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Posttraumatic stress disorder at the end of life: Extant research and proposed psychosocial treatment approach

Published online by Cambridge University Press:  22 November 2011

David B. Feldman
David B. Feldman*
Affiliation:
Department of Counseling Psychology, Santa Clara University, Santa Clara, California
*
Address correspondence and reprint requests to: David B. Feldman, Department of Counseling Psychology, Loyola Hall, Santa Clara University, 500 El Camino Real, Santa Clara, CA95053. E-mail: dbfeldman@scu.edu
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Abstract

According to some estimates, 84% of people experience a traumatic event during their lives (Vrana & Lauterbach, 1994), and 15% to 24% then develop posttraumatic stress disorder (PTSD). Many carry with them lasting effects of trauma as they age and enter the last phase of life. PTSD manifests in unique ways at the end of life, possibly disrupting factors associated with a positive dying process, including social support, medical communication, life review, and acceptance of death. Terminally ill people with PTSD may suffer more emotional distress, lower quality of life, and poorer medical prognosis than those without PTSD. Unfortunately, healthcare providers may not be trained to address this issue. This article reviews the literature concerning how PTSD may affect the end of life and proposes an intervention model based on a palliative care philosophy.

Keywords

PTSDEnd of LifePalliative careCognitive-behavioral therapy
Type
Review Article
Information
Palliative & Supportive Care , Volume 9 , Issue 4 , December 2011 , pp. 407 - 418
Copyright
Copyright © Cambridge University Press 2011

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