by Renda Brooks, LPN

Hospice of the Red River Valley

People who are in the final stage of their life and their loved ones face many challenges, and anxiety is often one of those challenges present during this phase of life. It’s natural for people to feel anxious because of the uncertainty or fear of dying.

Anxiety is a natural response to factors that create stress in our lives. It’s a feeling of worry or fear that is expressed differently by each person. Some people can verbalize how they are feeling, and others can’t. Anxiety can range from mild to panic attacks. When someone feels anxious, the body goes into high alert and the flight or fight responses are activated.

Symptoms of anxiety can include:

Avoidance of family/friends

Behavioral changes (uncontrollable crying, agitation, yelling/screaming)

Changes in vital signs (increased breathing, increased heartrate, chest pain)


Difficulty focusing



Lack of concentration

Muscle twitching/trembling


Nervousness (churning or “butterflies” in stomach)


Sleep disturbances (insomnia or difficulty falling asleep)



There are many things you can do to help your loved one cope with the anxiety that can accompany end of life.

Communication: Sometimes just being there to listen or to help a person understand what they are feeling can be enough. Give your loved one time to voice their fears and/or concerns about end of life. Ask open-ended questions, and allow pauses and moments of silence, so your loved one doesn’t feel rushed.

Reassurance: Reassure your loved one that anxiety is common. Acknowledge their feelings and don’t minimize them.

Relaxation techniques: Deep breathing, imagery and meditation are just a few examples of techniques that may reduce physical symptoms of anxiety when they occur.

Incorporate creativity or relaxing activities: Calming, relaxing music playing softly can alleviate anxiety. Suggest relaxing activities, such as taking a hot bath, reading or watching a favorite movie, sports team or show. Help your loved one activate their creativity through journaling, adult coloring or painting. You can add essential oils to paints to aid with stress relief and anxiety.

Support from professionals: If your loved one is on Hospice, they have professionals who can assist you and your loved one. Nurses, social workers, chaplains and certified nursing assistants (CNAs) can assist with listening, diffusing a situation, offering services (resources, prayer, support groups/services, etc.) and other assistance.

Underlying causes: There are times when underlying issues are causing anxiety. Shortness of breath and pain are two common causes. If your loved one is experiencing either of these, contact your Hospice care team to help treat or alleviate these issues, and their anxiety will likely be reduced.

Medications: Medications can help relieve signs and symptoms of anxiety. Remember to give medications as directed and let your Hospice care team know if they seem to be working or not, as adjustments may need to be made.

Anxiety is difficult not only for the one experiencing it, but also those around them. If you find yourself feeling overwhelmed on how to help your loved one, seek assistance. Don’t be afraid to ask for help, so you can avoid feeling anxious yourself.

Renda Brooks is a licensed practical nurse with Hospice of the Red River Valley.