Psychosocial care

Good communication and assessment skills can help nurses develop a strong relationship with the person and their family. A structured and holistic assessment enables nurses to identify the needs of people in their care and help connect them to services that can provide appropriate support.

It is not uncommon for people to require repeated conversations to make sense of new information or changes, particularly if they are anxious. Allow them to ask questions, repeat information and offer a space for people to absorb and understand their situation. This can help prevent misunderstandings, alleviate worries, and decrease feelings of isolation.

Applying a “total” approach to symptoms helps to understand the symptom(s) within the person’s context. For example, management of pain or breathlessness may need to consider the relationship with the person’s feelings such as anxiety, fear, guilt, and anger or worries about the family. Responding to changes in appetite may need to consider the social and cultural attitudes of the person and their family to eating and drinking.

Physical symptoms can indicate possible psychosocial needs include:

• breathlessness
• insomnia
• pain
• sadness
• crying
• changes to appetite or weight.

In supporting a person’s psychosocial needs nurses can:

• use the fundamental skills of nursing care such as active listening, comforting touch (as appropriate), empathy, and encouragement.
• listen to concerns and acknowledge and respond empathically to feelings that are expressed
• ask open questions to invite the person to talk about how they are feeling.
• encourage the person to talk about their fears and worries in a calm, private and safe environment.
• listen actively and without judgement.
• acknowledge how the person is feeling and find out how they prefer to be supported emotionally.
• be prepared for people in their care to cry. Crying is a common emotional response and expression of distress. If a person cries suddenly, avoid feeling pressured to 'say the right thing' and sit with them in silence. Showing empathy, offering respectful physical touch, and offering a chance to talk, are good ways to support a person who is crying.
• encourage the person to think about how they want to be cared for; this may help them feel more in control.
• for people who are vulnerable or face barriers to accessing care, identify someone to assist with communication between palliative care services and other services (mental health, disability support, social services).