The Integrative Palliative Podcast
Conversations about communication, caregiving, and changing the experience of serious illness.
Hosted by physician, educator, and speaker Dr. Delia Chiaramonte, The Integrative Palliative Podcast explores one central question:
How do we improve the experience of serious illness when we cannot change the illness itself?
Through thoughtful conversations, practical tools, and evidence-informed insights, each episode helps listeners navigate the challenges of serious illness with greater clarity, compassion, and confidence. Topics include communication, family caregiving, clinician wellbeing, decision making, whole-person care, and the emotional realities that accompany serious illness.
Whether you're a healthcare professional, a family caregiver, or simply someone walking beside a loved one through illness, you'll discover practical skills that can improve your confidence, reduce your stress, and help you find meaning even if the patient's illness can't be cured.
If you're a caregiver, visit www.DoctorDelia.com for information about programs, resources, and personalized support from Dr. Delia.
If you are a healthcare organization or interested in discussing speaking or consulting with Dr. Delia, visit www.integrativepalliative.com.
The Integrative Palliative Podcast
Writing a Meaningful Letter to a Loved One
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When someone is nearing the end of life, the idea of leaving behind a “goodbye” or legacy letter can feel meaningful, but also overwhelming. What do you say? How do you start? In this episode, Dr. Delia offers a gentle guide to writing a letter that captures your love, gratitude, and wisdom without the pressure to be perfect.
You’ll learn:
- Why legacy letters matter so deeply for both the writer and the reader
- Simple tips to make the process less overwhelming
- Ten powerful prompts to spark your writing — from sharing what you’ve cherished in your life to what you love most about your person
Whether you’re a patient, a caregiver, or simply someone who wants to capture your story for those you love, this episode will help you find the right words.
Coping Courageously: A Heart-Centered Guide for Navigating a Loved One’s Illness Without Losing Yourself is available here: www.copingcourageously.com
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Welcome to the Integrative Palliative Podcast, where we bear witness to both the tough stuff and the blessings that come with caring for people who are aging or ill. Their well-being matters, but yours matters too. I'm your host, Dr. Delia Chiaramti. Hey friends, it's Dr. Delia, and today we're going to talk about writing meaningful letters. I had a patient once who wanted to do some sort of legacy project for her sons, her two adult sons. And she had in her mind that she was going to write them letters. And she was the person who had said that she wanted to do her end of life right, correctly. And what she meant by that, I think, was she she didn't want to hide. She didn't want to pretend it wasn't happening. She wanted to be brave and wide-eyed and just address it head on. And part of that was doing something special, some kind of legacy for her sons. But despite that, every time I saw her, I would check in, like, hey, how's the legacy thing going for your sons? How are the letters going? And she would say, I haven't started them. And I don't know why I haven't started them, but I haven't started them. And so at some point I said, Hey, you know, you don't have to do letters. There's nothing that says you have to do letters. And she said, I know, I know, but I want to. And so we talked about what might be stopping her. She she wanted to, but she wasn't doing it. So something was up. And what was that? And what she said was that she had in her career been an editor. And so she, when she really thought about it, she thought, gosh, maybe I'm just being too critical. Like I think it has to be perfect because I spend so much time criticizing other people's writing. And this is so big and heavy and important, and I don't want to mess it up. And so she was holding herself up to this impossible standard. And so therefore she couldn't get started. And she ultimately decided not to do letters, but to do something else instead, a special trip with each son. But the truth is, I think they probably would have loved a letter, and they wouldn't have cared if it wasn't perfect. And so it just got me thinking about how could we address this idea of writing a letter with a little bit of structure or guidance so it doesn't just feel like the scariest blank page in the world. And also on the other side, I did write a letter to my dad before he died, and I'll read that to you at the end. Okay, so let's just start by talking about, well, why write a letter? Now, you don't have to write a letter, of course, not everybody wants to do that. But if it speaks to you, why bother doing that? Part of it is because it can be meaningful for the letter writer to share love or to share meaning or gratitude or forgiveness or something. So there's something about the energy from the writer of the letter to the other person. And then there's something about what it feels like to the other person to receive this letter. And I think there are different levels of what does it feel like to receive it in the moment? And then if this is a letter from someone who has died, there's something about having that letter and being able to revisit it and read it again. So it's totally normal, totally normal to be afraid or hesitant to start a letter like this because it feels like, how do you sum up a whole life in one letter? And what if it's not exactly right and all that heavy stuff? And I would just encourage you to throw all of that out and just do it anyway. There's no right way to do it. There's no right length, there's no right prose. The idea here really is to just be human. You know, your regular, imperfect, personal, quirky, human self. Just human. It's not supposed to be an essay that you turn into the professor. It's supposed to be some form of sharing your heart with somebody else's heart. So don't pressure yourself for perfection. It doesn't have to be perfect. As a matter of fact, if it were perfect, it's probably going to be less personal and maybe less meaningful to the person. So it doesn't have to be poetic or profound or anything. It doesn't even have to be a letter