Hope

KEYPOINTS

  • It is important to identify and understand the hopes of patients and family/caregivers
  • Hope is about possibility and is a common coping mechanism
  • Hope builds strength, and is critical to the psychosocial well-being of patients and family/caregivers
  • Feelings of hope and hopelessness may occur at the same time
  • People’s hopes may change throughout the course of their illness
  • Patients and family/caregivers may be hoping for different things and at different points throughout the illness continuum
  • Health care professionals have influence on the hopes of patients and family/caregivers
  • To foster hope, it is important to set goals and encourage patients and family/caregivers to participate in decision making

CONSIDERATIONS

What might patients and family/caregivers hope for?

  • For a cure
  • For control and management of pain and symptoms associated with the disease
  • For continued quality of life as defined by the individual
  • For continued connections to important social relationships
  • For resolving interpersonal conflicts or issues
  • That they are not a burden on family/caregivers
  • That the experience of dying will not be painful
  • That family/caregivers will be okay after they die
  • For spiritual connection

STRATEGIES

  • People’s hopes may change over time and circumstance. Hopes expressed by patients and family/caregivers may be very different than that of the health care team
  • It is important to find balance between being honest and providing hope
  • Communication and on-going assessment throughout the care continuum is important for understanding and supporting people’s hopes

Questions to facilitate investigation of hope

  • “Is hope important to you? What do you hope for at this time? In the future?”
  • “How have these hopes changed for you over the course of your illness?”
  • “Tell me about what gives you hope during this time? How do you maintain hope?”
  • “How can I support you in your hopes at this time?”

SOURCES/REFERENCES

  1. Cairns M, Thompson M, Wainwright W. Transitions in dying and bereavement: a psychosocial guide for hospice and palliative Care. Victoria (BC): Victoria Hospice Society; 2003.
  2. Fanslow-Brunjes C, Schneider PE, Kimmel LH. Hope. Offering comfort and support for dying patients. Nursing 2007;27(3):54-57.
  3. Kuebler K, Davis M, Moore C. Palliative practices: an interdisciplinary approach. Missouri: Elsevier Mosby; 2005.
  4. Storey P, Knight CF. UNIPAC Two: Alleviating psychological and spiritual pain in the terminally ill. Gainesville (FL): American Academy of Hospice and Palliative Medicine; 1997.

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