Depression and anxiety are higher amongst those facing the end of their lives. Geriatric mental health programs exist across the globe due to the unique psychological landscape people face as they near end of life.  Psychiatric services generally only consider the effects that dying has on the psyche and not as much about increasing the quality of a dying senior’s life. 

It is important to consider mental health as important as physical and spiritual health.  Antidepressants work well on palliative patients together with short term psychotherapy.   Working with a death doula and a therapist can be very helpful, particularly when working through fears based on a process one has never yet experienced – death.  So many questions about what will happen to the body and soul arise.  Doulas are especially helpful as they understand the death process very well.  

There are often other underlying mental health issues that are outside the death process.  These must also be evaluated and addressed in a respectful and dignified way.  A significant number of palliative patients suffer from states of anxiety, depression, delirium, and other mental symptoms approaching the threshold of mental disorder.  It may be important to consult a geriatric psychiatrist or psychologist to better understand how to journey alongside somebody on their way to death.  

References:

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0970-y

https://depts.washington.edu/psychres/wordpress/wp-content/uploads/2017/07/100-Papers-in-Clinical-Psychiatry-Psychosomatic-Medicine-Psychological-issues-in-end-of-life-care..pdf

https://www.webmd.com/palliative-care/end-of-life-coping-with-anxiety-and-depression