Elizabet Tskhadiashvili on the Benefits of Counseling for Palliative Care Patients and...

Elizabet Tskhadiashvili on the Benefits of Counseling for Palliative Care Patients and their Families

Elizabet Tskhadiashvili

Elizabet Tskhadiashvili is a wellness and healthy lifestyles writer who contributes to several online publications.  Below, Elizabet Tskhadiashvili discusses how important it is to attend to the spiritual, emotional, and mental health needs of those in palliative care.

Palliative care helps people with terminal illnesses maintain quality of life. But aside from treating physical symptoms with medicines and therapy, Elizabet Tskhadiashvili says the best programs include counseling and other psychological services for patients and their families.

This article provides the benefits of counseling in palliative care, and the kind of support that patients and their families may need while facing such an existential crisis.

Counseling can address the emotional aftermath of diagnosis

Elizabet Tskhadiashvili explains that when a person is diagnosed with a life-changing or life-threatening illness, it’s normal to experience an upheaval of emotions, such as:

  • Fear. They may be afraid of losing their independence and becoming a burden or worry about how the disease (or death) may affect their loved ones. They can also be afraid of pain as the disease progresses, the side effects of treatment, and death.
  • Sadness. While this is a very normal reaction, it can escalate into depression and withdrawal from other people. Some patients may even refuse treatment because they have lost hope and will to live.
  • Anger. Patients may feel resentment (“Why did it have to happen to me?”), or express hostility towards caregivers and family members.
  • Insecurity. As their physical condition deteriorates and impairs mobility and self-care, patients may start feeling “useless” and “inadequate”.

Counseling helps support families and caregivers

Elizabet Tskhadiashvili reports that families and caregivers may also go through similar emotions, and their reaction may be compounded by the physical and financial demands of providing care. Counseling may be needed to address:

  • Stress and anxiety. Caregiver stress and burnout is real, and can lead to physical problems like physical exhaustion, sleep disorders, poor focus and concentration, anxiety attacks, mood swings, and a higher risk for substance abuse and depression. These affect not just the caregiver’s health, but his or her ability to care for the patient.
  • Guilt. Elizabet Tskhadiashvili notes that caregivers are often exhausted, but they still feel guilty for not doing enough or neglecting other areas of their life because of the time they spend with the patient. They may also repress negative emotions, because they it is bad/unloving/unfilial to resent having to take a caregiver role.   
  • Pain and grief. It is hard to watch a loved one become sick and experience pain, and even harder to imagine life without them. Family members may swing from wanting the person to be free from pain, and clinging to them—and need counseling to articulate and process these conflicting emotions.
  • Unresolved family issues. Old resentments, conflicts, traumas, and complicated family dynamics can resurface or intensify during a health crisis.

Counseling is also necessary for families to cope with the changes to their routine and their relationship to the patient says Elizabet Tskhadiashvili, and eventually, to the reality that their loved one “is not going to get better.”

Palliative care experts call this final stage Fading Away, or the end of life as they know it: lack of mobility, extreme weakness, and diminished mental capacity. Families will go through several stages of acceptance – from initial denial, to taking it day by day, and finally preparing for death.

At each stage, counseling can help family members articulate the feelings, find coping mechanisms, and prepare both themselves and the patient for the end.

Elizabet Tskhadiashvili

Supporting family members before making important medical decisions

Elizabet Tskhadiashvili explains that when the patient is unable to make important medical decisions, the family must have to on his behalf. This may include discontinuing treatment, removing life support, or whether or not to proceed with a high-risk surgery.

Counseling can help families process emotions, manage conflicts, and weigh the medical and financial impact of each option. While the families will still have to make the choice themselves, they don’t feel they are alone. Sometimes, just being able to “vent” to a neutral, sympathetic outsider can help give them the strength and clarity to take charge of a situation.

Elizabet Tskhadiashvili says social and spiritual needs still need to be met

According to the American Counseling Association, terminally ill patients have increased social and spiritual needs, and need as much support as possible to find meaning in their lives and in their illness.

While families can provide company and comfort, patients may hide their feelings because they don’t want to distress or burden them even more. Elizabet Tskhadiashvili explains that counselors provide a “safe place” where they can freely share thoughts, fears, or even their final wishes.

Counselors are also trained to use developmentally appropriate techniques for children who are in palliative care and employ methods like art therapy to help them articulate very intense and complicated feelings.

Counseling and psychological services are crucial for holistic palliative care

Palliative care uses a multi-disciplinary approach, explains Elizabet Tskhadiashvili, and often involves a team of specialists who address the patient’s specific needs.

But everyone—regardless of age, medical condition, or circumstance—will face emotional and psychological struggles after a difficult diagnosis. Counseling and psychological services are a critical part of any truly holistic palliative care program, and can help patients and their families find clarity, hope, and peace of mind during one of the most difficult times of their lives.