Palliative psychologist: how to find support during the most difficult period
Palliative care isn't about death. It's about quality of life when the disease is beyond cure. The WHO clearly states this: assistance should be aimed at reducing suffering—physical, psychological, social, and spiritual. Psychological support is part of maintaining a normal quality of life for the patient and their family. It is officially part of a multidisciplinary approach to treatment.
A palliative psychologist works with a doctor, nurse, and social worker. Their goal is to reduce internal pain. Sometimes it's as severe as physical pain.
Palliative psychology doesn't replace treatment. It complements it. And it helps a person remain themselves until the end.
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Tasks of psychological assistance for incurable diseases
As the disease progresses, everything changes: the body, roles, plans, and self-perception. At this point, psychological support is needed. It helps the patient and their family avoid falling apart or going crazy from worry.
Patient support: from accepting the diagnosis to finding meaning
Accepting a diagnosis is a long process. It's impossible to immediately believe that you'll soon be gone from this world. The brain resists, refusing to accept the facts. A person may vacillate between hope, anger, and despair. And that's normal.
Fear of death—a psychologist's work is especially important here. It doesn't eliminate anxiety completely. It helps accept that it will happen anyway.
A psychologist helps:
- Maintain a sense of dignity
- Determine what is important now
- Complete unfinished business
- Restore contact with loved ones
Psychological care for palliative patients is often built around a simple question: "What is most important to you now?"
This is how the search for meaning begins, even if time is short.
Helping relatives: preventing burnout and dealing with feelings of guilt
Illness affects the entire family. Supporting relatives of palliative care patients is a separate part of the work.
Emotional burnout in relatives develops quickly. Constant tension, insomnia, fear of deterioration. Guilt is added: "I'm tired," "I want this to end."
We are all human, and it is important to learn to distinguish real guilt from imagined guilt. The family is not to blame for the illness or the failure of treatment. A psychologist explains that such thoughts do not make a person bad. They help clear the mind and accept that there is no shame in thinking about oneself.
Supporting relatives of palliative care patients also means teaching simple self-soothing techniques. Bad thoughts will always be present in their heads, but a psychologist teaches them to accept them as inevitable and not fear the future.
Anxiety is a common cause of conflict at the patient's bedside. This is also the specialist's area of expertise.
How do consultations take place in the palliative care unit?
Palliative care psychologist consultations are conducted in hospital and at home. The format depends on the patient's condition.
At the core of the consultation is an individualized family support plan. It takes into account religious, cultural, and ethical considerations.
Individual work with emotional state
The work begins with an assessment of distress. What is currently bothering you most: pain, anxiety, insomnia, loneliness?
Psychological support is structured in short sessions. Avoid overload. Sometimes 20–30 minutes is enough. The goal is to reduce stress today. Avoid making long-term plans unless you have the resources for them.
Family counseling: how to talk about important things
Families often avoid discussing the diagnosis. Some are protective of the patient. Others aren't ready to hear the truth. A consultation with a palliative psychologist helps facilitate an honest conversation with a relative.
Here's how it works: the specialist asks questions, clarifies positions, helps each other hear each other out. And relieves some of the tension.
Working with Grief and Loss (Support during the Grieving Period)
Grief begins before death. This is called anticipatory mourning.
Psychological support continues after the loss. It helps reduce the risk of complicated grief and return the person to everyday life.
When to see a specialist: key markers
You should consult a specialist if:
- Constant anxiety or panic attacks
- Reluctance to talk about the illness
- Severe feelings of guilt
- Family conflicts
- Signs of depression
- Emotional burnout of relatives
If conversations end in tears or silence, this is also a reason to consult a specialist.
Specialist Tasks: Comparison
| For the Patient | For Relatives |
|---|---|
| Overcoming the Fear of Loneliness | Teaching Self-Regulation Techniques |
| Finding Resources to Combat Depression | Dealing with "Bystander Syndrome" |
| Working Through Unfinished Business and Conflicts | Assistance in organizing communication with the patient |
Conclusion: Life goes on until the end
A palliative psychologist helps preserve the human dimension of illness. Not remove reality, but make it bearable.
Palliative care is about quality of life. And about respect for the individual.
Life goes on until the end. And during this period, a specialist who can support without illusions and empty promises should be at hand.
FAQ
Is it possible to get help at home?
Yes. Many services offer on-site consultations.
Is working with a psychologist necessary?
No. However, psychological support for palliative care patients reduces anxiety and improves family ties.
Should I seek medical attention only if my symptoms are severe?
No. It's better to seek medical attention sooner rather than later.
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Who is a palliative psychologist and what do they do?
This is a specialist who supports the patient and family throughout all stages of the illness, from the diagnosis to the final days and the period of loss.
They don't try to persuade you to "hang in there." Nor do they promise miracles. Their job is to make the experience bearable, reduce anxiety, and help you talk about difficult things.
Psychological care for palliative patients includes:
A psychologist is a doctor, just like an oncologist. Relatives of palliative patients seek them not after the loss, but during treatment, when negative thoughts can't leave their minds.