title: Growing old and getting sick: maintaining a positive spirit at the end of life.
abstract: End of life throws up significant mental health challenges. A high proportion of people in the terminal stages of illness experience depressive symptoms. This paper integrates a theory of hierarchy of human needs and empirical research describing experiences of grief and depression in terminal illness, to develop a model of care aimed at reducing depression and suffering. This care attends to physical, psychological, social and spiritual aspects, taking into account the concerns of patients and their families. Professional help can be offered to patients to restore dignity and hope, strengthen their ways of coping, and encourage social connections. To offer this, a well-resourced and coordinated, multidisciplinary and skilled workforce is needed.
authors.affiliation: Discipline of Psychological Medicine, Monash University, Melbourne, Victoria, Australia. david.clarke@med.monash.edu.au
authors.forename: David M
authors.initials: DM
authors.lastname: Clarke
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000375:Aging / Q000523:psychology*; D001293:Attitude to Death; D001294:Attitude to Health; D003376:Counseling / Q000458:organization & administration; D003863:Depression / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D004328:Drive; D005190:Family / Q000523:psychology; D006301:Health Services Needs and Demand; D006379:Helping Behavior; D006801:Humans; D008016:Life Change Events; D008603:Mental Health; D008960:Models, Psychological; D009013:Morale; D010348:Patient Care Team / Q000458:organization & administration; D011369:Professional-Patient Relations; D011788:Quality of Life / Q000523:psychology; D019035:Rural Health Services / Q000458:organization & administration; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D013727:Terminal Care / Q000458:organization & administration / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology*