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Last updated on 2024年8月2日

You're faced with end-of-life care decisions. How do you cope with emotional exhaustion in the process?

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Facing end-of-life care decisions for a loved one is an emotionally taxing journey that can leave you feeling drained and overwhelmed. The responsibility of making critical choices about healthcare, comfort, and dignity during a person's final days can weigh heavily on your shoulders. It's a period marked by a complex mix of feelings, including sadness, guilt, and sometimes relief, all of which can contribute to emotional exhaustion. Navigating this challenging time requires not only practical decision-making but also a compassionate approach to self-care and emotional management.

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1 Seek Support

During this difficult time, it's crucial to seek support from friends, family, or professional counselors. Sharing your feelings with others who understand what you're going through can provide a sense of relief and perspective. Support groups specifically for end-of-life care can also be invaluable, offering a space to express your emotions freely and learn from others' experiences. This network of support acts as a buffer against the isolation that often accompanies caregiving and decision-making in end-of-life situations.

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Rejane Vieira

Neuropsicopedagoga, Gerontóloga, Neurocoach, Terapeuta Holística e TCC para idosos, Professora, Analista DISC, Palestrante
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Conhe?o histórias de pessoas que venceram os últimos dias, desenvolvendo a clareza sobre as coisas pelas quais est?o passando. O entendimento de que somos responsáveis por nossos comportamentos e escolhas, se bem trabalhado, pode nos dar o poder de autocuidado Quanto mais nós sentimos vítimas do acaso, ou os que nos escutam, nos permitem ou nos colocam neste lugar, mas refém ficamos da situa??o e isso certamente n?o contribui para um estado de paz, o que na morte, acredito eu, se torna até menos dolosa para quem fica, além da probabilidade de prover um sobrevida à quem a desenvolve.

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Burton Singerman

Psychiatrist, Cibola Psychiatry (cibolapsych.com). Past Chairman, three academic psychiatry departments. Named Exemplary Psychiatrist of the Year,National Alliance on Mental Illness
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Having an excellent professional support group that meets to discuss clients and share issues that are draining you is incredibly helpful. One can’t be isolated dealing with difficult client issues. Others can help normalize your feelings.

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Christine Gibson MD

Family Physician, International Keynote Speaker (2xTEDx), Author of The Modern Trauma Toolkit, Director of Safer Spaces Training
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Palliative care and geriatrics are typically multidisciplinary care teams to address many needs holistically. Challenges include physical symptoms, psychological stress, caregiver burnout, legal ramifications, and financial changes. Seeking support for all of this should involve social work, transition services, and lawyers. From a position of emotional distress, share with everyone involved that this is expected and to proactively find support before they feel like they need it (or reach crisis).

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Monica Machado

Psicologa
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Seria importante que o apoio emocional e psicológico no processo de envelhecimento/ doen?a terminal fossem reais em Portugal. Na verdade, a maioria das institui??es de cuidados continuados, lares, cuidados paliativos n?o tem nas suas equipas profissionais formados em saúde mental que possam auxiliar os pacientes/ clientes/ idosos na sua fase final e inclusive estes profissionais s?o relevantes para os próprios cuidadores e famílias, que sentem sempre até ao último momento que ir?o ser capazes de superar aquela perda ou que est?o preparados para a perda, o que culmina, em alguns casos, com processos de luto patológico.

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Rosana da Matta

Fitoterapeuta | Aromatóloga | Terapeuta Floral | Perfumista Botanica | Consultora de Projetos
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Todo processo de ir para a vida, de se movimentar para algo, envolverá um gasto energético para sustentar a autodetermina??o rumo ao sucesso desejado. Fazer pausas para reabastecer é importante. Os aportes para dar suporte a caminhada, inclusive para superar as pedras do caminho. Uma reflex?o sobre os valores e pilares da vida vai ajudar. Seja cuidados com alimenta??o, fé, medita??o para respira??o consciente, atividades físicas, uma caminhada, amigos para dar risada e claro, n?o tenha medo de pedir ajuda profissional.

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2 Understand Grief

Understanding that grief is a natural response to impending loss can help you cope with emotional exhaustion. Grief doesn't follow a linear path and can manifest in various ways, from sadness and anger to numbness. Recognizing these emotions as part of the grieving process can allow you to accept them without judgment. It's important to give yourself permission to feel whatever comes up and know that it's a normal part of saying goodbye.

