Chapter 1: Interpersonal challenges

The anxious patient or family member

The grief experts says
Dr. Chris MacKinnon explains how to navigate situations where the patient or the family is anxious at end of life. (3:22)Video transcript

The end of life naturally evokes anxiety for patients and families. Many patients are concerned about:

  • What the end of life will look and feel like.

  • The afterlife.

  • How their family members will be affected.

  • How their family members will manage after their death.

Family members are commonly concerned about:

  • Life without the person.
  • How they’ll cope emotionally, financially, practically (around the home, with children, running a  business).
  • What end of life will look, sound and feel like and how they’ll they handle it.

  • Whether the patient is safe and comfortable and if they’ll suffer.

Responding to anxiety

Several approaches can be used to support an anxious family member:

  •   Remove the person

Anxiety can be a contagious kind of energy. Ask the anxious person to step into another room or, weather permitting, outside with one of your colleagues. This physical separation is especially important when you observe the anxiety affecting others. However, when death is imminent, this may not be the best option if the person wants to be present at the time of death.

  •   Establish rapport

Acknowledge and normalize their distress. Reassure the person you’re there to help. Make gentle eye contact, speak clearly and with compassion, and move slowly.

  •   Model a regular breathing rhythm 

Breathe deeply and audibly, slowly exaggerating the sounds of the in and out breath. Invite them to take a few breaths with you.

  •   Suggest a distraction

Assign a task if the person seems up to it. People often feel less helpless when they can focus their energy and attention. Purposeful activity may reduce their anxiety. For example, ask them to:

    • Put on favourite music.
    • Make tea or coffee.
    • Get warm blankets or cold compresses.
    • Stroke the patient’s hand and reassure them while you and your partner work.

Conversation Prompts

Please look into my eyes. We’re going to get through this together. I’m here to help.

Listen to the way I’m breathing. See if you can follow me. You’re doing great.

In the case of a panic attack

Acknowledge how difficult the situation is and reassure them that the panic attack will end. Once it has passed, ask if this has happened before and encourage them to see their family doctor or a mental health professional if they haven’t already done so. In some situations, another family member may be able to help.