children and young adults that can help you broach the subject with children. To find a selection of books SevenPonds has reviewed, visit our Healing Library and browse the section Books for Children About Death. 

Promoting Death Positivity 

Death positivity, like death literacy, is a term that was coined in the not-too-distant past as a way to help people in our society return to the realization that life inevitably ends. As recently as the 1900s, death was a regular occurrence in everyone’s lives. There were few hospitals and no ICUs, and people who died were not brought back to life with sophisticated treatments and hi-tech machines. When an individual became ill or injured, they were treated by a local physician in the family home and cared for by family members and friends. If the doctor could not cure them, that is also where they died. Death was, in a genuine sense, a part of life. 

Since the mid-20th century, however, illness and death have been medicalized to the extent that most people never think about the fact that everyone dies. Those who talk openly about death are often viewed as morbid or “weird,” and their attempts to engage friends and family in death-related conversations are typically poorly received. Sadly, it is generally not until a loved one is diagnosed with a severe illness or someone dies that a conversation takes place.

It is possible, however, to overcome others’ reluctance to talk about death if you approach the discussion with confidence and sensitivity. Start from the premise that talking about death is valuable, and avoiding it promotes uncertainty and fear. A simple statement like “I know you may think it’s morbid, but I believe we need to talk more about death. After all, we are all going to die someday,” can be a great conversation starter. You can also approach the subject with a question, for example, “Have you ever wondered what it’s like to die?” Understanding that many people are more afraid of the process of dying than they are of death itself is also a place to start. You may even introduce humor into the conversation, saying, “ I don’t think I’ll mind being dead, but I am not thrilled with the idea of getting there.” The goal is to normalize death as a natural part of life and to help others become comfortable with thinking about how they want to live their lives right up to the very end. 

Another way to promote death positivity is to participate in death-related community events. One example: death cafes are community-led events where individuals gather in an informal setting to talk about death in a confidential, non-judgemental atmosphere. They are sponsored by the nonprofit “social franchise”  Death Cafe, which lists events all over the world. You may search for a death cafe near you or, if none currently exists, organize one yourself. The website offers a free guide to help you plan, organize, promote and run a death cafe session that walks you step-by-step through what you will need to do. If you have the time to travel to a national conference, you may also want to look into End Well, a nonprofit dedicated to enhancing death awareness and death positivity that hosts an annual symposium about end-of-life issues each year.

Summary

In summary, conversations about death and dying are still largely taboo in Western society, much to our collective detriment. When we avoid talking about death, we feed into the uncertainty that underlies many of our fears. On the other hand, open conversations about death and dying promote death literacy and provide us with the tools, resources and language to express our values and goals. This, in turn,  allows us to explore our attitudes about dying and consider how we want our own end of life to unfold. Most importantly, it brings us face-to-face with the finite nature of all things and allows us to live and die with an attitude of acceptance and grace. 

Sources

“Why we’re so terrified of the unknown”. BBC. https://www.bbc.com/worklife/article/20211022-why-were-so-terrified-of-the-unknown

“Developing death literacy.” Progress in Palliative Care. https://doi.org/10.1080/09699260.2015.1103498

“Lancet Commission on the Value of Death”. The Lancet. https://www.thelancet.com/commissions/value-of-death

“Ars Morendi”. Encyclopedia of Death and Dying. http://www.deathreference.com/A-Bi/Ars-Moriendi.html

“More Than 1.4 Million US Children Have Lost a Family Member to Drug Overdose”. American Journal of Public Health. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2024.307847?emci=1cb67e19-327c-ef11-8473-6045bda8aa34&emdi=f0578699-7d85-ef11-8474-6045bda8aae9&ceid=1944680

“Former Mercy Health CEO: U.S. Needs to Embrace ‘Death Literacy’”. Hospice News. https://hospicenews.com/2023/11/21/former-mercy-health-ceo-u-s-needs-to-embrace-death-literacy/ 

“In the ICU, what is a good death?”. Northwestern Now. https://news.northwestern.edu/stories/2024/03/what-is-a-good-death-in-the-icu#:~:text=Critical%20Care%20Medicine.-,Approximately%2020%2D30%25%20of%20people%20who%20die%20in%20the%20U.S.,of%2Dlife%20care%20actually%20delivered.