Hope is an important element for a sick patient to stay positive which is essential for his/her emotional well-being. It helps in bringing about good outcomes with the treatment. A patient who stays positive is more likely to cooperate with the health care professionals who are taking care of the patient. Therefore, the concept of hope is important for a patient’s betterment.
Absolute hope is built in the patient based on the truth regarding the disease progression and the outcome of treatment. It could be a sad truth or a good truth.
False hope is the deception of recovery or healing from an ailment such as talking about the miraculous healing even though all the treatment options have got exhausted, and death is inevitable. For example, patients who are on the verge of death often have a false hope of their survival. This could be either due their reluctance to accept the fact that they will not recover or due to the false promises made by the doctor who faces the challenge of being honest to maintain hope.
Hopelessness is a psychological problem which significantly decreases the performance of the sufferer.
A disabled patient who has hope regarding the treatment of the condition can perform the daily activities much better than the patients who are not having the hope of recovery from the disability. Family members and friends can build this hope by assisting the patient in his/her daily activities.
In the case of a mentally ill patient, hopelessness can further degrade the condition increasing the suicidal tendencies. A depressed patient may not be able to come out the state unless a high level of hope is developed either by the caretakers or by the physician.
Acute illnesses are for a short term, and thus the patient need not worry regarding the recovery from the illness. The available medications can treat such conditions and the patient can soon become normal. For example, conditions such as diarrhea, constipation, hair fall, etc. can be treated if the patient can strictly adhere to the medications provided by the physician.
In the case of chronic illnesses such as diabetes, kidney failure, chronic obstructive pulmonary disease (a serious lung disease), etc. the patient should be hopeful that certain life style changes can be very helpful in the management of the condition when combined with the prescribed medication.
Family members support along with the health care professionals care is required to build hope in these patients.
The diagnosis of a terminal illness can precipitate vulnerability and isolation in such patients. It can affect their activities of daily living. A sudden confrontation of death wanes away the hope of that unattainable goal of extending their lives. This denial of the fact that life is ending can lead to a much faster advancement of the illness.
Now comes the paradoxical question: if hope is defined as an expectation of good in the future, then it can be a few hours or days or months in the future and need not necessarily be an extension of the future or life. Thus, hope in terminally ill patients cannot be equated with cure of the disease.
Terminally ill patients often become marginalized from the mainstream society which creates a distress and the feeling of social isolation, loss of personal and professional roles, further dissipating their hope. It makes the physicians more hesitant to reveal the bad news and thus they may end up giving a “false hope” in an attempt to bolster the patients hope.
Patients who are not told about their approach towards death can make several plans for future (which is not guaranteed). So it is important to tell them the truth. Patients acknowledged of the fact have more time to make final preparations before they have to say good bye to all.
A true practitioner should understand that telling the truth can create anguish initially in the terminally ill patient. However, the future of such patients is defined majorly by their family members and friends. It is essential to realize to be happy for the remaining life instead of worrying about the length of the life.
As the death approaches, such patients often have a desire for serenity, eternal rest, and inner peace. For a peaceful death, a meaningful end of life is important, and it indicates that the purpose has been achieved. Thus, in the context of terminal illness, the patient can still have the hope of a good rest of life, which is limited for him/her. It can be developed by strengthening relationships with friends and family members, appreciation of the patient’s values, through exploration of their own spiritual matters, and managing the symptoms. Thus, when everything seems to be lost, this hope can still be stronger than before. The patient can hope for the goals which can be attained before death.
There are several ways how hope is built in the sick.
Having hope is important for the sick patients with respect to the relief from their suffering. That ‘fighting spirit’ built with the hope brings about the greater likelihood of cure from the disease. It need not necessarily be in terms of expectancy of longer life but about a good future.
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