More Americans talk about dying since the pandemic ended

Over 90% of Americans think we should be able to discuss death openly. Yet only 27% actually feel comfortable doing it. That gap—between what we believe and what we do—sits at the heart of why end-of-life conversations stay so hard, even when they matter most.

But something shifted after the pandemic. More people are finally having those conversations about what happens at the end. Harvard palliative care physicians who spend their days with dying patients and their families have noticed the change. They're also noticing something else: the relief that comes when people actually talk.

What's really getting in the way

One insight from these doctors cuts through a lot of the awkwardness. Patients and their families often live on what they call "different islands of worry." A patient declining in health focuses on their own body, their own fear. Family members are somewhere else entirely—worried about the patient's condition, counting down time, managing their own grief before it's even happened. These islands sit close enough to see each other, but far enough that real conversation feels impossible.

Except it's not. The doctors describe something simpler: "acknowledge what's happening, face it more squarely, and prepare to have it be a shared experience." That's not therapy-speak. It's permission to stop pretending. When people stop pretending, something shifts. There's relief. There's connection. There's the chance to grieve together instead of alone.

Yes, these conversations are awkward. Yes, they're hard. But the alternative—silence—leaves people isolated in their worry. The doctors are clear about this: an awkward conversation beats no conversation. Every time.

What actually needs to be said

When time is short, palliative care physicians recommend focusing on four things. Not everything. Not a whole life's worth of unfinished business. Just four:

"I love you." "Thank you." "I forgive you, and please forgive me." And then, if there's time, say them again.

That forgiveness piece matters more than it might seem. People want the chance to make peace. They want to acknowledge what went wrong, what they regret. They want to stop carrying it. And they want the person they're saying goodbye to know they've let it go.

The remarkable part: these words work whether someone is awake and alert or barely conscious. A moment of lucidity. A sleepy nod. A hand squeezed in response. The person hearing it—even if they can't respond—registers something. That's not sentiment. That's what the research shows.

Don't wait

The doctors' final advice is the hardest: it's never too early. If you feel like time might be short, don't wait for the right moment. Go. Say what you want to say. Repeat it if you need to. The worst outcome isn't awkwardness. It's the silence that comes after.

Since the pandemic, more Americans are learning this. They're crossing their islands of worry. They're having the conversations they thought they couldn't have. And they're finding out that the relief on the other side is real.