Volunteers and psychologists reflect on the personal in palliative care
An article written by Dr Florence Chiew, Clinical Psychologist in Supportive & Palliative Care, Nepean Blue Mountains Local Health District
For those of us supporting patients and families in palliative care, it seems only natural and inevitable that this experience evokes powerful personal reactions. Being with people who are critically ill and dying can be psychologically and emotionally confronting. Yet, we don’t often talk about this personal-professional interface – the feelings, beliefs, and meanings that arise when our life experiences meet the suffering of others. Surprisingly, empirical research has largely overlooked this deeply human dimension of palliative care work.
My own path into palliative care began as a volunteer, then as a researcher, and now as a psychologist. Although I did not consciously join the dots at the time, my enduring interest in questions about death and dying was in part motivated by significant losses in my life. In hindsight, I could see that my research was a kind of “me-search,” an attempt to make sense of grief and mortality by turning toward them, in the company of people who offer resilient reminders of what it's like to bear the unbearable finitude of life.
Together with colleagues from the Cairnmillar Institute and Australian Catholic University, I conducted two qualitative studies exploring how personal feelings and responses to death and dying, grief and loss, intersect with the work of palliative caregiving.
The first study, published in 2023, involved interviews with 11 palliative care volunteers. [1] While volunteering is defined by the absence of monetary pay, it is, nonetheless, a form of care work, an offering of time, skills and labour in service of others. In our interviews, we asked volunteers with a lived experience of grief and bereavement to reflect on their previous losses in relation to their volunteering role. Volunteers described how their personal experiences of grief and loss deepened their empathy for those they supported and, in turn, invited reflection on life’s meaning and purpose. Many found their own grief normalised in the process of connecting with another’s grief experience. Importantly, these findings suggest that when processed reflectively, personal grief can become a powerful source of empathy and presence, challenging assumptions that bereaved individuals need to “resolve” their loss before serving in caregiving roles.
In a second study, published in 2025, 11 psychologists were asked to reflect on their beliefs, attitudes, and feelings about death and dying in the context of their professional practice in palliative care. [2] Psychology is still a relative newcomer to palliative care, and participants often described how this work had expanded or transformed their professional identity. Nearly every participant shared moving accounts of how working in palliative care reshaped their understanding of what it means to live and die well. These reflections align with existing research on other palliative care professionals such as doctors and nurses, suggesting that working with dying patients can deepen one’s appreciation for life, reorient priorities and enhance gratitude and self-compassion.
Taken together, these two studies highlight the complex interplay between the personal and the professional in palliative care. They show us how our lived experiences and emotional responses can and do inform professional caregiving roles – and how, in turn, being with dying patients transforms one’s sense of meaning, mortality and vocation.
Practically, the findings from these two studies underscore the importance of cultivating self-reflection and self-awareness as an essential and ongoing part of providing supportive and palliative care. Regardless of whether participants are volunteers or psychologists, those able to critically and honestly reflect on the impact of their personal histories, vulnerabilities and faith-based or cultural beliefs appear to be enlivened by the work even when it is felt to be challenging. Creating space for this reflective practice—through supervision, tailored training, or peer support—may be as important to quality palliative care as any clinical intervention.
References:
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Chiew F, Windsor N, Modesto O. Beautiful even if it’s very sad: Psychologists’ beliefs, attitudes and feelings about death and dying in palliative care. Death Studies.1-12.
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Chiew F, Krupka Z. You’re teaching me something about living: Australian palliative care volunteers’ evolving experiences of grief and loss. OMEGA - Journal of Death and Dying. 2023;91(4):1823-1843.
Author
Dr Florence Chiew
Clinical Psychologist in Supportive & Palliative Care
Nepean Blue Mountains Local Health District