Elton John famously claimed that “sorry seems to be the hardest word”, but, as it turns out, he was incorrect.

Saying goodbye is far harder.

Which is why Dr VJ Periyakoil, who has spent over a decade working as a geriatrics and palliative care doctor, has come up with a project that encourages us to write a final letter to our loved ones – before it’s too late.

Explaining her reasoning in a piece for the New York Times, she revealed that the most common emotion expressed by patients reaching the end of their lives is one of regret.

“Regret that they never took the time to mend broken friendships and relationships,” she said. “Regret that they never told their friends and family how much they care.”

“[And] regret that they are going to be remembered by their children as hypercritical mothers or exacting, authoritarian fathers.”

However, when it comes to saying a truly meaningful goodbye, it can often be difficult for us to find the words.

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Which is why Periyakoil, with guidance from seriously ill patients and their families, has developed a free template for a final goodbye letter. 

The Stanford Letter Project encourages people to, while they are still healthy, reflect on the “important relationships they have cultivated” over the years.

“Sadly, almost everyone forgets to do this or postpones it until it is too late,” it reads on the Stanford Letter Project’s site. “Thus, they never have an opportunity to express the deep love, gratitude, and commitment they feel towards their friends and family.”

The template advises people to complete seven vital life review tasks within their letter: acknowledge the important people in your life, remember treasured moments, apologise to those you may have hurt, and forgive those who have hurt you.

Most importantly, it reminds us to say “thank you,” “I love you” and “goodbye.”

Writing a final goodbye letter when you are happy and healthy may seem strange, morbid, even.

However, if you put it off until it’s too late, you risk leaving your loved ones with a plethora of unanswered questions.

It is for this reason that Periyakoil has created two letter templates; one for people who are battling an ongoing illness, and one for people who are in good health. 

“I recommend that people write only the parts that they feel comfortable with,” she advises, adding that it takes “tremendous courage” to write a life review letter.

Once your letter is complete, she adds, you can store it in a safe place to be given to your family and friends in the future. Or, if you prefer, you can use it as a living legacy document and update it over time.

Read more: poignant goodbye letters and moving messages of farewell

While many have responded positively to the Stanford Letter Project, others have claimed that it promotes an attitude of “too little, too late”.

Instead, they advise that you speak up about your feelings with those you care for - and feel free to express your emotions on a regular basis.

Or as one reader commented on the project: “Why write a letter when you're still here and can SAY all these things to those you love?”

However, while some people find it easy to open up, it is worth remembering that many others – particularly those from older generations – find it difficult to say what they really feel.

So much so that, in Bonnie Ware’s The Top Five Regrets of the Dying, the palliative nurse revealed that one of the biggest regrets experienced by her patients was that they hadn’t found the courage to express their feelings.

She explained: "Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming.”

Others, she said, regretted that they had failed to “realise the full benefits of old friends until their dying weeks… [and] there were many deep regrets about not giving friendships the time and effort they deserved.”

Perhaps, for people who find it hard to express themselves on a daily basis, the letter project is perfect.

And, for others, it is worth remembering that the letter is not for you - not really.

It is, rather, a way to comfort those people who loved you best - and whose lives were rocked by your passing.

Images: iStock