Hospice And Palliative Care - Spirituality And Psyche

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Hospice And Palliative Care - Spirituality And Psyche
Hospice And Palliative Care - Spirituality And Psyche
Video: Hospice And Palliative Care - Spirituality And Psyche
Video: Spiritual Support in Hospice Care - How Does Hospice Help with Spirituality and Grief? 2023, February

Hospice and Palliative Care: Psyche and Spirituality

In order to ensure a satisfactory quality of life in the last phase of life, the treatment of psychological and spiritual burdens on terminally ill people is particularly important.

Religious values ​​and beliefs that are independent of religions can provide stability in the face of approaching death, but they can also trigger uncertainties. Feelings and spirituality are therefore often closely intertwined.


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  • Which emotional phases can occur at the end of life?
  • What psychological stress can occur?
  • How can psychological stress be treated?
  • The role of spirituality in the last phase of life
  • How are people spiritually cared for in the last phase of life?

Which emotional phases can occur at the end of life?

The Swiss death researcher Elisabeth Kübler-Ross described phases in which many people feel or behave when they find out that they have an illness from which they will die. The model describes five sections that merge into one another and focuses primarily on external and internal behavior. This description can be helpful to better understand the behavior of the dying person or oneself. It is important to know that this classification represents complex emotional reactions in a very simplified manner and that each person reacts individually in this situation. The duration of these phases can vary widely, and they can also run in parallel or be skipped.

The following phases are described:

  • Not wanting to be true and withdrawal or isolation,
  • Anger,
  • Negotiating (e.g. hoping for previously unknown treatment),
  • Depression,
  • Acceptance.

What psychological stress can occur?

People deal with the last phase of life and death very differently. Serious psychological reactions and even mental illness can develop.

However, mental illnesses can also be present as concomitant illnesses. Other possible causes of psychological stress at the end of life are:

  • certain personality traits (e.g. particularly pessimistic, more introverted / extroverted people),
  • (additional) conflict situations or
  • previous mental illnesses.

Frequent stressful feelings, complaints and mental illnesses at the end of life are:

  • Anxiety as well as anxiety disorder
  • Grief or depression
  • Anger or aggression
  • sleep disorders
  • Fatigue (persistent tiredness)
  • Psychosis or delirium

How can psychological stress be treated?

In the event of psychological stress, discussions with family, friends or other people close to you can be helpful. It often happens that terminally ill people and their relatives and relatives (e.g. friends) avoid difficult conversations in order not to burden one another. However, in most cases this is a fallacy. Joint discussions, for example about values, feelings, future decisions or death usually have a relief for the terminally ill as well as for their caregivers. In addition, misunderstandings can be eliminated and relationships strengthened. However, conversations should not be conducted against the will of one of the interlocutors.

In hospice and palliative care, biography work (e.g. in the context of psychological treatment or psychotherapy, but also in the general nursing or care process) is very important. Information on attitudes, likes or dislikes, significant experiences and phases of life or life-long problems are found out. With this knowledge in the background, the support can be designed individually. In addition, incurably ill people often feel the need to deal with conflicted life situations or relationships and to resolve conflicts.

In addition, the professional alleviation of psychological complaints and the treatment of psychological illnesses represent an important aspect in hospice and palliative care. Psychological complaints and illnesses are considered holistically in hospice and palliative care. Psychological care, psychotherapy, pastoral care, social assistance and medical therapies are used for prevention, support and treatment.

Psychological complaints can also have physical causes. If these are treated, psychological complaints can also recede. In addition, the relief of physical complaints relieves the psychological burden on patients.

Physical changes or illnesses that can cause psychological complaints include, for example:

  • Anemia,
  • Brain metastases,
  • Dehydration,
  • Lack of oxygen,
  • Inflammatory reactions of the body.

Mental stress can also be specifically treated with medication:

  • Anxiety Disorder: Anxiolytics (anti-anxiety drugs);
  • Depression: especially antidepressants;
  • Sleep disorder: hypnotics (sleeping pills);
  • Fatigue: Psychostimulants ("stimulants") - the positive effect of these drugs is not very pronounced here, however - as well as corticosteroids before important occasions (eg family party);
  • Psychosis or delirium: especially neuroleptics.

The role of spirituality in the last phase of life

Spirituality gains importance for many people in the face of death. On the one hand, a belief or a worldview can make it possible to face a life-threatening illness with confidence. On the other hand, pain and other distressing complaints or the approaching of an unwanted end of life can shake a belief system. The feeling of powerlessness in relation to “nature” or “the unfathomable ways of God” can cause fear, anger and sadness, among other things. This can lead to a worldview that was previously held to be questioned. This can be very stressful.

If a particular worldview has been accompanied by a lifestyle that has contradicted a person's intuitive desires, this can also trigger anger, anger, and sadness.

How are people spiritually cared for in the last phase of life?

Spiritual care for terminally ill people is very important in hospice and palliative care. The entire palliative and hospice team takes into account the patient's individual beliefs and values ​​when advising, accompanying, treating or caring for.

Spiritual support is mainly provided by pastors. With these, for example, questions of faith can be discussed, common prayers can be said and farewell rituals can be planned or carried out. In addition, attempts can be made together to resolve inner spiritual conflicts and adapt values ​​to the current situation.

Pastors are available in every hospice and palliative care facility. You can contact the Austrian Telephone Counseling Service by telephone around the clock.

In spiritual conflict or crisis situations, a psychologist or a psychotherapist can also be called in to provide support.

You can find more about crisis intervention here.

Note In the event of an acute mental crisis, you can contact the psychosocial service, for example. You can find more emergency numbers here.

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