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Counseling for Terminally Ill Patients

Preparing for death and the issues that surround dying is something everyone must eventually face. Terminally ill patients, however, are often forced to confront these issues sooner than they had hoped. Their families also feel the impact of a terminal diagnosis.

In an ideal situation, the patient and their friends and family members can join together to support each other. But that isn’t always the case. Each has fears, anger, and other issues that they are reluctant to share with each other and everyone grieves differently. So, while the idea of holding one another up during difficult times is a lovely thought, it’s not generally what occurs. Instead, both the patient and their family members may need to look for other counseling support.

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Services for the Patient

The terminally ill patient is not always eager to talk about their diagnosis, especially at the beginning, when they are coming to grips with what now lies ahead of them. It is normal for the newly diagnosed individual to be dealing with all sorts of feelings including denial, anger, shock, numbness, confusion, and guilt. These emotions will no doubt strain their body and their psyche. Some feelings will last for just a few days; some for much longer.

There is no denying that most terminally ill patients will need some sort of emotional and/or spiritual guidance to take them to a point where the anxiety is reduced and they can accept – as best as possible – the inevitable. It is the rare person that simply comes to terms with death without worrying about what lies ahead, including pain, losing control of their body and mind, and what their passing will mean to their family. Counseling can help the patient come to grips with some of these issues, lessening their fear as the end of life draws nearer and providing a more peaceful passing.

There are a variety of counseling options available to patients. In many cases, especially if the patient is being treated at a cancer center that advocates care by a multi-disciplinary team of specialists, a psychologist or psychiatrist will be part of the patient’s medical team. This particular person will be skilled in the counseling of individuals with terminal illnesses and know what kind of issues to address with the patient. The counselor will probably be willing to also meet with the patient’s family, but it’s usually a good idea for the patient to attend the first few sessions on his/her own and then ask family members to join, if desired. Issues that might be discussed in counseling could include:

  • The stages of the grief cycle and how to get through them
  • Dealing with pain and other end-of-life changes to the body
  • Lessening guilt about leaving one’s family
  • Addressing unresolved relationships
  • Spiritual issues
  • Practical end-of-life issues like living wills, power of attorney, etc.

Those who choose to enter a hospice program will undoubtedly find that the counselors there are among the most well-trained in dealing with terminal patients. Hospice-based counselors often make daily visits to their patients – if so desired – and can help sort out any remaining concerns the patient may have.

For many terminal patients, spiritual counseling is also paramount. Those with any sort of belief in a higher being as well as life-after-death are usually eager to chat with a clergy member about their situation. Some may have questions about why they are sick (i.e. “Why did God allow this to happen?”), while others may simply want to engage in prayer with a trusted clergy person. If the patient does not have a place of worship, the hospital or hospice program can usually provide a chaplain that will fit these needs.

Services for the Family Member

For many individuals who have a family member that is dying, counseling is a welcome way to “let it all out.” Often, the family members are reluctant to speak to the person that is dying, fearing they will say the “wrong” thing and further upset their loved one. Counselors can help spouses, children, siblings, and close friends sort through these issues and learn to talk to the terminally ill person.

Oft times, family members deal with the same issues as the patient such as denial, guilt, blame, depression, anxiety, and anger. They may feel as if they didn’t do enough to help the loved one who is dying or may be less than happy with their past relationship. In the end, there may be guilt that they can no longer assist with the care of their loved one. All of these issues can be discussed with an experienced counselor who understands the steps of the grieving process and how to alleviate some of those overwhelming emotional burdens.

Many hospitals have psychologists or other medical professionals on staff that have experience in working with the families of terminally ill patients. Hospice-based counselors also care for the needs of family members by offering one-on-one or group sessions for the family of the individual who has just a short time to live. Some of these facilities also offer support groups that allow for the sharing of grief with others in a similar situation. Many loved ones of terminal patients note that this is a good way to address certain issues that needn’t be kept private.

When an older person dies or is dying, they are leaving behind a spouse with whom they have shared most of their life. Experienced grief counselors – both medical doctors and spiritual leaders - can specifically address the needs of the elderly family member who is grieving, especially the spouse of the terminal patient, who must suddenly face the reality of life without this treasured partner. Issues like loneliness, depression, or assimilating back into the society without their spouse may need to be discussed.

Young children of terminally ill patients also need specialized counseling and many hospitals and hospice programs provide this as well, addressing issues like the loss of security, facing changes in the future, and dealing with the finality of death – an issue that is often confusing for a child. Clergy members can also help with this, if so desired.

Communication

Often, counseling will help open the lines of communication between the patient and his family or close friends. Through counseling, the two factions will learn how to speak honestly to each other without fear of offending or upsetting. Most counselors note that this is the ideal situation in the end and one that provides the most peaceful transition to death for both the terminally-ill patient and those he loves.

Last modified: August 06, 2010.