When All Seems Lost: Hopelessness in Patients


Article Categories: Diseases & Caregiver Corner

Perhaps one of the most challenging patient interactions nursing assistants face is providing care to someone who has lost all hope.



Patients give up for many reasons, but this primarily happens because treatments have not improved their health as they expected or because their diagnosis reveals that a cure is impossible. Despair can also be triggered by a permanent loss of a bodily function or even a loved one. Repeated failed attempts to get better and overwhelming grief or frustration can make them abandon hope and give up on life altogether.

For these patients, every single day is the same, mostly full of pain, discomfort, and disappointment. They feel that they are of no use or help to anyone and they consider themselves a burden to others.

Why is caring for a hopeless patient more challenging?

Nursing assistants must realize that caring for a hopeless patient is like fighting a battle whose leader has already surrendered, or like watering a withering plant. You want to keep going, but they won't take another step further. Seeing a patient in despair, refusing to move forward, is devastating and heart-breaking.

Hopelessness can strike anyone, but some patients tend to experience it more often. Those in hospice, nursing homes, cancer institutions, and intensive care units, or those in recovery rooms, experience many reasons that cause them to decide to stop taking steps to get better.

Why should hopelessness be addressed?

Studies show that when a patient gives up on their situation, they recover slower, get sicker, or die sooner than those who are steadfast in their efforts. Hopelessness is hard to prevent, but CNAs and other healthcare workers must never stop trying.

What are signs that your patient might be losing hope?

1. Saying these phrases:

a. “What’s the use?”
b. “No more treatments!”
c. “I just don’t care anymore. I give up.”
d. “Nothing good would come out of it anyway.”

2. Appearing sad

3. Refusing food, water, medications, treatments

4. Withdrawal from friends, family, and staff

5. Loss of appetite

6. Trouble sleeping, whether lack of sleep or spending enough time in bed but feeling tired

7. Mood changes

8. Feeling trapped in a situation or that nothing can be done, whatever the effort

9. Feeling that nothing good will happen or that life is not worth living anymore

When CNAs see these signs and symptoms in a patient, what’s the best thing to do?

If you observe any symptoms of hopelessness in a patient, here are some tips on how to help them cope with their negative emotions:

1. Be kind, compassionate, and non-judgmental.

Patients who are in despair about their situation experience an overwhelming sense of hopelessness, and CNAs and other healthcare workers find themselves having a hard time connecting with them.

The last thing these patients need is someone who passes judgment on them for having those feelings. Acknowledge that the patient is at their lowest moment and be sensitive to their situation.

2. Let them express their feelings.

When a patient’s words reflect their lack of motivation to go on, encourage a conversation where they can continue to voice how they feel, being careful not to give your personal opinion on the matter. Avoid using phrases like, “If I were you, I would . . .” or, “There’s a reason for everything.”

3. Show your support by conveying your presence.

Sometimes, saying nothing means a lot when providing care. Silence and just sitting beside patients while gently holding their hands can do more than giving them a list of things to do to overcome their hopelessness.

4. Be positive, but do not try to convince them to be happy or force them to be hopeful.

When patients lose hope, they are in emotional turmoil, and persuading them to smile or be happy is insensitive. Just let your positive vibes show that you sincerely care and that you want to do your best for them.

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