Death anxiety is the "feeling of dread, apprehension or solicitude (anxiety) when one thinks of the process of dying, or ceasing to ‘be’." (1)

Introduction Recognition of death anxiety is important in hospice care, but assessment and management is often down to subjective interpretation and personal skills.

There are a number of formal death anxiety scales (2, 3) with an acceptable level of reliability, but these are not routinely used in hospice work. Informal assessment of death anxiety is based on narrative disclosure within a holistic assessment and covert death anxiety is often missed. (4). Generalised anxiety often masks the more specific concerns of ‘death anxiety’ – and the treatment may differ.

Death anxiety can be managed with psychological interventions specifically aimed at existential distress, spiritual support, and facilitation of open discussions regarding death. These include ‘meaning- based’ interventions and legacy work.

Standard health anxiety approaches within a cognitive behavioural approach (CBT) have been adapted to treat death anxiety with good effect (5); however a specific death anxiety model is not available.

As part of a Masters Degree in Cognitive Behavioural Therapy I plan to research and design a model of care for death anxiety that can be used in front-line palliative practice. The following work is a baseline survey to underpin the research.

Aim To establish current level of understanding, assessment and management of death anxiety at the Hospice of St Francis.

Method Inpatient staff completed an anonymous questionnaire to highlight :

• their understanding of the concept of death anxiety

• confidence staff feel in diagnosing and assessing death anxiety.

• subsequent management of death anxiety.

These questions consisted of rating scales and narrative responses.

Future work

• To develop an assessment tool to detect death anxiety in a hospice setting,

• To develop a CBT model specifically for the treatment of death anxiety.