Palliative Psychological Care In Terminal Illness

In this article we discuss palliative psychological care for a terminal illness. Adapting to your environment is always a challenge. After all, everything is constantly changing and you can only control it up to a point.

You may have wondered why some people who are financially well in life still commit to something or get involved in new projects.

On the other side of this natural tendency to seek out complications and problems is the situation that poses the greatest challenge to your adaptability: the diagnosis of a terminal illness.

We all know we will die. You could die suddenly in a car accident, not knowing it was coming when you woke up that morning. However, most of us assume that we still have years to live, if only because we still have things to check off our to-do list.

This is how we live. We are making plans for tomorrow, next week, next month and next year. In other words, by imagining death as an event far in the future or as a very small chance, we place ourselves in spacetime in a unique way.

This strange edifice we build around us is beginning to crumble with a terminal illness diagnosis. In today’s article, we want to talk about the sadness that comes with these kinds of diagnoses. We also discuss the important aspects of terminal illness that psychologists usually focus on.

Anticipatory grief in a terminal illness

In this situation, the body tends to react as if it were being threatened. On an emotional level, fear is the most common reaction, but other reactions are also possible.

It usually depends on how the patient processes the news. Immediately after being diagnosed with a terminal illness  , many people deny it. This is especially true if the diagnosis is sudden and unexpected. rather than after treatment to eliminate or slow the progression of a disease.

Therefore, one of the most important things we psychologists can do is to help the patient process the news in a way that is comprehensible to him or her. The first job as mental health professionals is therefore to listen and to be there. We need to get to know our patients.

Indeed, a proper evaluation will teach us about all that has been destroyed along with the patient’s hopes. It also helps identify the most painful regrets you have when you know you’re running out of time.

Our help becomes meaningful when the patient comes to see us as a helpful resource. Someone you can turn to for effective strategies to deal with their suffering. It is not the terminal illness itself that requires our attention, but the suffering it causes.

First steps

After the fear caused by the news, it is important to work with the patient to identify their emotions at different levels. On a cognitive level, we can help the patient find a place in this new space-time dimension.

Living in the here and now, which so many guidebooks encourage, is not realistic for terminally ill patients. If you want to leave the house, get dressed. When it’s time to go to bed, brush your teeth. When you travel, pack your suitcase. In other words, in these cases the patient will continue to think about the future and that is necessary.

Most interventions in this context focus on the sense of threat caused by:

• Compromised life integrity.
• Uncertainty about what will happen after death.
• Lack of resources.
• A negative attitude towards the disease.

On a physiological level, fear causes activation. Remember, it was the emotion that helped our ancestors escape predators in the wild. Therefore, it would be very good for the patient to let go of that over-activation.

Relaxation techniques and exercise can be helpful. The options are highly dependent on the patient’s physical condition. Their lifestyle, health history, willingness and support network will also play a role.

Meeting the needs of the patient with a terminal illness

The main starting point for intervention, as Mariant Lacasta proposes in her article The role of psychology in palliative care (translated from Spanish), is to identify the patient’s needs. The effectiveness of an intervention depends on whether we are able to meet the patient’s needs that are within our means.

We’ve talked about listening, including normalizing the patient’s emotions (especially contradictions that may surface during the process), dealing with fear, what we mentioned, fear of abandoning those around them and managing the hope that almost always remains, no matter how bad the news.

It is important not to raise unrealistic expectations, but neither should we discourage moderate optimism about future events.

This is actually one of the most delicate parts of any treatment or procedure, as it requires great sensitivity. Keep in mind that we will not always work with someone who is fully aware of his or her impending death or who will talk like someone who is not going to get better.

Intervention with friends and relatives

One of our duties may also be to train a patient’s support networks. There are people who also have to deal with anticipatory grief and possible psychological problems. There will be times when the patient probably doesn’t want to talk but the people around them need that communication, and vice versa.

Either way, if you notice that someone is in a high-risk situation, immediately suggest treatment. In many cases, it would be best for another professional to handle the matter, while you keep the open lines of communication.

It is ideal for the intervention to take place with input from all health professionals involved in the case. This kind of collaboration increases the likelihood of making sure the patient feels in control of the process.

The patient may no longer be able to go out alone, but he or she can still decide when to go or what clothes to wear. While this may seem insignificant, it is very important for patients who face many more disabilities.