Most of my life I’ve been pretty clueless. When someone has revealed that they’re sick or broke or a loved one has just died or their life is otherwise falling apart, I kind of panic. I don’t know what to do. I want to help, but I don’t want to imply that I think they can’t handle it. I want to be a good friend, but I don’t want to insert myself into their business. And I want to make offers, but I also don’t want to make promises I can’t keep. Or worse, that they’ll resent or feel humiliated by. So I do what a lot of people do when we don’t know what to do: I lend a listening ear, then either put my foot in it or do nothing at all.
What I’m learning is when the ground crumbles out from under someone, they’re not going to be great at even thinking of what they need, let alone asking for it. We are now in an era, with COVID and climate change, when many more people are broke or sick or wrestling with mental health. Here are a few things I’ve learned, from being the household that needed help over the last seven months.
1. Simply ask what they need.
There’s always a chance they might know. If they’re really overwhelmed, you might have to read between the lines. “I’m exhausted” could mean they need some help around the house. “I don’t know where we’ll go” could mean they need a place to crash for a while. This doesn’t mean you need to jump in and offer that (truly, do not offer anything until you’ve had time to consider whether it’s right for you), but helping them clarify their needs can get them brainstorming ways to get those needs met.
2. If health is making daily tasks hard for them, ask if they’ve considered a home health aide.
Different states and insurance plans have different policies about this, but it’s always worth asking a doctor or insurance agent about the available options. Even having someone come in once a week to give a family caregiver a break or to catch up on light housework can make the difference between living in a pigsty or having a home that feels like a place where they can heal. If you are in a position of financial abundance, giving gift cards to home cleaning or meal services can be a real boon.
3. Send them meals, after confirming any dietary restrictions.
This could mean gift cards. It could mean dropping off a homecooked meal or ordering a delivery. If you’re choosing the food or venue, always check with them first because dietary needs may have changed or the grief and stress may have killed their appetite. But in times of upheaval, a lot of us forget to eat, or at least to eat well. And truthfully, if someone is experiencing skyrocketing medical bills or housing insecurity, they may not be able to afford to eat well.
I know comfort food can feel like the best gift. I mean, when I’m having a bad migraine season, I want donuts and banana splits and maple bars all the way home. But indulging their cravings may make you feel like a great friend in the short run, not so much in the long run as your loved one finds it even harder to keep functioning. You want to keep their engine running, and if they’re struggling to do that themselves, nourishing food is what they need.
4. Don’t give money as a gift on holidays or birthdays, unless you want it spent on treats.
If it’s presented for a festivity, it will be spent for the festivity. Poor people have wish lists, too, and if money is presented as being for a birthday or other special event, the recipient may even feel obligated to spend it on treats rather than necessities. It may not even matter what you say. Again, the stress level that accompanies grief, newly acquired disability, or life-threatening illness means words aren’t really going to stick anyway. Their brain is on survival mode. So a birthday gift is a birthday gift. By keeping your gifts separate from donations, you can help preserve relationships, ensure you aren’t frustrated by how your money is spent, and prevent your “help” from creating additional stress (if someone did hear your request that the money be spent on necessities, but they have no other way to afford a birthday or holiday gift). It will save everyone hurt and confusion.
5. Gas cards, bus passes, rides, and other transit-related gifts can be a huge help.
All those trips to doctor’s offices and hospitals add up. Between the copays and the parking fees and the gas, your friend may very well find themselves being nickled and dimed to death. Literally. Being sick in America is extraordinarily expensive, even if you have excellent health insurance. You can end up paying far over your deductible because copays don’t count toward it. Neither do prescriptions, parking fees, gas costs, and all the other expenses of regular commutes to high-end medical treatment. So this is a great category to offer to pitch in on, from gift cards and cash to free rides or even a parking spot at your place if you live near their medical offices or hospital. Whatever works for you.
6. Arrange some self-care for the primary caregiver.
If they have kids, offering (or hiring) baby-sitting services for a few hours or even a day can make a big difference for a parent struggling through a health crisis. Especially if another loved one has taken on the role of full-time caregiver for a spouse, child, or parent, sign this person up for a massage or take them out for a nice lunch or sit down with them to brainstorm ways they can ensure they get a day off without sacrificing their loved one’s quality of care. Again, you don’t have to give anything at all. Sometimes just helping people think through their options is the best gift. It’s all too easy when we’re distraught to forget about what we need or to even remember there are options at all.
7. If you’re a really close friend or relative and what they’re going through is a long process, invite them on a vacation.
