Updated: Jan 25
Do you know anyone who has been diagnosed with terminal illness? And have you ever wondered how they live their life knowing that they will be dying soon?
Being diagnosed with something for which there is no cure available is a very hard truth to live with. Usually these illnesses, although not entirely curable, have lengthy treatment procedures which are painful and stressful, not to mention that they can get very expensive too. People with terminal illness are usually fighting battles on many fronts such as physical, mental, emotional, financial, spiritual, existential, etc, which can be very exhausting for them. The illness not only affects the person suffering from it, but it also takes a toll on patients’ family members and loved ones.
So how do we make sure that these patients and their loved ones get all the help they need to effectively deal with their current life situation? That’s where Palliative Care comes in. It is holistic care for people who are going through some serious illness (especially terminal illness). The whole point of palliative care is to improve the quality of life of patients, their families and their caregivers. Palliative care involves teamwork of doctors, nurses, psychologists and spiritual advisors who provide assistance to the physical, psychological, social and spiritual needs of the patients and their loved ones. As stated here, Palliative care involves all the aspects of patients' needs, but in this article, I am going to focus on Palliative Counseling which caters to the psychological well-being of patients and their loved ones.
So some people might argue, what's the point of counseling a person who is going to die, anyway? Good question! As I stated earlier, the person going through serious illness is battling on many fronts and this could lead to tremendous mental stress for this person. Although there might be no cure available for that illness, so does that have to mean that the person should live the rest of his life in misery until death sets them apart? No. No matter how many months, weeks or days they might be left with, they all deserve to live a life as fulfilling as possible. And before you start imagining Shah Rukh Khan from ‘Kal ho na ho’, let me tell you, this life scenario is not that pretty and glamorous. Not everyone can have high spirits at such a critical time in their life and mask themselves with happy faces. Sometimes, movies fail to depict the real picture of such cases, which may lead to unrealistic expectations and falsified hopes from people. The reality is, that battling such illnesses is very hard, and there is little we can do to relieve them from their pain. Their physical pain may be inevitable and we may not be able to do much there but through palliative counseling we can at the least help relieve them of their mental and emotional pain. Although, the process of counseling might not extend client's life, but the least that could be done for them is to make that remaining time as good as possible.
Terminally ill patients usually go through mental health problems such as depression, anxiety, aggression, etc. Not only the patients but even their family members and close friends have a hard time adjusting to the idea that their loved one has limited time to exist with them and hence are highly vulnerable to these mental health problems. Palliative counseling is providing emotional and mental support for the patient and their family members. It is a skilled consultation between a psychologist and the patient in which, the professional uses their knowledge and expertise in assisting the patient to deal with their issues. The psychologist is trained in understanding the patient's problems and needs and has knowledge to come up with different coping mechanisms, solutions and perspectives. The counseling process between the psychologist and the patient can become a journey of discovery for what is important for the patient in the context of the illness and their life. The aim of conversation between the counselor and the patient is to always seek and maintain hope. Although hope is maintained, the psychologist takes special care in making sure that the patient does not develop any false hopes about their current situation. In this process, hopeful discussions about various topics such as the cure of the illness, decision-making about the patient’s care, patient’s primary relationships, meaning of life and death, etc, are explored.
Following are a few ways in which an intervention with the psychologist can help the patient.
Palliative counseling assures life, but it also helps the patient note that dying is a normal process. ‘Death is the only truth of life’ haven’t all of us heard this about death at some point of time or the other? But how many of us actually think of dying? It is possibly the last thing on our minds while doing our day to day chores. But alas, death is inevitable and everyone has to die, sooner or later. As inevitable as it may be, a lot of people, terminally ill or not, are not really comfortable with the idea of dying. As I mentioned earlier, the aim of palliative counseling is to maintain hope; it is also equally true that it does not mean that the patient is given false hope. It is made sure whatever misconceptions and concerns the patient has about their death are addressed and the patient is made comfortable and at peace with death.
Palliative counseling helps to establish a companionship with the patient so that they don’t feel isolated and left alone to die. Many terminally ill patients constantly feel lonely and fear that their loved ones will leave them alone to die. Due to this, these people need constant reassurance that they are not alone on this journey and that their family and friends still love them no matter what. Not only physical, but emotional care and support is required to be given by their loved ones and their caretakers. Talking to a psychologist can help the patient vent out their feelings and emotions and help them understand that there are people with them on this journey and they don’t have to do it all by themselves.
Counseling can help the patient and their family members bring meaning to their life and death with respect to their illness. Every good, bad and worst thing in our life has its meaning and significance in our life. The way we look at things, affects how we experience those things. Our attitudes define how we get to experience a particular event. As easier as it is to say than to actually do, everything, including the illness, has its reason to exist and helping the patient to make sense of it in their lives is one of the aims of the psychologist. This helps patients to make peace with their reality and encourage them to cherish and appreciate all the good life has presented them with up until now.
To offer utmost support and help to the family during the patient's illness and in their bereavement. Death of a loved one is not easy, especially if it is not a natural death. Although the patient is gone and is now free from all the pain and suffering, they have left all their loved ones in a deep, emotional loss. It is hard for people to accept and move on. And hence palliative counseling not only deals with the patient, but their family members even after their departure. The psychologist empathizes with all the members who have lost the patient and gives them all the appropriate care they require.
Palliative counseling not only helps the patient talk about their illness and their journey but also helps them have the right mindset during their treatment procedures. It helps the patients’ family members to care for them and communicate with the patient with care and ease.
- Moksha Patil Counsellor Cinq in
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Dr. Pranavjeet Kaldate | Consultant Psychiatrist
Piyusha Pande | Psychologist
Omkar Naik | Psychologist