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

This information is sourced from Dr Heather Wells, Clinical Psychologist

Anxiety is a natural response to stresses in our lives and is common in people living with a Palliative diagnosis.

What is anxiety?

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.

Common symptoms of anxiety
  • restlessness and irritability
  • feeling tired
  • bowel discomfort
  • breathlessness
  • excessive worry
  • not being able to concentrate
  • muscle tension
  • disturbed sleep
  • a constant feeling of dread

Some people may have panic attacks, where they feel sudden, intense or overwhelming fear and discomfort, lasting up to 30 minutes. They may cause strong physical symptoms such as: chest pain, dizziness, pounding heart, sweating or shaking.

Risk factors for anxiety in palliative care

For most patients with advancing illness, symptoms of anxiety are normal and understandable responses to the uncertainties about their future and the possibility of approaching death.

Other possible risk factors for anxiety in patients at this stage of life include:

  • Pain and other overwhelming symptoms
  • End of active treatment for an illness – people may struggle to adjust when their treatment eg chemotherapy stops 
  • Being isolated from friends and family
  • Family worries – for example, worrying about being a burden or worry about dependants
  • Financial worries/ Employment/ immigration status/ housing conditions
  • Spiritual distress
Managing anxiety

Talking to someone you trust. People may find it reassuring if they’re able to speak to the same professional over a period of time

Every Mind Matters offer practical tips for anxiety management 

Breathing exercises are often a helpful way to manage the symptoms of anxiety

Practical help – for example, help housing or finances

Symptom management, such as pain control

Medication (in some cases, a combination of medication and psychological therapy is recommended)

Spiritual care – supporting people to feel a sense of meaning, comfort, strength and connection in their life

Some patients may need additional care and may benefit from initially speaking to their palliative care providers for advice and support. They may consider an onward referral to specialist psychological support within the local Clinical Psychology Service or Talking Therapies Service (IAPT).

Recommended book : Free yourself from Death Anxiety. A CBT Self-Help Guide for a Fear of Death and Dying.  Menzies and Veale 2022

 

Recommended Resources

Marie Curie - Symptom Control - Anxiety

Published 10th February 2020

NICE Generalised anxiety disorder and panic disorder in adults: management

Published 15th June 2020

Share

Related Services

24 hour Advice Line Michael Sobell Hospice
Close

24 hour Advice Line Michael Sobell Hospice

T. 0203 824 1268

Offers support and advice on palliative care issues to GPs, Care Homes, District Nurses and hospital doctors.

It is also an Advice Line for patients and families who live in Hillingdon and need advice on any aspect of palliative care. 

The Advice Line is answered by hospice nurses in the Inpatient Unit and queries are escalated to the on-call palliative medical team if needed.

Breatheasy groups
Close

The support group is a way to learn more about living with a lung condition and share your experiences and stories with others.

CNWL Talking Therapies Service
Close

CNWL Talking Therapies Service provides psychological therapies. Self-referral accepted via the website for adults who are registered with a Brent, Harrow or Hillingdon GP.

Support is available for a range of difficulties, such as low mood or depression, anxiety, and stress, phobias, physical health anxiety, PTSD and Insomnia.

Hillingdon Community Palliative Care Team
Close

Hillingdon Palliative Care Team (hosted by NHS CNWL) provides specialist advice and visiting to palliative care patients living in Hillingdon. Each GP practice has their own named Clinical Nurse Specialist ( CNS ). A Triage CNS manages calls and referrals each day and they have the option to escalate to consultants if needed.

They can be contacted Monday to Friday 8.00am to 4.30pm excluding bank holidays.

Out of hours phone Michael Sobell Hospice 24 hour Advice Line on 020 3824 1268

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.1 (DOCX)

Related Articles

1st March 2024

Books to better understand dying, death and palliative care

12th March 2023

Financial help when you are living with a terminal illness

Feedback