How to Compassionately Manage an Employee with a Terminal Illness

With remarkable shifts in research and advances in medicine, life expectancy more than doubled between 1900 and 2021. Yet, there are many illnesses that still don’t have a cure. This means that, at some point in your career as a manager, you may have someone with a terminal illness on your team. When an employee receives a terminal diagnosis, continuing to work might offer them a sense of normalcy and purpose. Work can provide a respite by helping them maintain social connections and feel productive. At the same time, there will inevitably be difficult moments for everyone involved. Unlike many work challenges, it’s not about a business outcome. It’s about balancing the responsibilities of your role as a leader with the emotionally charged period leading up to the loss of someone you and your team know and care for. Our recent research focused on how becoming aware of an employee’s terminal illness can incite negative and positive leadership behaviors among managers. We learned that while this situation requires managers at any level to skillfully blend compassion with strategy, first-time managers find this situation most challenging as their inexperience can make it difficult to balance empathy with the demands of their role. We also learned that some managers may struggle with the emotional toll of supporting a colleague through a terminal illness while also maintaining team morale and productivity. The pressure to manage their own feelings, provide adequate support, and uphold workplace stability can be overwhelming. We recently expanded our research (forthcoming in BMJ Leader) as we wanted to understand how managers navigate the profoundly difficult challenge of managing a terminally ill employee. We conducted 60-minute semi-structured interviews with 21 supervisors — 18 of whom were new to this role — who each managed a terminally ill employee. The questions focused on their experiences, the challenges they faced, and the strategies they found most effective in supporting persons with terminal illnesses. Among other questions, we asked: Can you describe the specific challenges you faced when managing a terminally ill employee? How did you approach conversations with the terminally ill employee about their work and health needs? What steps did you take to ensure knowledge transfer from the terminally ill employee to other team members? What strategies did you find most effective in supporting the terminally ill employee while maintaining team morale? In addition to our interviews, we spent up to three days in each manager’s organization observing team dynamics and workplace interactions. We also spoke with 10 terminally ill employees and 20 of their coworkers at those organizations, gathering their perspectives on what worked well for them. These insights were then triangulated with our interviews with the supervisors, providing us with invaluable insights into the real-world challenges and practices that were effective in supporting terminally ill employees. Conducting research within workplaces where these situations were unfolding allowed us to observe interactions, practices, and the overall environment firsthand. Our inquiries helped us further understand the unique difficulties and effective practices in these sensitive situations. Based the insights we gathered, we’ve identified with three interlinked recommendations to help both new and experienced managers address both the emotional and practical aspect of the impending loss of a colleague. We hope that by integrating them, managers can create a supportive environment that values and respects the needs of terminally ill employees, maintains team morale, and ensures business continuity. Support Your Terminally Ill Employee Your first step is to make sure your employee feels a sense of security and belonging. To do that, here are two things you need to focus on. Involve them. Talking to your employee about their needs isn’t just practical, it allows you to provide emotional support. Letting them express their needs can provide clarity, direction, and purpose, as well as help them to feel valued and respected. “When Laura expressed her desire to mentor someone to take over her projects, it gave her a sense of purpose and allowed her to leave a lasting legacy,” one manager shared. Similarly, a terminally ill employee shared, “Discussing how I wanted to transition my responsibilities and make changes to my role gave me peace of mind and a sense of control over my work.” Address their needs. It’s crucial to adapt your work environment to meet the physical and emotional needs of a terminally ill employee. This might involve restructuring team responsibilities or providing them with options like remote work, flexible hours, or extended leave. Such flexibility can significantly help improve the terminally ill employee’s quality of life and ability to contribute effectively. “Being able to work from home gave me a sense of dignity and control. I could manage my energy and still contribute meaningfully, which made me feel valued rather than pitied,” one terminally ill employee shared. Similarly, one supervisor mentioned how adjusting a terminally ill employee’s schedule helped: “We shifted Tim’s hours to be more flexible, so he could work when he felt up to it and rest when needed. It gave him peace of mind knowing he could still do what he loved without overexerting himself.” A team member reflected, “Knowing our company was willing to bend the rules for someone going through such a tough time made me proud to be part of this team. It wasn’t just about work—it was about showing we care.” Another team member also shared, “Knowing that our company values flexibility made it easier for us to rally around our terminally ill colleague and provide the necessary support without hesitation.” One option to consider is to implement a future role-planning initiative where the terminally ill employee can help design the future structure of their role or department. This not only shows respect for their expertise but also give them a chance to make a lasting impact on the organization’s future. In our research, we observed two organizations