necessarily. It could be an audio or a video, it could be handwritten, it could be typed. It doesn't, there's no one format that's better than the other formats. It's really just, again, sharing your heart to somebody else's heart. You also don't have to do it all at once. You could break it up, you could get started and then come back to it in a couple days. You don't have to feel like, oh, I can't finish the whole thing today, so I won't start. Just like anything that's hard to start, just start it. Just start it. You don't have to finish it, but just start it because sometimes the hurdle is getting started. And then don't overthink it too much. I'm going to give you some guidance today, but you could throw all that out, you could keep some of it, you could change the order. Just pick what resonates and delete what doesn't and add what does. Don't overthink it. If you are feeling resistant, you might get some kind of ritual to help get you going. Like you might do the kind of classic take some deep breaths, light a candle thing. You might watch some funny YouTube videos first to lighten yourself up a little bit. You might pump up the music and have some, you know, really engaging, dancy kind of music to get your energy going. You might have a glass of wine. So think about what you can do to get yourself in the space where this feels more connected and less scary. Okay, so now I'm going to give you 10 ideas of things that you might share. And they are in four sections. So the first section is, who are you? You mean the letter writer. So you're saying to yourself, this is who I am. That's a section that you might consider. This is who I am. The next section that you might consider is something that speaks directly to your loved one. So the first part is this is who I am. The next part might be, here's my messages to you, person that I love. You might consider a section that's about fostering connection or supporting some sort of healing or repair of a relationship. And then you'll have some sort of close. So you don't have to do any of what I just suggested. You don't have to do it in that order, but just to give you some ideas to help you get started. So let's look at the who I am section. So you might share something about this is who I've been in my life. Like share something about the essence of who you are. What are your values that are really important to you? What are you passionate about? How do you want to be remembered? You know, this is who I've been in my time on this earth. That's a thing that you could share. That's one. Number two, you could share this is what I've loved about my life. So you could share just a memory of some kind of particular experience. You could share your perspective about the world, some small joys that really lit you up. You could share things that have brought meaning to your life or things that really pump you up. You could share a lot about what you've loved. You could make a huge list, or you could just share one sentence about how you try to see the world. So the first one is this is who I am. This is who I've been in this life. And the second part is what have I loved about my life? The third thing that you might want to share is here are some things that I've learned along the way in my time on this planet. So they could be specifically lessons that you want this person to learn. You know, this is a special lesson for you. Or it could just be, these are just some life lessons that I've learned that I think are important that I want to share with the universe in general. So the I am portion could have three pieces. This is who I've been in my time here. This is what I've loved about my life, and these are some things that I've learned. Okay, so let's talk about the second section that you might consider, which is speaking directly to your loved one. So you might share something like, What I see and love in you. So what are things that you admire about this person that you're writing to? What are some things that they taught you or moments in the life that you've shared that really made you proud? So this is about them. This is how I see you. This is what I am impressed by in you. This is what I honor and love in you. Think about what a beautiful thing that would be to receive as a person. So that's concept number four. What I see in you and what I love about you, person that I'm writing to. Then in the speaking directly to your loved one, you might share some memory. So this is a memory that I'll always cherish. This is one of the things that I really think about when I think about you. This was a special moment for me, and here's why. So a special memory that involves them. What a beautiful thing that is to share for them to keep. So number four was what I see in you and I love in you. Number five was here's a memory of the two of us together that I'll always really treasure. Number six is here are my hopes for your future. So you could put in some kind of words of encouragement here or some kind of guidance or reassurance. It could be generic, like I hope you live a happy life. It could be specific, I hope you end up opening a dog hospice like you had said you wanted to do. It doesn't matter, but it's just this idea of you are hoping something for them in their future. Okay, so this was the speak directly to your loved one section, where you might say, What I see in you and I love in you. Here's a memory of the two of us I'll always cherish, and here are some of my hopes for you for your future. Then the next section that you might consider is this fostering healing and connection, maybe repairing, if there are some challenging issues in the relationship. So in here is number seven, which is some version of I'm sorry, or I forgive you, or I love you, or all of those things. Maybe there's something you want to apologize for, maybe there's something you want to forgive someone for, maybe you just want to share how much you love them. If there are regrets, this is a place to share that. If you just want to deepen your connection with a person, that's sort of what this part is about. So this part is very individualized, depending on if you really just want to share, oh my gosh, I love you so much, and or here's a thing that I regret and I'm sorry for, and or here's a thing that I forgive you for. I think the letter that I wrote to my dad, which you'll hear in a moment, has a flavor of I forgive you. So that's seven. Then number