Hope and Hopelessness at the End of Life
Abstract
Efforts to improve end-of-life care have been hindered by widespread delays in discussing and initiating this care. The dynamics of hope and hopelessness may be crucial in these delays. The author reviews recent literature concerning hope and hopelessness at the end of life. Modern dying is more prolonged and more shaped by human choice than ever before. Therefore, hope and hopelessness play a more active role in the dying process. Hopelessness is not a simple product of prognosis, but is shaped by state and trait psychological factors. Hope at the end of life can come in various forms: for cure, for survival, for comfort, for dignity, for intimacy, or for salvation. Hopelessness at the end of life is therefore not simply the absence of hope, but attachment to a form of hope that is lost. The concept of anticipatory grief may help us interpret hope and hopelessness at the end of life. Improving end-of-life care will require looking beyond prognosis and preferences to understand the dynamics of hope and hopelessness. To be successful at diversifying hope at the end of life, we must foster the trusting interpersonal environment where this is possible.
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Some people with advanced progressive illness find it hard to engage in meaningful activities and relationships, may lose hope, and experience anticipatory grief.
“Some people find it hard to engage in meaningful activities and relationships, may lose hope, and experience anticipatory grief .6,7”
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Morita (2000) · doi:10.1002/(sici)1099-1611(200003/04)9:2
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Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation
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Hope: A Construct Central to Nursing
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Issues in End-of-Life Care: Patient, Caregiver, and Clinician Perceptions
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Advance Care Planning Does Not Adversely Affect Hope or Anxiety Among Patients With Advanced Cancer
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Processes of Adjustment to End-of-Life Losses: A Reintegration Model
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Hope and Related Variables in Italian Cancer Patients
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Preparing for the Worst While Hoping for the Best
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Religiosity and Hope: A Path for Women Coping With a Diagnosis of Breast Cancer
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Factor structure of the Beck Hopelessness Scale in individuals with advanced cancer
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Clinical Ethics Issues in Geriatric Psychiatry
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Drifting in a Shrinking Future
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Self-citationScreening for Depression in Nursing Home Palliative Care Patients
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The Experience of Hopelessness in a Population of Greek Cancer Patients Receiving Palliative Care
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Health-related expectations of the chronically critically ill: a multi-perspective qualitative study
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Rational Suicide in the Elderly
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Würde in der Begleitung schwer kranker und sterbender Patienten
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Anticipatory Grief Therapy for Older Persons Nearing the End of Life
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Healthcare Professionals’ Lay Definitions of Hope
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The evolution of hope in patients with terminal illness
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Contemporary Debates in Bioethics: European Perspectives
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Hope in palliative Care: Cultural implications
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A model of hopelessness, belongingness, engagement, and academic achievement
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Depressive symptoms and hopelessness among patients with cancer
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Psychological Issues in Head and Neck Cancer
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Bereavement and Loss: Understanding Grief in Older People
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“Waiting to Die”: Language, discourse and meaning in palliative care contexts in Kenya
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Suicide and Desire for Hastened Death in People with Cancer
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Hope for brain health: impacting the life course and society
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Adult Hope Scale: validation in older adults
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Psychosocial Aspects of HIV/AIDS
Levy, E. (2018) · Cited by 2 · see citing works
Hope: a tool for working with families affected by dementia during the COVID-19 pandemic
Pepper, A., Aldridge, Z., & Dening, K. H. (2023) · BJPsych Advances · doi:10.1192/bja.2023.38 · Cited by 2 · see citing works
Women Convict Hopelessness: Challenges for Service Guidance and Counseling
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Tipping Point: Pathogenic Stress and the Biopolitics of Euthanasia
Love, C. S. (2024) · The Linacre Quarterly · doi:10.1177/00243639241287918 · Cited by 1 · see citing works
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Defining a Good Death for Residents in Long-term Care
Munn, J. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/mk2r-7565 · Cited by 1 · see citing works
Hope or Truth: Commentary on the Case of Mr. T
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A remény pszichológiája. Elméleti áttekintés az empíria tükrében
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Current awareness in geriatric psychiatry
(2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.794
- Authors
- Sullivan, M. D.
- Affiliations
- University of Washington (US)
- Corresponding author
- Sullivan, Mark D.
- ORCID
- Sullivan, Mark D.
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 11
- Issue
- 4
- Pages
- 393-405
- ISSN
- 1064-7481 (ISSN-L)
- OpenAlex
- W2140759036
- Cited by
- 109
- References
- 109
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 3 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 7 · 2012: 5
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- National Institutes of Health (5k01mh001351-05)
- National Institute of Mental Health (K01 MH1351)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- hope, hopelessness, end-of-life care, dying, anticipatory grief, prognosis, psychological factors, trust, interpersonal relationships, palliative care
- MeSH terms
- Aged, Chronic Disease, Death, Major Depressive Disorder, Depressive Disorder, Major, Hospitalization, Humans, Interpersonal Relations, Professional-Patient Relations, Psychology, Quality of Life, Religion, Social Environment, Suicide, Critical Illness
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