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Psychosocial issues in advanced illness

Laurie Rosenblatt, MD
Fremonta L Meyer, MD
Section Editors
Kenneth E Schmader, MD
Susan D Block, MD
Deputy Editor
Diane MF Savarese, MD


Psychosocial concerns are nearly universal among patients who have advanced life-threatening illnesses. Patients face challenges to their sense of wholeness. The ways in which people respond to these threats to personal integrity range from highly effective strategies for coping to dysfunctional reactions, often in the same person at different times. Patients undergo adjustment in response to these challenges, during which they may deny, withdraw, or become sad and angry at care providers, family members, friends, themselves, or God. Understanding these issues and the ways in which they interact with physical distress is essential to assessment and management in end of life care.

This topic presents an overview of psychosocial issues for patients with an advanced illness who enter palliative care. In addition, this topic provides a series of questions to use with patients and caregivers that can guide the clinician in discussing sensitive issues. Other topics in UpToDate discuss specific issues related to psychosocial issues in palliative care in more detail.

(See "Communication of prognosis in palliative care".)

(See "Discussing serious news".)

(See "Overview of spirituality in palliative care".)


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Literature review current through: Sep 2016. | This topic last updated: Feb 5, 2016.
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