ABSTRACT
FROM the foregoing it is evident that the terminally ill patient has very special needs which can be fulfilled if we take the time to sit and listen and find out what they are. The most important communication, perhaps, is the fact that we let him know that we are ready and willing to share some of his concerns. To work with the dying patient requires a certain maturity which only comes from experience. We have to take a good hard look at our own attitude toward death and dying before we can sit quietly and without anxiety next to a terminally ill patient. The door-opening interview is a meeting of two people who can communicate without fear and anxiety. The therapist-doctor, chaplain, or whoever undertakes this role-will attempt to let the patient know in his own words or actions that he is not going to run away if the word cancer or dying is mentioned. The patient will then pick up this cue and open up, or he may let the interviewer know that he appreciates the message though the time is not right. The patient will let such a person know when he is ready to share his concerns, and the therapist will reassure him of his return at an opportune time. Many of our patients have not had more than just such a door-opening interview. They were, at times, hanging onto life because of some unfinished business; they cared for a retarded sister and had found no one to take over in case of their death, or they had not been able to make arrangements for the care of some children and needed to share this worry with someone. Others were guilt-ridden about some real or imagined “sins” and were greatly relieved when we offered
them an opportunity to share them, especially in the presence of a chaplain. These patients all felt better after “confessions” or arrangements for the care of others and usually died soon after the unfinished business was taken care of.
