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Palliative Psychology

Friendly relationship between caregiver and happy eldery woman during nursing at home

What is Palliative Care Psychology?

Palliative care psychology, also known as palliative psychology or psycho-oncology, is a specialized field within psychology that focuses on addressing the psychological, emotional, social, and spiritual needs of individuals facing life-threatening illnesses and their families. It aims to improve their overall well-being and quality of life throughout the course of the illness, including during palliative and end-of-life care.

What are key principles of Palliative Psychology?

Palliative psychology is guided by several key principles that inform the approach and care provided to individuals and families facing life-threatening illnesses. While the specific principles may vary slightly depending on the context and setting, here are some common principles of palliative psychology:

  • Person-Centered Approach: Palliative psychology recognizes the unique experiences, values, and preferences of each individual. It emphasizes a person-centered approach, where the psychological care is tailored to meet the specific needs and goals of the patient and their family.
  • Holistic Care: Palliative psychology takes a holistic view of care, considering the physical, emotional, social, and spiritual dimensions of well-being. It acknowledges that psychological support is integral to comprehensive palliative care and addresses the interplay between these different aspects.
  • Collaboration and Interdisciplinary Care: Palliative psychology emphasizes collaboration and teamwork within a multidisciplinary care team. Psychologists work in conjunction with other healthcare professionals, such as physicians, nurses, social workers, and chaplains, to provide coordinated and comprehensive care.
  • Psychosocial Assessment: Palliative psychologists conduct thorough psychosocial assessments to understand the psychological and emotional needs of patients and their families. This assessment helps in identifying sources of distress, developing appropriate interventions, and measuring progress over time.
  • Symptom Management: Palliative psychology recognizes the impact of psychological factors on symptom experience and management. Psychologists collaborate with the healthcare team to help patients manage symptoms such as pain, anxiety, depression, and insomnia through psychological interventions and strategies.
  • Communication and Decision Making: Palliative psychology supports effective communication and shared decision making between patients, families, and healthcare providers. Psychologists assist in facilitating these discussions, ensuring that patients’ values, preferences, and goals are considered in treatment decisions and care planning.
  • Bereavement Support: Palliative psychology recognizes the significance of grief and loss in the context of serious illness. Psychologists provide bereavement support to patients and families, offering assistance and counseling throughout the grieving process.
  • Education and Advocacy: Palliative psychologists play a crucial role in educating patients, families, and healthcare providers about psychological aspects of care. They advocate for the integration of psychological support within the palliative care framework and raise awareness about the importance of addressing psychological needs.

These principles guide palliative psychologists in providing compassionate, patient-centered, and comprehensive care that attends to the psychological well-being of individuals and families facing serious illnesses.

Who can benefit from Palliative Psychology?

Palliative psychology can benefit a wide range of individuals who are facing life-threatening illnesses and their families. It is not limited to any specific age group or type of illness. Here are some groups of people who can benefit from palliative psychology:

  • Patients with Life-Threatening Illnesses: Palliative psychology can benefit individuals diagnosed with various life-threatening conditions, such as cancer, heart disease, organ failure, neurological disorders, and chronic illnesses. It addresses their psychological and emotional needs, helps them cope with the challenges of the illness, and enhances their overall well-being.
  • Family Members and Caregivers: Palliative psychology extends support to family members and caregivers who are providing care and support to individuals with life-threatening illnesses. It helps them manage their own emotional distress, cope with caregiver burden, and navigate complex family dynamics.
  • Individuals in Palliative Care: Palliative psychology is particularly relevant for individuals receiving palliative care, regardless of the stage of their illness. It assists in managing symptoms, addressing emotional distress, and promoting quality of life during this specialized form of care.
  • Those Facing End-of-Life Care: Palliative psychology is essential for individuals approaching the end of their lives. It provides support, comfort, and guidance in addressing existential concerns, facilitating meaningful conversations, and ensuring dignity and peace during the dying process.
  • Bereaved Individuals: Palliative psychology offers support to individuals who have experienced the loss of a loved one. It helps them navigate the grief and mourning process, cope with emotional pain, and find ways to remember and honor their loved ones.
  • Healthcare Professionals: Palliative psychology also extends its support to healthcare professionals involved in the care of patients with life-threatening illnesses. It helps them manage their own emotional well-being, address compassion fatigue and burnout, and enhance their communication and support skills.

