As a longtime counselor with the Institute on Aging’s Friendship Line, the country’s only accredited crisis intervention line and warmline focused on callers age 60 and older, I listen to and talk with dozens of callers each week—many of them anxious, distressed, in crisis, or depressed. It’s a volunteer gig, and understandably, not everyone’s bag of tea. But I look forward to the time spent there—an opportunity to learn lessons about aging, both from those who are doing it well and from those who are not.
I hear a common denominator in those who seem lost in the struggle, in a final bitterness that often marks their words:
“I wish I would have been able to thank my brother for supporting me and even taking me into his home, when I was lost and depending on drugs. But I feel like that’s a missed opportunity.”
“I never should have gotten divorced. My life went downhill after that.”
“I wish I never gave up my daughter for adoption. But it’s too late to tell her that now.”
Steering the conversation around to the present or to hopes for the future never seems to help much. They’re stuck in regret.
V.J. Periyakoil, director of the Successful Aging Program at the Stanford School of Medicine, came up against the same roadblock during her years of practice as a geriatrics and palliative care doctor. And after carefully documenting her findings in research on end-of-life discussions with healthcare practitioners and patients from varying racial and ethnic backgrounds, she took the step of doing something about it—coming up with an idea that has morphed into the Stanford Friends and Family Letter Project.
Thank You, I Love You, Goodbye
Periyakoil says the exercise of writing a “last letter” to shed life’s regrets can be helpful for those of any age and stage, but is especially invaluable for those who are ill or elderly and contemplating the end of their lives nearing.
For most people, the hard part is getting started.
To that end, the Life Review Letter offers free templates for Androids, iPhones, and iPads with prompts and suggestions for completing a document that Periyakoil says allows them to say “Thank you, I love you—and goodbye.”
There are two templates available: one for users who are “currently in good health” and the other for those with “any chronic illness.” The one for those with health challenges begins by assuring friends and family that their support is helpful in coping with the illness. Both templates are available in eight languages: English, Spanish, French, Urdu, Hindi, Tagalog, Vietnamese, and Chinese—with the promise that more languages will soon be added.
The resulting letters are structured to help people express sentiments many struggle to express out loud or in person. And in them, writers are encouraged to contemplate and write about the “seven vital tasks of life review:”
- Acknowledge the important people in your life.
- Remember treasured moments from your life.
- Apologize to those you love if you hurt them.
- Forgive those who love you if they have hurt you.
- Express your gratitude for all the love and care you have received.
- Tell your friends and family how much you love them.
- Take a moment to say “goodbye.”
Those using the templates are encouraged to consider all seven of the “tasks,” but to “write only the parts they feel comfortable with.” In early trials, for example, it was found that some people balked at the final step of saying goodbye, fearing it might jinx their chances of living. Users are encouraged to either share the letters with their loved ones immediately—or to store them in a safe place, perhaps update them as sentiments change over time, and give them to designated people after they die.
In these days of easy snaps and selfies, some people also opt to include photos or videotape themselves reading their letters. And for those even more interested in sharing, Periyakoil urges submitting results to the site: “If any of your participants are interested in sharing their letters for the benefit of others, we would welcome that,” she says.
Why and What They Write
Interestingly, when they sit down to the task, many of those steeped in regret say they have the hardest time letting go of grudges, asking others to forgive them for slights and oversights suffered in life. But several of those who shared excerpts from their Life Review Letters did that beautifully.
Wrote one man:
“To my daughter, the most kept moment in my life is being reunited with you and meeting all my grandsons. It’s been 16 years since then, and now, I’m a great-grandfather—three times. What a blessing.”
Wrote another parent to his children:
“Forgive me for not remembering all of your birthdays. Forgive me for not calling on holidays. Forgive me for all of my mistakes. I know I wasn’t perfect. I want to ask for your forgiveness for hurting you. I am so sorry.”
A woman to an estranged friend:
“A friend so dear to our hearts: There’s been an interruption in our friendship, shared so many, many years. I’m asking for your forgiveness.”
And another to a family member:
“I am sorry I was unable to attend your mother’s funeral, my youngest sister. She would have wanted me there. I know we had conflicts and I ask your forgiveness for being so insensitive. I want to ask your forgiveness for hurting you.”
Those participating in the letter-writing project were universally grateful for the push to clear the air. “It’s hard to say those things. It’s easier to write, actually,” said one.
Another was moved to spread the word: “I encourage everyone to write a letter like this when they are still capable of doing so,” he said. “Because the worst thing in our life is to regret.”
(This article was reviewed April, 2024 since it originally published October, 2016.)
