The Meaning of Hope in the Dying

Abstract

Abstract This chapter explores the many dimensions of hope and identifies its possible influence on health and quality of life. Hope is a key factor in coping with and finding meaning in the experience of life-threatening illness. Hope is integrally entwined with spiritual and psychosocial well-being. Although terminal illness can challenge and even temporarily diminish hope, the dying process does not inevitably bring despair. The human spirit, manifesting its creativity and resiliency, can forge new and deeper hopes at the end of life. Palliative care nurses play important roles in supporting patients and families with this process by providing expert physical, psychosocial, and spiritual care. Sensitive, skillful attention to maintaining hope can enhance quality of life and contribute significantly to a “good death,” as defined by the patient and family. Fostering hope is a primary means by which palliative care nurses accompany patients and families on the journey through terminal illness. In this chapter, nursing assessment and strategies to nurture and respect individual variations in hope are described. Specific issues such as “unrealistic hopefulness” and cultural considerations in the expression and maintenance of hope are discussed. The goals of the chapter are to provide the reader with an understanding about this complex but vital phenomenon; to offer guidance in the clinical application of this concept to palliative nursing care; and to explore some of the controversies about hope that challenge clinicians.

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