Background In Germany, approximately 850,000 people die each year. 90% spend their last days and weeks in inpatient facilities. The question of meaning often arises in great intensity. Suffering from feelings of futility, of spiritual pain, and unresolved religious issues often remains largely ignored in practice, despite the “total pain” concept in Palliative Care. Meaning-centred accompaniment following Viktor Frankl’s logotherapy recognises the individuality of the individual and provides an important impetus for interdisciplinary collaboration and enhanced mental health.

Aim A better and more precise understanding of spirituality in the context of Spiritual Care.

Methods Logotherapy, Pastoral counceling, Spiritual Care.

Results The theme of suffering is central in palliative care. The neurologist and psychiatrist Viktor Frankl (1905–1997) has developed a theory for dealing with suffering, the psychology of logotherapy.

It is worthwhile to put logotherapy in compound with the approach of Spiritual Care.

Discussion The value of existential psychotherapy in end-of-life care is that it encourages patients to seriously explore their past, present, and future in terms of meaningful choices.

It is observed that there are patients who cannot see any realisation of meaning in their lives.

Conclusion The emptiness and seeming futility (Frankl’s “existential vacuum”) of facing one’s suffering and death become transformed by active engagement with the meanings of life and living. Death anxiety becomes more something to explore and learn from. The findings show the importance of an interdisciplinary approach to palliative care.