When treatment options have been exhausted, although this does not necessarily mean that death is imminent, the challenges associated with terminal illness come sharply to the fore. As well as helping with all aspects of pain control, palliative care teams and hospice staff are sensitive to the emotional needs of both the patient and their immediate family. Unlike a busy hospital ward, they will have the time to talk to you and help you to confront the situation.

However, no matter how kind or how sensitive the staff, the switch from active treatment to palliative care represents one of the most demanding transitions any of us have to encounter. You are likely to feel a mixture of emotions – sadness, anger, fear, despair, loneliness or a numbed sense of fatigue for example – all of which can threaten to overwhelm you and lead to an increased sense of isolation.  It is important to find people you trust in whom to confide, either within the family or outside it, so that you do not have to face everything on your own.

You may also feel very anxious about leaving those you love, especially if you have young children. It can really help to plan for them and their future so that they have continuing reminders of your love for them.

Partners too need an opportunity to voice their fears and feelings in order to help them offer the maximum support to the patient while trying to confront the reality of a separate future.  There is a danger that in trying to protect each other, patient and partner no longer feel able to speak to each other truthfully about what is happening, leading to an increasing sense of isolation for both.

As well as looking to the immediate family and specialist professionals, including cancer counselling for support, there are a number of useful organisations offering help:

Marie Curie   www.mariecurie.org.uk

Bereavement UK         www.bereavement.co.uk/forum

Cruse Bereavement Care     www.crusebereavementcare.org.uk

The Way Foundation  (young widows and widowers)   www.familiesonline.co.uk

Winston’s Wish  www.winstonswish.org.uk

The Child Bereavement Trust     www.childbereavement.org.uk