A Review of the Construct of Demoralization: History, Definitions, and Future Directions for Palliative Care. (February 2016)

• Record Type: Journal Article
• Authors: Robinson, Sophie; Kissane, David W.; Brooker, Joanne; Burney, Susan
• Is Part Of: American journal of hospice & palliative care. Volume 33:Number 1(2016)
• Page Start: 93
• Page End: 101
• Publication Date: 2016-02
• Subjects: demoralization -- depression -- existential distress -- end of life -- loss of meaning -- terminal -- palliative care; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909114553461
• Languages: English
• ISSNs: 1049-9091

Abstract

Demoralization has been the subject of discussion in relation to end-of-life care. It is characterized by hopelessness and helplessness due to a loss of purpose and meaning. The purpose of this review was to consolidate the conceptual understanding of demoralization and argue for its existence as a psychiatric syndrome. The history of the construct is explored, including the nature of existential distress and related psychological conditions that precipitate demoralization. Recent definitions of demoralization are described and differentiated from similar constructs. Future directions are highlighted, specifically in relation to the assessment, diagnosis, and treatment of demoralization in palliative care. Overall, demoralization is a clinically useful construct for those facing existential threat, guiding the clinician toward efforts to restore morale, meaning, and purpose.