Psychosocial and spiritual support is a common need for people affected by a life-limiting illness. Identifying and addressing these needs is an integral part of palliative care.
Psychosocial care attends to the psychological and social aspects of a person’s life. Psychological characteristics include emotions, thoughts, attitudes, motivation, and behaviour. Social aspects include the way in which a person relates to and interacts with their environment. This includes a person’s sense of identity, relationships and living arrangements.
A psychosocial approach looks at a person in the context of their psychological status and the surrounding social environment and the way they influence the person’s physical and mental health and ability to function.
As palliative care seeks to address the physical, psychological, social, and spiritual needs of the person and their family and carers, psychosocial care is a fundamental part of this.
Nurses are in a unique position to monitor for psychosocial care needs and distress. By building rapport, nurses can begin to understand how patients view themselves, what is important to them, and how their relationship with others may affect their decisions and their ability to live as they approach death.
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
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.
can indicate possible psychosocial needs include:
Download Palliative Care Network of Wisconsin - Psychosocial Assessment in Palliative Care
Download Psychosocial Assessment in Palliative Care
A psychosocial needs assessment can include different questions depending on the person and the context of care. The Palliative Care Network of Wisconsin has suggestions on what to say when assessing psychosocial needs including the person’s:
The validated tools available to assess and monitor psychosocial needs include:
If you use a tool, continue to use the same tool to monitor for change.
In supporting a
person’s psychosocial needs nurses can:
Psychosocial interventions should address the specific needs of the person, whether it is ways to cope with symptoms, enhance their sense of dignity, or start a difficult conversation with healthcare providers about prognosis and treatment.
Common psychosocial interventions used in palliative care include
These interventions may need to be brief to improve quality of life and reduce emotional and existential distress in end-of-life care.
This information was drawn from the following resources:
Visit palliAGED Practice Centre - Psychosocial Care
Go to Providing Emotional Care by Marie Curie
See more Psychosocial Care Resources
Page created 15 August 2022