I find it interesting the extent to which we define a good death with the ability to have a conversation with loved ones before death. In a recent issue of her magazine, Martha Stewart wrote about her mother's death. One of the circumstances she found most moving and comforting was that she had time to talk to her mother before her death. Stewart's mother was able to tell all of her important surviving family members that she loved them and to say goodbye to them.
Is it these actual words that comfort the surviving family members? In contrast, when my grandfather passed last fall, he was essentially in a coma for three weeks before he died and was unable to communicate with any family members. I wonder if the comfort comes not from those actual words of love and goodbye but from what they implicitly say.
When someone gives a "goodbye and I love you" talk on their death bed, aren't they really communicating that they know they're going to die and they're at peace with it? In my grandfather's case, we all knew that he loved us; he was a person who was very vocal about his feelings. No one was in doubt of his affection for them. But, he was afraid of death. And we could have used the comfort of hearing him say that he knew it was the end and he had accepted it.
I think that's the real comfort that comes from those end-of-life conversations. The words coming out may simply be "I love you," "Goodbye," "Take care of your mother," etc., but what they're really saying is, I know I'm dying, and I've accepted it.