Anxiety At The End of Life

Feelings of nervousness, also known as anxiety, are normal responses when things feel uncertain or beyond your control. Because of the many physical and emotional changes associated with illness, feelings of nervousness may occur. Although anxiety is a natural response, being nervous is uncomfortable and can affect the quality of your life.

Causes of Anxiety
Over the course of an illness, there are things that can cause feelings of anxiety or nervousness. It is helpful to identify what may be causing you to feel anxious. Identifying the cause of your nervousness will be helpful in determining what to do about it. However, it is possible to feel anxious without being able to say why. Some of the things that may cause feelings of anxiety include:

• Fear of the unknown
• Changes in how the disease is advancing
• Fear about relieving symptoms such as constipation, pain or shortness of breath
• Concerns about medications
• Fear about giving or receiving care
• Fear about not being able to care for yourself 
• Fear of physical or emotional loss
• Responding to changes in your life
• Concerns about your family or loved ones
• Concerns about moving to a nursing home or assisted living facility
• Unexpected news, favorable or unfavorable
• Fear related to making decisions about the future
• Concerns about making the right decisions
• Questions or concerns about spiritual or religious issues
• Financial concerns
• Changes in your role within the family or the community

Signs and Symptoms of Anxiety
Each person responds differently to situations which cause feelings of anxiety. Your body has many different ways of showing anxiety. Knowing that you may be nervous is the first step to feeling better. Some of the more common symptoms of anxiety include:

• Restlessness or not being able to relax
• Irritability
• Stomach upset or nausea
• Butterflies in the stomach and/or feeling as though there is a lump in your throat
• Muscle tension, aches, soreness or just feeling tense
• Feeling very tired or exhausted
• Trouble falling or staying asleep or having nightmares
• Getting upset about things which normally would not upset you
• Worrying about what could or may happen
• Trouble concentrating or feeling overwhelmed
• Headaches
• Eating more or eating less than usual 

What You Can Do
While feelings of anxiety are normal, it is important to decrease the effect these feelings may have on you or the people you care for. The symptoms of anxiety are your body's way of letting you know it needs to relax. It your body is relaxed, it helps you cope with what is happening in your life. Talking to someone you trust is usually a good place to start. Other suggestions to reduce anxiety may include: 

• Talk about your feelings, fears and concerns with someone who will listen and provide support, including family members, friends, clergy and/or your Arbor Hospice team
• Take slow, deep breaths
• Enjoy a relaxing activity such as a hot bath, a good book
• Take a short walk or find a place that you can relax, uninterrupted for awhile
• Seek spiritual support from your clergy and/or the Arbor Hospice spiritual care coordinator
• Allow yourself to cry
• Keep a journal and write about your fears, feelings, concerns and/or things that are happening in your life
• Listen to soothing music