It’s important to note that palliative psychology is not limited to individuals in advanced stages of illness or those receiving end-of-life care. It can be integrated at any point in the illness trajectory to provide psychological support, improve coping skills, and enhance the overall well-being and quality of life for patients and their families.

The dying process feels so out of control, what can I do?

Finding a sense of control in the dying process can be challenging when so much is out of our control.  However, there are strategies and approaches that can help. Here are some suggestions:

  • Open Communication: Very often, there can be fear around dying and as a result people often do not talk about it.  This silence can lead to a sense of isolation and aloneness and can increase anxiety levels as imagine what others are experiencing.  Good communication can help bring people together so that they feel closer and more connected allowing better support throughout the process.  Engage in open and honest communication with your healthcare team, loved ones, and caregivers. Discuss your preferences, goals, and concerns regarding your care, treatment options, and end-of-life decisions. Having these conversations can help you feel more in control and ensure that your wishes are known and respected.
  • Advance Care Planning: Engage in advance care planning by documenting your healthcare preferences in advance directives, living wills, and naming a healthcare proxy or durable power of attorney for healthcare. This allows you to make decisions about your care in advance, ensuring your wishes are upheld even if you’re unable to communicate them later on.
  • Seek Information: Educate yourself about your illness, treatment options, and what to expect in the dying process. Understanding the process can help you feel more in control and make informed decisions. Ask your healthcare team for information and resources and consider seeking a second opinion if necessary.
  • Participate in Decision Making: Stay actively involved in decisions about your care. Ask questions, seek clarification, and express your preferences. Remember that you have the right to be informed and to be an active participant in decisions that affect you.
  • Pain and Symptom Management: Work closely with your healthcare team to manage pain and other symptoms effectively. Openly communicate about your symptoms, their intensity, and any concerns you have. Collaborate with your healthcare providers to find the most suitable approaches for pain relief and symptom control.
  • Emotional and Psychological Support: Seek emotional and psychological support from professionals trained in palliative care or psycho-oncology. Palliative care psychologists or counselors can help you navigate the emotional challenges, address anxiety or fears, and explore coping strategies to enhance your emotional well-being.
  • Create a Supportive Environment: Surround yourself with loved ones, friends, and caregivers who provide a supportive and comforting environment. Communicate your needs and preferences for emotional support, companionship, and assistance with practical matters.
  • Focus on What You Can Control: While there may be many aspects of the dying process that are beyond your control, focus on what you can control. This may include aspects such as your attitude, how you spend your time, your interactions with loved ones, and finding meaning and purpose in each day. 
  • Planning: While we often do not have control over the dying process, at times we can have control over the dying experience itself and events that occur after dying.  These might include:
    • Deciding where the death will take place (ie. Hospital vs. Nursing Home vs. family’s home)
    • Deciding who will be at the death (spouse, children, other family)
    • Planning the funeral and/or wake: often the dying individual might have thoughts on how they envision these.  For example, will it be a big party, or a small gathering?  Will there be any specific music?  Will people quietly mourn or tell funny stories about the decedent?
  • Tying up loose ends: At the end of life, there can be a sense of things being left unsaid or undone, this can contribute to an overall sense of helplessness.  It can be important for family to use the dying process as a time of conflict resolution so that all parties can feel comfortable that they have been heard and understood.
  • Seek Spiritual or Existential Support: If spirituality or existential concerns are important to you, seek support from a chaplain, spiritual advisor, or counselor. They can assist you in exploring your beliefs, finding solace, and addressing any existential questions or concerns you may have.

Remember, finding control in the dying process is a personal journey, and everyone’s experience is unique. It may be helpful to discuss your specific concerns and goals with a healthcare professional or a palliative care team who can provide personalized guidance and support.  While these will not change the dying process itself, it can help those involved to feel more connected, engaged, and involved in the process.  This can help everyone to find peace throughout the dying process.