Management of Psychosocial Issues in Terminal Illness

Abstract

January 2006

Section Clinical Essentials

XI Management of Psychosocial Issues in Terminal Illness

Jennifer Rhodes-Kropf, M.D.
Assistant Professor of Medicine (Geriatrics), Mt. Sinai School of Medicine

Ned H. Cassem, M.D.
Professor of Psychiatry, Harvard Medical School, and Psychiatrist, Massachusetts General Hospital

For patients with terminal illnesses, symptom management is only one aspect of the care that is required; the psychosocial and spiritual problems that arise at the end of life also need attention. Emotional suffering, fear, depression, and anxiety are a few of the psychosocial symptoms that patients may experience after learning of their diagnosis and throughout the course of their illness. This chapter discusses the psychosocial issues involved in the care of patients with terminal illness, including breaking the news of the diagnosis; telling the patient the truth about his or her condition and its prognosis, treating the patient with compassion and cheerfulness, and helping the patient prepare for the end of life. The support systems available to help patients cope with a terminal illness are discussed: family and friends, occupation and work, and religion and spirituality. Normal and abnormal grieving are described, with a discussion on ways to help the bereaved. This chapter contains 56 references.

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