who took this approach. In one, managers found that involving the terminally ill employee in planning their role’s transition gave them a sense of control and purpose during a difficult time. However, it’s important to note that responses to this approach may vary — while some employees may welcome the opportunity to contribute, others may find it somewhat triggering and prefer a less formal role in future planning, which was the case in the second organization. Keep Up Team Morale After establishing a supportive environment for managing the terminally ill employee, it’s equally important to focus on your team’s emotions and morale. To achieve this, here are a few things you can do. Balance honesty with sensitivity. When talking to your team members about the situation, use compassionate language and provide clear, factual information that can help the other employees feel empowered to support their colleague. You might say, “While [colleague] is facing serious health challenges, we are committed to supporting them in every way possible. It’s important that we remain strong and united during this time.” This fosters a sense of security and shows that the organization values the well-being of all its members. Listen actively. To support your team members, our research indicates that it’s essential to offer specific times and spaces for them team to express their feelings and process the situation. Facilitated group discussions, counseling sessions, or informal gatherings can make a significant difference. You can look to HR or your employee assistance program for resources and guidance on how to do this. One manager recalled how he held weekly group discussions where everyone could share their feelings. These sessions provided a structured yet empathetic environment for employees to voice their concerns and support each other. Our findings also showed that the need for emotional support evolves as the illness progresses, and managers should remain flexible, adapting the format and frequency of these discussions based on team needs and feedback. During these discussions, signal active listening by nodding along, maintaining eye contact, and offering affirmations like “I understand” or “I hear you.” By being fully present, managers can reinforce a compassionate and cohesive team dynamic even in the most challenging situation. Manage Business Continuity While supporting the team is critically important, managers have the added responsibility of making sure that any needed work gets done. To walk this difficult line: Take action right away. To ensure a smooth transition, it’s crucial to act quickly once the news of a terminal illness is shared. Our research suggests that managers should work closely with the terminally ill employee to document key responsibilities, processes, and unique knowledge. There are a few ways you can do this. You can assign a team member to immediately shadow the employee to observe daily tasks, join key meetings, and learn essential processes directly. For example, if the employee manages specific client relationships or handles specialized tasks, the shadow can participate in these activities to grasp the subtleties involved. As the employee’s condition changes, shadowing can adapt to virtual sessions or brief check-ins, allowing for continuous knowledge transfer even if the employee’s health declines. Another option is to pair the terminally ill employee with team members for mentorship, providing a hands-on approach to transferring practical insights. Formalizing these mentorship sessions with regular meetings and clear objectives ensures a systematic transfer of knowledge. One team leader told us, “John mentored several team members, and the knowledge he passed on was invaluable.” This approach not only facilitates the transfer of essential skills but also strengthens team relationships and builds confidence among team members. Make it a team effort. Our research indicates that engaging team members in discussions about the transition of responsibilities is key to maintaining productivity and morale. One manager shared how they created weekly transition meetings in which team members were encouraged to ask questions about the transition process and offer their input on how to best oversee the projects previously managed by their terminally ill colleague. “We found that this level of transparency and involvement helped the team feel more united and empowered during a challenging time,” the manager explained. In cases where there may not be time for a complete transition due to sudden changes in the employee’s health, it’s crucial to develop a contingency plan. This could include identifying critical tasks that need immediate coverage, assigning temporary point people for urgent projects, and maintaining a shared document or platform where key information is regularly updated. One manager shared how their team created a contingency plan that included cross-training team members on critical tasks and documenting key processes and contacts. When their colleague passed away unexpectedly, this preparation allowed the team to quickly reassign responsibilities and continue work with minimal disruption. This proactive planning helps the team remain resilient and focused, even in the face of sudden changes. . . . By integrating these strategies, managers can provide a compassionate and practical approach that addresses both the emotional and functional needs of the terminally ill employee and the team, creating a supportive, resilient work environment. This approach will not only help you deliver on your business responsibilities as a leader, but it will also foster a culture of empathy and support that can positively impact the entire organization. Ultimately, handling such sensitive situations with care and thoughtfulness can strengthen team cohesion and enhance the overall workplace morale. In moments of profound challenge, the way we support one another defines our humanity and the enduring strength of our workplace community. By prioritizing compassion and connection, we honor the dignity and contributions of every individual.

How to Compassionately Manage an Employee with a Terminal Illness

Summary.

Partner Center