Consistency Over Intensity: Staying Connected Through the Hard Days
By Cody Hufstedler, Palliative Care Chaplain and Host of "Dying To Tell You"
I've often observed a pattern in how people respond to someone's terminal diagnosis. There's often an initial outpouring of support—flowers, visits, calls, offers of help—followed by a gradual tapering off as the reality sets in that this isn't a problem that will be solved quickly. Meanwhile, the person facing the illness continues living with their diagnosis day after day, month after month, often feeling increasingly isolated as others return to their normal lives.
Through my conversations on "Dying To Tell You," I've learned that what people value most isn't the grand gestures or intense periods of attention, but the quiet consistency of knowing someone cares enough to stay present for the long haul. It can be difficult to sustain support over extended periods, but I've also discovered that small, consistent actions often mean more than dramatic displays of care.
When someone is having a particularly difficult day—whether due to treatment side effects, pain, depression, or simply the weight of their situation—they often don't have the energy to engage in normal social interactions. This is precisely when many well-meaning friends and family members pull back, assuming their loved one needs space or worrying that they're bothering them during a tough time.
But here's what I've learned from countless conversations with people facing terminal illness: bad days are when they most need to feel connected, even if they can't actively participate in that connection. The key is learning to maintain presence without expecting reciprocation, to show care without creating obligation.
A simple text message saying "thinking of you today, no need to respond" accomplishes something profound. It communicates that you're aware they might be struggling, that your care isn't conditional on their ability to engage, and that you're not adding to their burden by expecting a response. This type of no-pressure communication creates a lifeline that they can grab onto if they want to, or simply appreciate knowing it's there.
The people I interview consistently tell me that the friends who matter most are those who show up predictably rather than intensely. I have come to an understanding that consistency matters more than perfection in how we care for one another. Staying connected during someone's illness is a marathon, not a sprint, and pacing ourselves accordingly.
Consider establishing a gentle rhythm of contact that you can maintain over time. Maybe you send a brief check-in text every Tuesday, or you call at the same time each week. The predictability of this contact can be deeply comforting because it removes the uncertainty of wondering when they'll hear from you next while ensuring they know support is consistently available.
I've discovered over the years that understanding, comfort, even joy can come through intentionally facing the end of life with a companion, and this includes being present for both the good days and the bad ones. On difficult days, your consistent presence becomes a reminder that they're not navigating this journey alone, even when they feel too overwhelmed to reach out.
As we have discussed on the podcast, people facing terminal illness often feel guilty about being a burden during their bad days. When you communicate your care without expecting anything in return, you're directly addressing this concern and giving them permission to have difficult days without losing your support.
Sometimes staying connected on hard days means adapting your usual way of showing care. Instead of planning a visit that might feel overwhelming, you might drop off soup without staying to chat. Instead of calling to talk, you might send a photo of something beautiful you saw that made you think of them. The goal is maintaining the thread of connection while honoring their current capacity.
Bad days in terminal illness can be unpredictable and intense. Someone might feel energetic and social one day, then completely depleted the next. Learning to flow with these changes rather than taking them personally is one of the most valuable gifts you can offer. Your consistency provides stability in the midst of physical and emotional ups and downs. It also shows them that you understand and accept the uncertain nature of their situation and that you will continue to love and support them through whatever comes.
Remember that consistency doesn't require perfection. If you miss your usual check-in day, simply resume the pattern without making a big deal about the gap. The goal is creating a reliable sense that you're thinking of them regularly, not adding pressure to maintain perfect communication.
What matters most is that when someone is having their worst days—when they feel most alone, most scared, most overwhelmed—they know without question that someone cares enough to keep showing up, even when there's nothing to be gained from the relationship except the satisfaction of loving well.
