Psychologists in Palliative Care PDF

Psychologists in Palliative Care Health Psychology Dr. Stacey Dunn Fall 2024 What happens when healing is no longer the primary goal? Defining the Landscape of Palliative Care Palliative care is a relatively new medic...

Psychologists in Palliative Care Health Psychology Dr. Stacey Dunn Fall 2024 What happens when healing is no longer the primary goal? Defining the Landscape of Palliative Care Palliative care is a relatively new medical specialty. Officially recognized by the World Health Organization (WHO) in 1990, though it has existed in various forms for much longer. Takes a holistic view of the person, addressing their physical, emotional, social, and spiritual needs.  Dr. Dale Larson, a renowned figure in the field: “The end of life is a lot more than a medical event.” Palliative care is about addressing the profound emotional and psychological challenges that arise when life is nearing its end. Psychologists are uniquely positioned to support patients and their families in navigating these challenges Why are psychologists critical in palliative care? Mental Health Support Serious illness often brings with it a wave of psychological distress. Patients might experience anxiety, depression, or fear of the unknown. Psychologists step in to help manage these emotions by: o Assisting patients in managing anxiety and depression o Helping them process trauma o Navigating complex emotions like grief, loss, and existential fear o Supporting them in making meaningful decisions about their care and end-of-life choices  Innovative Therapeutic Approaches In palliative care, traditional therapies often don’t fit the unique needs of the patients. Psychologists, therefore, develop specialized interventions, such as: o Dignity Therapy: Helps patients document their life stories and legacies, providing a sense of meaning and closure. o Meaning-Centered Psychotherapy: Focuses on helping patients find purpose and meaning in their lives o Abbreviated Trauma Interventions: These are quick, yet effective therapies that provide immediate relief from psychological distress. Holistic Pain Management Pain in palliative care is often emotional, spiritual, and existential. Psychologists help patients manage pain by: o Teaching relaxation techniques o Providing psychoeducation on the mind-body connection o Training patients in effective communication, enabling them to advocate for themselves o Helping patients navigate the complex dynamics of their family relationships during this time Challenges in the Field  Underfunded healthcare systems  Limited specialized training opportunities  Psychologists are involved in relatively small percentage of palliative care cases A Powerful Perspective on the Psychological Journey Dr. Brian Carpenter, a leading researcher at Washington University, describes the final phase of life as “the nexus of so many important psychological issues”. It is the culmination of a person’s life journey, and thus, a critical time for emotional and psychological support. The challenges patients face are not just about illness but also about identity, relationships, and the search for meaning. As Dr. Julia Kasl-Godley eloquently puts it, working in this field teaches us to “embrace living fully until we die.” In palliative care, we’re not just managing death—we are helping people live as fully as possible in their remaining time. Practical Insights: Navigating End-of-Life Conversations Dr. Brian Carpenter emphasizes that end-of-life planning is not just for older adults; it’s relevant to everyone, because life is unpredictable. Key topics to consider include: 1. Housing Preferences: Where do you want to live during a serious illness—at home, in a hospital, or in residential care? 2. Medical Care Wishes: What medical treatments do you want? Equally important: what treatments would you prefer to avoid? 3. Financial Planning: Ensure your financial situation is documented and that your family knows where important documents are kept. 4. Post-Life Arrangements: Discuss funeral preferences, who you want involved, and what you want to happen after your passing. These conversations should not be one-time events but should be ongoing discussions that evolve over time. The Psychological Dimension of End-of-Life Decisions Why are end-of-life decisions such a significant psychological issue? Because they involve:  Decision-making under pressure  Emotional management of mortality and fear  Relationship dynamics with family members, healthcare providers, and loved ones  Cultural and personal understanding of life and death  Personal identity and life reflection, which can lead to a renewed sense of meaning and dignity at the end of life. The Psychological Journey of Facing Death Facing deathis not just about an end but also about finding meaning, dignity, and peace. Research suggests that the process of dying is highly individualized—there is no fixed sequence of emotional stages. The Grieving Process: A Continuous Adaptation The grieving process is continuous and can include both negative and complex emotions. It is not linear or predictable, and psychological support should focus on helping the individual navigate this emotional landscape without rushing or suppressing their feelings. Conclusion: The Power of Palliative Care Psychology Role of psychologists in palliative care is not merely to treat the mind but to offer humanistic support at the most vulnerable and profound moments of life. Their work is crucial in helping individuals and families find meaning, dignity, and connection, even in the face of terminal illness. The interesting thing about talking to people about death is that you really aren't talking about dying; you're talking about how they want to live the remainder of their lives. - Dr. Veronica Shead