Anxiety towards the end of life: Information for patients and carers

Anxiety is a feeling of worry or fear. It can be helpful in the short term by keeping us alert and ready to act in response to danger. However, if these feelings continue for a long time or are difficult to cope with, they can affect quality of life.

• restlessness and irritability
• feeling tired
• breathlessness
• not being able to concentrate
• muscle tension
• disturbed sleep
• a constant feeling of dread
• panic attacks (sudden, intense or overwhelming fear often accompanied by chest pain, dizziness, pounding heart, sweating or shaking)

Worrying about the future when you are seriously ill is normal. Issues that can make anxiety worse include:

• Pain and other overwhelming symptoms
• End of active treatment for an illness, people may struggle to adjust when their treatment e.g. chemotherapy stops 
• Being isolated from friends and family
• Family worries for example, worrying about being a burden or future care of partners or children
• Financial worries/ Employment/ immigration status/ housing conditions
• Spiritual distress

Here are some approaches that people may find helpful:

• Every Mind Matters offer practical tips for anxiety management 
• Breathing exercises are often a helpful way to manage the symptoms of anxiety
• Practical help is important for example with finances
• Spiritual care - talking about what gives life meaning and brings comfort 
• Reading books: Free yourself from Death Anxiety. A CBT Self-Help Guide for a Fear of Death and Dying. Menzies and Veale 2022
• Symptom management, such as pain control
• Some people may need additional care and should speak to their GP or palliative care team to consider medication and/or a referral to their local Talking Therapies Service (IAPT)