The power of psychological support in palliative care is an often-overlooked aspect of end-of-life treatment. It's a journey that demands a holistic approach, focusing not just on the physical, but also the emotional well-being of both the patient and their loved ones.
The Impact of Emotional Well-being in Palliative Care
Psychology plays a pivotal role in this process, offering a unique perspective and a set of tools to navigate the emotional challenges that come with advanced illnesses. The goal is clear: to enhance the quality of life for those facing such circumstances, ensuring they can approach their journey with as much serenity and understanding as possible.
A Conversation with Fátima Castaño, Psycho-Oncologist
Fátima Castaño, a psycho-oncologist at MD Anderson Cancer Centre, Madrid–Hospiten, shares her insights on this sensitive topic. She explains how psychologists can support patients and their families during this difficult time, and the life lessons she's learned through her work.
The Role of Psychologists in Palliative Care
"Palliative care is a specialized form of treatment when the focus shifts from curing the disease to managing its progression. It has a profound emotional impact on both the patient and their family. Psychological support during this time is crucial as it helps manage these emotions, navigate the various stages, and address any psychological issues that may arise. It's about adapting to the new reality and ensuring the patient's comfort is a priority."
Addressing Fear and Anxiety
"Fear of death is a universal emotion. It challenges our survival instinct, is often taboo, and is associated with pain and discomfort. As healthcare professionals, we aim to mitigate these fears and provide comfort. However, accepting the reality of death is not an easy task. It brings with it loss, sadness, and anguish. The idea of non-existence and the impact our death may have on loved ones is a heavy burden."
Strategies for Managing Fear
"It's crucial to listen to the individual, their unique circumstances, fears, and needs. While we can't change the course of their illness, we can ensure symptom management to improve their quality of life. In psychology, we help patients and families regain a sense of control, adjust expectations, and make informed decisions. We focus on listening and helping them redefine their goals, reducing their suffering, and ensuring a peaceful end-of-life experience. We also ensure their families have access to all the resources they need to manage their grief and exhaustion. When medicine can no longer prolong life, psycho-oncology steps in to improve its quality."
Anticipatory Grief: A Natural but Potentially Harmful Process
"Anticipatory grief is a process where we grieve the pending loss of a loved one in advance. It's a protective mechanism as we try to come to terms with the future. However, it can lead to fast-forwarding to events that may not happen soon, preventing us from living in the present. From a psycho-oncology perspective, we detect and evaluate its impact. While it's a natural process, it can become harmful when it causes distress and prevents living in the moment. We work with patients to address this, giving them a sense of control and focusing on the present, ensuring they can still enjoy life and do the things they want. Our goal is to provide them with the tools to face their grief in the future."
Addressing Concerns in Palliative Care
"Palliative care is often viewed negatively as it's associated with death. People tend to think it's a last resort when all other options have failed. However, for healthcare professionals, it's a continuum of care, offering the best and most appropriate treatment at all times. If treatments can't stop the disease, the focus shifts to mitigating symptoms and ensuring quality of life, including a peaceful death. Many are reluctant to seek this support, and we need to educate people about its benefits, both physical and emotional, for patients and their families."
The Importance of Family Support
"Supporting the entire family is crucial. It prevents emotional burnout, manages psychological issues as the illness progresses, and ensures the process is handled in a humane and healthy manner."
Tools for Expressing Feelings and Needs
"In difficult times, listening and empathy are our most powerful tools. They allow us to assess each patient and family's unique needs and provide tailored strategies."
Depression and Hopelessness in Palliative Care
"It's normal to feel sadness and hopelessness when facing the progression of an illness. It's important not to force a 'good attitude'. Giving patients and families space to express their fears, worries, and grief is crucial. Support at the end of life is about listening, understanding, and ensuring comfort. Our goal is not to make them 'happy', but to help them find peace."
Lessons from Working in Palliative Care
"One of the main lessons I've learned is the incredible capacity of human beings to face even the most difficult circumstances, given the right support. Life is full of changes and our plans don't always go as hoped, but we always have the power to decide how we respond and what we take from these experiences. Life is in the present, and we should strive to make each moment meaningful. I've learned to truly value the simple acts of love and support, like a kiss, an embrace, or an encouraging word."
Challenges for Psychologists in Palliative Care
"As psychologists, we have our own challenges, especially when a case resonates with our personal history or when we feel overwhelmed at work. It's important to manage our well-being and find meaning in our work to continue supporting those in need."
Emotional Management for Psychologists
"Psychologists specializing in palliative care are trained to provide this support. We feel emotions, sadness, and sometimes frustration, but our focus is on offering support, resources, and presence. We aim to provide the best therapeutic care while maintaining professional distance."
The Most Challenging Aspect of Palliative Care Work
"Striking a balance between using our psychological skills and being emotionally open to patients without getting overwhelmed is a constant challenge. Factors like a patient's medical condition or a family's personal situation can make this difficult. As professionals, managing our own frustrations is also a significant challenge."
Personal Lessons from Working with End-of-Life Patients
"Every patient and family I work with teaches me something new. They make me reflect on how to better care for people at the end of their lives and ease their emotional pain. The greatest reward is the sincere gratitude we receive, knowing we've helped and lightened their load."
About the Expert
Fátima Castaño is a psycho-oncologist at MD Anderson Cancer Centre, Madrid–Hospiten, dedicated to supporting patients and families through the emotional journey of palliative care.
