Decreasing Death Anxiety

"Patients with serious medical conditions frequently suffer psychological, relational, and spiritual distress that is being inadequately addressed by modern health care," writes first author Douglas Miller, M.D., Indiana University School of Medicine professor of medicine, Regenstrief Institute, Inc. research scientist, and associate director of the IU Center for Aging Research. People facing their death may feel many pressures: Spiritually (What was the meaning of my life? Where will go in the afterlife?), socially (What is my illness doing to my family? How will my family deal with things after I die?), and emotionally (anxiety, depression and denial).

In the study, individuals with serious medical conditions who were expected to live more than six months but less than two years were divided into three groups. The first was patients with cancer or life-threatening heart, lung or diabetic diseases. The second was geriatric frailty accompanied by serious illness. The third those having HIV/AIDS related conditions.

Some were randomly assigned to support groups, which met monthly progressively discussing more difficult and challenging issues. They addressed topics such as recognizing and asserting needs, feelings and emotions, symptom control, living well while sick, intimate relationships, spiritual needs, end-of-life planning and decision making, hope and gratitude, and legacy.

Other patients received what is called "usual care," and received mailings of standard support materials related to their disease, many of which could be found in their doctors' offices.

"We were able to improve depression symptoms and lessen death anxiety, which led to better spiritual well-being in support group participants," says Dr. Miller. "We consider this pilot work as a promising approach, but a lot of work needs to be done to fully meet patients' needs at this most difficult time in their lives."

The study was supported by a grant from Supportive Care of the Dying: A Coalition for Compassionate Care of Portland, Ore., and the Project on Death in America of New York City.