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Christine Gibson MD

Family Physician, International Keynote Speaker (2xTEDx), Author of The Modern Trauma Toolkit, Director of Safer Spaces Training
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The modern concept of grief comes from the work of Dr. Elizabeth Kubler-Ross, but interestingly, this research was based on chronic disease in general - not necessarily end of life. As we lose our physical and psychological capacities, we grieve each stepwise decline. One excellent resource is the book "It's OK that You're Not OK" by Megan Devine.

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3 Self-Care Rituals

Implementing daily self-care rituals can be a cornerstone in managing emotional exhaustion. This might include activities that you find calming or rejuvenating, such as meditation, reading, or walking. Prioritizing your well-being helps to replenish your emotional reserves, making it easier to face the demands of end-of-life care. Remember, taking care of yourself isn't selfish—it's necessary to maintain the stamina required for this journey.

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Christine Gibson MD

Family Physician, International Keynote Speaker (2xTEDx), Author of The Modern Trauma Toolkit, Director of Safer Spaces Training
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Self-care can take many formats from routines - this can be mindful eating, mindful walking, mindful toothbrushing - to formal therapy. We should consider both somatic (body-based or bottom-up) and cognitive (mind-based or top-down) forms of regulating the nervous system and stress levels. My book The Modern Trauma Toolkit has 40 activities that can be tried, including examples of both. Some to try include (1) creative expression, perhaps it's journaling gratitude or recording historical moments, (2) music playlists that match our nervous system state (active or calm), (3) finding time to connect - in nature, with others (pets matter too), with spirituality, (4) creating a path to legacy, to leave behind traces of what matters most to you.

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4 Set Boundaries

Setting boundaries is essential to prevent burnout. This might mean delegating tasks, saying no to additional responsibilities, or limiting the time spent discussing end-of-life decisions. Boundaries help protect your energy and provide space for you to process your emotions. It's okay to take a step back and breathe when you need to; doing so will help you maintain the strength needed to support your loved one.

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Christine Gibson MD

Family Physician, International Keynote Speaker (2xTEDx), Author of The Modern Trauma Toolkit, Director of Safer Spaces Training
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One of the best concepts related to chronic illness was created by a community member who has experienced it directly - Spoon Theory is a bit like the metaphor of a battery or a gas tank. For those who are at end-of-life, they are beginning the day with less energy supply. So they have to spend it wisely. Boundaries are one of the ways we can do this. When you need to pace yourself, you cannot move the same way. When you have little energy, you have to manage relational expectations differently. When you have finite time with multiple competing priorities, you have to deeply consider what matters most.

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5 Professional Help

If the emotional toll becomes too heavy, seeking professional help from a therapist or counselor trained in end-of-life care can be a lifeline. They can offer coping strategies tailored to your specific situation and help you navigate complex feelings. Professional support can provide clarity and guidance, ensuring you don't have to face this journey alone.

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Christine Gibson MD

Family Physician, International Keynote Speaker (2xTEDx), Author of The Modern Trauma Toolkit, Director of Safer Spaces Training
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Many palliative care teams will include a counsellor or therapist. They will specialize in the kinds of issues faced at end of life. It's best to engage with them before a crisis intervention is necessary. We should normalize seeking support.

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6 Reflect & Recharge

Finally, take time to reflect on the journey and recharge when possible. Whether it's through journaling, spending time in nature, or engaging in a hobby that brings you joy, these moments of reflection and recharging can provide emotional relief. They allow you to step away from the immediate pressures of decision-making and caregiving, offering a respite for your heart and mind.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Sarah Mann Willcox

Executive Director at N.C. Network of Grantmakers
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My husband passed away after 6 years of intense cancer treatment. We had many difficult conversations in advance of the “end stages” so they weren’t decisions so much as fulfilling his wishes. Would encourage everyone to have those conversations now - long before they are necessary!

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You're faced with end-of-life care decisions. How do you cope with emotional exhaustion in the process?

1

2

3

4

5

6

7

1 Seek Support

2 Understand Grief

3 Self-Care Rituals

4 Set Boundaries

5 Professional Help

6 Reflect & Recharge

7 Here’s what else to consider

Healthcare

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You're faced with end-of-life care decisions. How do you cope with emotional exhaustion in the process?

1

2

3

4

5

6

7

1 Seek Support

2 Understand Grief

3 Self-Care Rituals

4 Set Boundaries

5 Professional Help

6 Reflect & Recharge

7 Here’s what else to consider

Healthcare

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