It is normal for someone who is sick to feel uneasy, restless, afraid, or anxious. Certain thoughts, pain, or trouble breathing may trigger these feelings. Palliative care providers can help the person cope with these symptoms and feelings.

End of life care - fear and anxiety; Hospice care - fear and anxiety

Palliative care is a holistic approach to care that focuses on treating pain and symptoms and improving quality of life in people with serious illnesses and sometimes a limited life span.

Fear or anxiety may lead to:

• Feelings that things are not right
• Fear
• Worry
• Confusion
• Unable to pay attention, focus, or concentrate
• Loss of control
• Tension

Your body may express what you are feeling in these ways:

• Trouble relaxing
• Trouble getting comfortable
• Needing to move for no reason
• Fast breathing
• Fast heartbeat
• Shaking or tremors
• Muscle twitches
• Sweating
• Trouble sleeping
• Bad dreams or nightmares
• Extreme restlessness (agitation)

Think about what worked in the past. What helps when you feel fear or anxiety? Were you able to do something about it? For example, if the fear or anxiety started with a pain, did taking pain medicine help?

To help you relax:

• Breathe slowly and deeply for a few minutes.
• Listen to music that calms you.
• Slowly count backward from 100 to 0.
• Do yoga, qigong, or tai chi.
• Have someone massage your hands, feet, arms, or back.
• Pet a cat or dog.
• Ask someone to read to you.

To prevent feeling anxious:

• When you need to rest, tell visitors to come another time.
• Take your medicine as it was prescribed.
• Do not drink alcohol.
• Do not have drinks with caffeine.

Many people find they can prevent or manage these feelings if they can talk to someone they trust.

• Talk to a friend or loved one who is willing to listen.
• When you see your health care providers, talk about your fears.
• If you have worries about money or other issues, or just want to talk about your feelings, ask to see a social worker.

Your provider can give you medicine to help with these feelings. Do not be afraid to use it the way it is prescribed. If you have questions or concerns about the medicine, ask your provider or pharmacist.

Contact your provider when you have:

• Feelings that may be causing your anxiety (such as fear of dying or worrying about money)
• Concerns about your illness
• Problems with family or friend relationships
• Spiritual concerns
• Signs and symptoms that your anxiety is changing or getting worse

Arnold RM, Kutner JS. Palliative care. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 3.

Cremens MC, Robinson EM, Brenner KO, McCoy TH, Brendel RW. Care at the end of life. In: Stern TA, Freudenreich O, Smith FA, Fricchione GL, Rosenbaum JF, eds. Massachusetts General Hospital Handbook of General Hospital Psychiatry. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 46.

Iserson KV, Heine CE. Bioethics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap e6.