Adapting to the environment when it is scalable and can only be controlled to some extent always poses challenges, often one wonders how some people, life already installed, acquire certain commitments or get involved in certain projects. From this natural search for complications and problems, we find one of the challenges that most compromise our adaptation: the news of a terminal illness. In this context, today we will talk about psychological palliative care.
One way or another, we all know that we are going to die, we know that an accident can lead to this outcome in a few moments, without being announced or planned, yet all, or at least most, breathe the hope that we still have something left. many more years.
- We’re working on this combination.
- Life invites us to make plans for tomorrow.
- A week.
- A month or two years.
- That is.
- To place death on a distant horizon or as a very distant possibility places us in space-time in a very particular way.
An architecture that inevitably breaks down when our life is compromised upon receiving the news of a terminal illness, that is why in this article we want to talk about this early grief and the most important points on which psychological palliative care tends to focus.
In these cases, the biological response is usually the same as we would have in the face of a threat, emotionally, anxiety is the most common reaction, which does not mean that other reactions cannot occur.
In large part, it will depend on the cognitive development of today, in the first moments many people opt for denial, especially if the news is sudden and not the result of previous intervention to eliminate or slow the progression of the disease.
Therefore, one of the pillars on which psychology can act to improve the quality of life of the patient is precisely to help the development of today, by building a valid story for the person, so our first task as professionals will be to listen and accompany, to meet the person in front of us.
Good research/assessment will tell us everything that has collapsed in this hope, what are the resignations associated with this premature ending that causes so much pain.
Thus, much of our assistance will be more valuable when we get the person to see himself as a useful support, a reference, an effective provider in the face of his suffering, it is not the terminal illness that requires our presence as a professional, but the suffering that results from it. Emotionally, we can be helpful, but for the disease, many of the attempts we make will not work or be unpredictable.
As a result of the anguish that the news has created, we can work at different levels, cognitively we can help the person to be placed in his new dimension of space-time.
The alternative of living the present that we see in so many books and films is not real, to leave the house we dress, to go to sleep we brush our teeth, to travel, we pack our bags. , in such cases, the person will continue to think about the future, and that should be the case.
Most interventions in this context focus on the sense of threat that comes from:
Physiologically, anxiety produces activation. Remember that it was the emotion that helped us escape the predators when we lived in the jungle, so it would be very positive if the person could release this overactivation.
To download it you can opt for relaxation techniques or even practice sport, the choice of one or the other option will depend on the physical conditions in which the patient is located, but also on their life history or the disposition and possibilities of their support circle.
In this sense, we agree with the first point of intervention raised by Mariant Lacasta in her article The role of the palliative care psychologist: identifying needs. We will have a good intervention as long as we are able to meet the needs of the patient in Our hands.
There is a lot of talk about listening to each other, what happens to normalize the patient’s emotions, including the contradictions that may arise during the process: dealing with anxiety, the fear of leaving people around them or managing that little hope that almost always remains, no matter how daunting the news.
In this case, we will not succeed in creating false expectations, but we cannot suppress moderate optimism about future events, perhaps this is one of the most sensitive parts of intervention because of the sensitivity it requires, in this sense let us think. that we will not always work with a person who is fully aware of the likely outcome or who will speak as a person who will not heal.
Often, one of our duties will be to perform a didactic exercise with your circle of support; people who will also experience their particular early bereavement and whose mental health must also be protected. There are times when the patient does not want to talk and their environment needs this communication and vice versa.
In any case, if we detect that a person is at risk it is best to plan an intervention directly with that person, in many cases it is best to take them to another healthcare professional, always maintaining communication.
On the other hand, it is preferable that the intervention be carried out in contact with other agents of the health system (S-noz Sobrino and Sastre Moyano, 1996), in this way we can find a way to preserve, as far as possible, the sense of control and autonomy.
The person may no longer be able to go for a walk alone, but can choose the schedules of the departures or clothes they want to wear, they are small details, but in these cases the details are even more important than in others because of the limitations we have in our intervention.