eight, again, in this section of connection, is some form of, hey, I would love for you to keep me with you somehow. So even when I'm gone, you could give suggestions of how maybe you would like to be remembered. Things like, hey, tell your kids about me, or when you go to the lake and you sit in our special spot, I hope you'll think about me, or on your birthday, I hope you'll play our special song, or whatever. Something about if this speaks to you, I hope that you'll keep me with you, you'll carry me forward with you, and here's some ideas about what that might look like. And then the last section that you might consider is some sort of closing. And one option would be here is what I most want you to know. And that could be what I most want you to think about in your life, or what I most want you to know about me, or both. So some distilled, heartfelt message that your loved one can carry with them. So what I most want you to know, or what I most want to share with you, is that's nine. And then for 10, some sort of connected and loving closing. So if there's some special thing you said to each other, this would be a nice place to end with that. It could just be, I love you. It could just be, I'll watch over you. It could just be think of me when you see a ladybug. If there is a special something, it's a nice place to put it, or it just could be, I love you. So I really want to encourage you that if this is on your list, it doesn't have to be on your list. Some people don't want to write a letter, but if you want to write a letter and you're not writing a letter, I really, really encourage you to just start. Starting is the hardest part of anything that you're putting off. You could today just start by open a file on your computer or get out your pad and pen and put it someplace where you can get to it. It could be just that. You could start with writing bullet points of what you want to say. You could write down these topics that we just talked about today and start thinking about what you might say. You could write a paragraph, or you could just do the whole thing. It doesn't have to be perfect. You could just sit down and do the whole thing. Don't even edit it. If you don't know how to start, you could start by saying, I don't know how to start. You know, you could say something like, I don't know how to say this, but I wanted you to know blank. Or I don't even know how to start this letter, so I'm just gonna start it. I think it's likely that if you just start, you'll find it's not as hard as you thought it was. Just do it and lower your expectations. This is just your heart to the other person's heart. That's it. And the other thing I want to say about this is you don't have to be dying to do this, and your loved one doesn't have to be dying to do this. There may be a letter that you'd love to write to somebody in your life that you think needs some sort of repair of a relationship or that you just want to be more connected to. So all of the things that we talked about, these can be parts of other connected letters that aren't even involved in end-of-life situations. And then think about if you want to add a quote or a poem or a lyric from a song or a joke. It's okay to be funny in a in a letter like this, or a photograph, or a recipe, or some memento, staple a ticket from a special concert that you went to together, or anything like that. And if the writing part feels too hard, you can just record it on your phone or you could speak it to someone who could write it down for you. So the big picture here is try to manage your perfectionism. This is not supposed to be perfect, it's supposed to be heart to heart, and just start. Okay, so I'm gonna tell you a little about my story. So my dad did not leave a letter for me. I so wish that he had. Once upon a time, a long time ago, we talked about that. And he said, Well, I mean, what would I even say? I don't know. And I I share that to say that I think he didn't leave a message because he couldn't imagine what message he would leave or how to do it. But it would have, no matter what it was, it would have been so meaningful to me. But I wrote a letter for him a few weeks before he died, and I'm gonna read that to you in a second. And I I found it on his desk when I cleaned out his apartment. So now I have it again. And here's why I wrote it. I mentioned before that maybe it had a touch of forgiveness in it. So he was a very introverted, self-sufficient guy, not a real emotional connector type. But I know he cared very much about his family. And I have wondered, did he wish he had done things differently? But he would never be someone who could have said that. So as I knew his life was coming to a close, it was important for me to tell him that I it was good, that I appreciated him and what he had done. So essentially in my mind, I was saying, I forgive you for being imperfect as a father. So here's the letter. Dear Dad, since it seems that you don't have a lot of time left on this planet, I wanted to say thank you. Thank you for showing up as a father when I was a kid, even though it probably wasn't your natural state to do so. Thank you for helping to support me through college. Thank you for playing chess with me. Thank you for taking me to museums. Thank you for gifting me your art. Thank you for coming to visit us. Thank you for modeling, creating a life that you enjoy. Thank you for taking me to your sister's house so I could feel connected to family. Thank you for all the pizzas. Thank you for showing up for and connecting with your granddaughters. I know that talking about emotions is not your natural state. I'm not sure exactly how you feel about me, but you've shown up for me, my husband, and my kids, and that seems like love to me. My kids adore you with all their hearts. Thank you so much for being their no-no. Thank you for being like a father to my husband. He doesn't love many people, but he absolutely loves you. Thanks for being my dad. I love you. Now, go write your own letter. I'll see you next time. Thanks for listening. I hope you'll practice what you learned, and you can learn more from my book, Coping Courageously A Heart Centered Guide for Navigating a Loved One's Illness Without Losing Yourself, which is now available as an audiobook. You can join me for healing the caregiver's heart. And if you'd like more personalized guidance, you can reach out for Caregiver Coaching at integrativepalliative.com.