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

This information is sourced from Marie Curie, NICE and 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.

Accordion body...

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 20

 

Recommended Resources

Marie Curie - Symptom Control - Anxiety

Published 10th February 2020

NICE Generalised anxiety disorder and panic disorder in adults: management

Published 5th June 2020

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