If something is going to take years, such as grieving the loss of a loved one or navigating a debilitating chronic illness or lengthy recovery, a short, relaxed getaway somewhere can change everything. Not only does it give your loved one a much-needed escape hatch, but it can remind them that the world is bigger than it seems most days. When most days consist of physical therapy exercises, pill timers, and doctor’s offices, it can get hard to remember that life is still worth living.
However, only do this if you aren’t going to feel resentful when your loved one needs to stay closer to home than you’d like or if they need to spend a lot of the trip resting and recuperating, rather than hiking to that waterfall you were hoping to see or trying that hot new restaurant. Again, if you aren’t sure or if you’re telling yourself I’m sure Betsy wants to try that new beach spot as much as I do—she’s strong, she can push through, just don’t offer. Please. “Helping” when you’re likely to be stressed and resentful or when you are secretly hoping to get your friend “back” pre-health problems can actually do more harm than good.
Mainly because as someone who’s grieving or injured or sick, your friend has grown accustomed to disappointing people and hates it. They indeed will push through for you because they want to disappoint you least of all, and as you return home patting yourself on the back for proving to them that they can do more than they thought, they will be left paying the price for that. Going back home for them will be drearier and harder and more angering because they will feel worse after a trip that has placed more expectations on them, not fewer. It’s cruel. Don’t do that to someone already suffering. Know your limits, and offer only what you can give freely. Which may mean a weekend at the beach where your loved one simply takes lots of naps.
8. Figure out what you’re comfortable giving, and stick to that.
Your own boundaries matter here, too. The last thing a suffering friend needs is for an overeager helper to end up jeopardizing a relationship they’re leaning on. If you’re worried that having them crash on your couch is going to make things rough on you, don’t offer. If you’re not sure that you’re up for that commute to their place, don’t offer to drive out. This is not the time to play the martyr.
Playing the martyr is a fundamentally selfish act because it’s about easing the conscience of the person overextending themselves (their engine running off “should” rather than “can” or “want to”) and because it never, for a moment, focuses on the actual needs of the people they claim they’re sacrificing themselves for. I have known too many people who say they’re okay doing something to accommodate me only to show up and find out they’ve made it all about themselves (“I was so inconvenienced that I had to drive for hours to pick this up, I was so overwhelmed at work but I did this for you anyway, I put in all the effort to plan and prepare this meal that I don’t care how you’re feeling, you have to eat it”). Not only does it not help me (hello, stress!), but it makes me think twice about continuing a relationship with that person.
People in crisis need a long-haul friend they can depend on. Not a one-time act of heroic generosity that doesn’t actually solve anything. If someone asks you to do something you don’t want to do or can’t or shouldn’t, you can always act like a grown-up and say no. That, or say you need to think about it, or simply don’t offer. The last thing we all need when we are facing death, illness, and loss is a “friend” who’s sulking and icy because things didn’t go the way they wanted.
So here’s the thing. At the end of the day, our loved one isn’t keeping score. We don’t get brownie points for how many hospital visits we made or how many flowers we sent or how many meals we prepared or how many hours we dusted and vacuumed so their injured lungs could cope better. We just don’t. When our loved one looks back, this whole period is going to be a blur of hospitalizations and icy examination tables and terror. It’s also going to be remembered as a time of cascading financial crises (in 2018, pre-COVID, over 33% of a group of sick Americans said they’d spent all or most of their savings to cover healthcare costs). With that level of distress, they are not going to remember a whole lot about what we did for them. It’s important to go in knowing that. We will not get any practical benefit, even in the calculus of the relationship, from our effort and support.
What they will remember—and I promise you this—is how they felt around us.
“People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”Maya Angelou
This is the moment when we set the tone for our relationship. It isn’t what we do right now that matters. It’s the heart with which we do it. If we are ticking off boxes, if we are following etiquette rules, and if we’re proudly telling other people “I just visited Betsy in the hospital today,” we’re going to be forgotten. Every time. Because we’re coming at this like a lot of people who congratulate themselves for being “great with” the sick, the dying, and the disabled. If we’re coming at it to feel like a good person, we’re a dime a dozen. Our loved one is surrounded by such people.
But if we’re the one who simply sits next to them and holds their hand and says, with tears in our eyes, “I don’t know what’s going to help, and I’m scared, too. But I care about you so much, and I really want you to make it through this, even if your life never looks the same again. I don’t know what’s going to happen, but I know I’m here for you.” If we can sit with our loved one in their not-knowing and their fear and their grief, they will never forget that.