Question

In 3-4 paragraphs, describe two common psycho-social problems faced by those approaching death. What resources might someone utilize to deal with these issues? Give an example.

Answer 1

Psycho social problems of approaching death

• Anxiety Disorders
  • It commonly results from medical complications for individuals approaching death
  • Nonpharmacologic interventions for anxiety include supportive psychotherapy and cognitive-behavioural psychotherapy
  • It is intended to reduce perceived isolation and provide an outlet for the expression of fears and worries
  • It induces physical and mental relaxation and to direct attention away from anxiety-arousing cognitions
• Existential Distress
  • It is classified in terms of whether patients are focused on past, present, or future concerns.
    • Past
      • focus on unfulfilled aspirations or previous actions they regret.
    • Present
      • focus on the loss of personal integrity or the loss of important occupational, social and familial roles
      • Perception that their continued existence represents a burden and source of distress for others
    • Future
      • focus on their impending death and separation from loved ones.
  • Psychodynamic life narrative
    • a review of the patient's life in order to place the current illness in a personal context

Resources to solve these issues

• From goals of cure to comfort care.
• Through shifts in hopes and expectations.
• With personal, psychosocial and spiritual issues
• Possibly between care settings
• Being authentic.
• Facilitating caring relationships.
• Using humour and play.
• Encouraging determination and courage.
• Establish short-term, attainable goals.
• Supporting spirituality.
• Engaging in reminiscing.
• Being physically present in crisis.
• Listening attentively.
• Managing pain and other symptoms.

A checklist by Frazer Health

Questions which can help to obtain the patient and family’s perspective:

1. What is your understanding of the illness?

2. What do you think caused the illness?

3. What kind of impact has the illness had on you and your family?

4. How have roles and relationships changed within your family?

5. How would you describe your communication style?

6. What do you fear the most?

7. Who do you turn to for help?

8. Who should be involved in decision making?

9. What is most important to you?

10. What would be most helpful to you at this time?