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Palliative care - fear and anxiety

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

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.

You might feel:

  • That things are not right
  • Fear
  • Worry
  • Confused
  • Unable to pay attention, focus, or concentrate
  • Loss of control
  • Tense

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 doctor 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 doctor or pharmacist.

When to Call the Doctor

Call your doctor 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

Irwin SA, Montross LP, Chochinov HM. What treatments are effective for anxiety in patients with serious illness? In: Goldstein NE, Morrison RS, eds. Evidence-Based Practice of Palliative Medicine. Philadelphia, PA: Elsevier Saunders; 2013:chap 34.

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.

Update Date 2/6/2016

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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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