Mental health involves our emotional, psychological, and social wellness; it affects our emotions and determines our actions. The state of our mental health will affect how we handle stress, relationships, and important decisions. Understanding how mental health and well-being integrate into hospice care is essential for patients and their families. Maintaining the happiness and safety of patients is the primary goal of hospice care, and diagnosing any mental health concerns is vital to helping patients and families to cope.  

hospice care counseling

Many different types of mental illness may surface when a patient is in hospice care, such as: 

  • General anxiety, panic attacks, and phobias
  • Depression and bipolar disorder 
  • Hallucinations and schizophrenia
  • Anorexia, bulimia, and binge eating
  • Alcohol or drug abuse
  • Obsessive-compulsive disorder (OCD) and paranoid personality disorder

Addressing Mental Health in Hospice Care

Hospice care focuses on mitigating a terminally ill patient’s physical pain while providing necessary end-of-life emotional and spiritual support. 

While every patient’s hospice care plan is unique, it is essential to understand that hospice care patients often exhibit symptoms of mental health issues. Approximately 15%-20% of terminally ill patients are diagnosed with significant depression. When an individual’s mental health is not correctly addressed, other serious problems may develop, such as family and relationship issues, financial and legal troubles, self-harm and suicidal thoughts, and social isolation. Physical health conditions such as heart disease, high blood pressure, a compromised immune system, and obesity may also manifest. A compassionate life and plan for a hospice patient require treatment for not only the terminal illness but the mental health issues they may be living with.

It is best for the patient if a mental health plan is developed and initiated before they arrive in hospice care. This strategy would allow them to continue with familiar treatments when they enter palliative care. However, not all patients have doctors or families who have considered the mental health aspect of end-of-life planning. Hospice workers should ask about obtaining an accurate diagnosis so a treatment plan can be created and implemented as soon as possible.

In a hospice care environment, mental health professionals must meet the patient where they are, acknowledging and respecting their circumstances and the decisions they have made for their own care. One of the more challenging aspects of mental health in hospice care is determining if the patient has a genuine mental disorder or if they are experiencing a symptom of their illness or a side effect from their prescription medications. Once a mental health condition has been identified and diagnosed, a specific care plan will be developed and adapted over time as the patient moves through their end-of-life journey. 

Both palliative hospice care services and mental health care are essential for every terminal patient. Working side-by-side with their physicians, patients should feel comfortable in their care and overall well-being.

Although the stigma of seeking mental health counseling is significantly less prominent in today’s culture, treatment for hospice care patients has not seen the same level of acceptance. However, it is clear that patients and their loved ones have a desire and need to communicate their feelings during this challenging and emotional time. Caregivers must notice how their treatment is tolerated and speak with their doctor if they feel their emotions and mental health are compromised. 

Denise Schonwald is a nationally certified mental health counselor with experience in palliative and hospice care counseling. If your loved one is entering this season of their life, call Denise today to learn more about how the appropriate treatment can ease distress, suffering, and other mental health trauma and make the hospice experience as positive for the family as possible. 


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