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Palliative care - fear and anxiety

It is normal for someone who is sick to feel uneasy, restless, afraid, or anxious. Certain thoughts, pain, or trouble breathing may trigger these feelings. Palliative care providers can help the person cope with these symptoms and feelings.

Palliative Care

Palliative care is a holistic approach to care that focuses on treating pain and symptoms and improving quality of life in people with serious illnesses.

When You Have Fear or Anxiety

Fear or anxiety may lead to:

  • Feelings that things are not right
  • Fear
  • Worry
  • Confusion
  • Unable to pay attention, focus, or concentrate
  • Loss of control
  • Tension

Your body may express what you are feeling with:

  • Trouble relaxing
  • Trouble getting comfortable
  • Needing to move for no reason
  • Fast breathing
  • Fast heartbeat
  • Shaking
  • Muscle twitches
  • Sweating
  • Trouble sleeping
  • Bad dreams or nightmares
  • Extreme restlessness (called agitation)

How to Help Yourself

Think about what worked in the past. What helps when you feel fear or anxiety? Were you able to do something about it? For example, if the fear or anxiety started with a pain, did taking pain medicine help?

Use the energy of the feeling to do something, such as:

  • Write down what you are feeling and thinking.
  • Exercise.
  • Talk to someone.

To help you relax:

  • Breathe slowly and deeply for a few minutes.
  • Listen to music that calms you.
  • Slowly count backward from 100 to 0.
  • Do yoga, qigong, or tai chi.
  • Have someone massage your hands, feet, arms, or back.
  • Pet a cat or dog.
  • Ask someone to read to you.

To prevent feeling anxious:

  • When you need to rest, tell visitors to come another time.
  • Take your medicine as it was prescribed.
  • DO NOT drink alcohol.
  • DO NOT have drinks with caffeine.

Many people find they can prevent or manage these feelings if they can talk to someone they trust.

  • Talk to a friend or loved one who is willing to listen.
  • When you see your doctor or nurse, talk about your fears.
  • If you have worries about money or other issues, or just want to talk about your feelings, ask to see a social worker.

Your health care provider can give you medicine to help with these feelings. Do not be afraid to use it the way it is prescribed. If you have questions or concerns about the medicine, ask your provider or pharmacist.

When to Call the Doctor

Call your provider when you have:

  • Feelings that may be causing your anxiety (such as fear of dying or worrying about money)
  • Concerns about your illness
  • Problems with family or friend relationships
  • Spiritual concerns
  • Signs and symptoms that your anxiety is changing or getting worse

Alternative Names

End of life care - fear and anxiety; Hospice care - fear and anxiety

References

Maytal G, Hutner LAE, Cassem NH, Brendel RW. Psychiatric and ethical aspects of care at the end of life. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 60.

Rakel RE, Trinh TH. Care of the dying patient. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 5.

Review Date 2/18/2018

Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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