Spiritual Distress

Patient & Family Teaching Sheet

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What is spiritual distress?

Spiritual distress is a disruption in a person’s belief or value system. It may occur when a person cannot find sources of meaning, hope, love, comfort, strength, and connection in life or when conflict arises between his/her beliefs and what is happening in their life. It may affect his or her entire being. Something in a person’s past can also be a cause of distress.

What are the signs and symptoms?

  • Sadness, anger, despair, depression, anxiety.
  • Questions the meaning of life. Questions the meaning of suffering.
  • Asks why this is happening, “Why now?”, “Why me?”
  • Afraid to fall asleep.
  • Questions his/her belief system.
  • Feels a sense of emptiness, loss of direction, or abandonment.
  • Talks about feelings of being left or forgotten by God/higher power.
  • Seeks spiritual help or guidance.
  • Pain and other physical symptoms may be expressions of spiritual distress.

What to report to the care team?

  • Signs of behaviors listed above.
  • Side effects of medications.
  • Behaviors that seem out of character.
  • Symptoms that are getting worse.
  • Talk about suicide, ending it all, asking for help to die.
  • Known history of spiritual distress.
  • Not caring about self and life in general.
  • Sudden rejection or neglect of previous practices or beliefs.

What can be done for spiritual distress?

Spiritual distress is common with terminal illnesses. Not  everyone experiences it the same way or to the same degree.

Patients and Family

  • Do not feel you are bothering the hospice/palliative care team by asking questions.
  • Look for ways to keep and honor desired rituals and ways of life.


  • Remember, not everyone has spiritual distress.
  • Have at least one person to talk with whom you trust about your concerns, fears, or anger.
  • Do not be hard on yourself for not feeling very spiritual.
  • Listening to devotional recordings may offer comfort.
  • Listening to instrumental music may be soothing.
  • Allow someone to pray with/for y Meditation may be helpful.
  • Write, paint, or draw your feelings.
  • Take your medication as prescribed.
  • Forgive yourself, forgive others, and forgive God/higher power.
  • Say thank you.


  • Provide a calm, relaxing setting.
  • Treat the person with dignity and respect.
  • Be willing to be present. Provide support.
  • Be willing to listen and reminisce.
  • Enjoy the time together and look for ways to make memories.
  • If asked, be open to contacting a spiritual leader (minister, rabbi, priest).