What is psychosocial care?
Psychosocial care addresses a person’s emotional, psychological, and social wellbeing, considering how these factors affect their health. [1] In palliative care, psychosocial support can help people cope with illness, disability, death and dying by strengthening emotional resilience and maintaining social connections. [1,2]
Psychosocial support is part of routine care for people with life-limiting illnesses, with additional help available from specialists such as psychologists, social workers, counsellors, chaplains, pastoral care workers, and art of music therapists. [2-4] Cultural liaison workers, such as Aboriginal and Torres Strait Islander Health Workers, and members of a person’s cultural community can provide culturally appropriate support. [3]
While psychosocial and spiritual care are distinct, they are interconnected. [5,6] Psychosocial care focuses on emotional, psychological, and social needs, whereas spiritual care addresses existential concerns such as meaning, purpose, and beliefs, including religious dimensions. [5-7] These overlap when emotional distress involves existential issues, such as fear of dying. [6,7] Both are integral to holistic care. [5,6,8]
Why psychosocial care matters in aged care
Palliative care aims to address the psychological and social needs of people with serious illnesses and their families. [9] Psychosocial care improves quality of life, particularly in palliative and end-of-life care settings where emotional and existential concerns are common. It can help older people transition into residential aged care, cope with change, reduce isolation, and navigate family dynamics, especially during grief and loss. [10-13]
Loneliness and social isolation are often major challenges for older people. [10,14] In long-term care and community settings, loneliness can contribute to depression, suicidal thoughts, and physical decline. [10,14] Maintaining relationships with family and friends, engaging with volunteers, and increasing social opportunities help counter loneliness and improve wellbeing. [10]
The Aged Care Quality Standards emphasise psychosocial care by addressing emotional, social, and cultural needs in aged care. [15] The Quality Standards promote person-centred care, dignity and respect for individual identities while ensuring emotional and social support. They also encourage social engagement and meaningful activities to support mental health and culturally safe care, ensuring services recognise and meet the diverse needs of older Australians.
What the evidence tells us
Psychosocial needs change over time, requiring ongoing assessment. [15] Validated tools for assessing and monitoring psychosocial wellbeing include:
A holistic approach helps understand symptoms in context. [2] For example, pain or breathlessness may be linked to anxiety, fear, or guilt, while changes in appetite may reflect cultural attitudes to eating and drinking. [2] Understanding and addressing these factors allows for more individualised care.
Strong relationships with older people help aged care workers understand an older person’s values and how relationships influence their decisions. [15] Advance care planning can help individuals explore and express their care preferences and ensures their wishes are communicated to family and service providers. [16] Maintaining regular contact with family and friends through phone calls, visits, or video calls reduces loneliness. [10,14] Encouraging friendships among residents and offering structured activities fosters community in aged care settings. [14] Meaningful interactions where individuals feel at ease have the greatest impact on wellbeing. [10,14]
Therapeutic approaches such as life review therapy, narrative techniques, and peer support groups may help people reflect on experiences and maintain social connections. [4,11,14,17,18] Training staff in communication and empathy improves engagement and enhances the quality of interactions with those in their care. [18] Relationships with other residents shape daily experiences and overall quality of life, and working closely with families ensures care aligns with personal and cultural preferences. [10,18]
Psychosocial interventions
Psychosocial interventions should be tailored to individual needs, addressing concerns such as coping with symptoms, maintaining dignity, or navigating difficult conversations about prognosis and treatment. Common psychosocial interventions in palliative care include: [4,11-13,17,19]
- cognitive-behavioural therapy
- acceptance and commitment therapy
- dignity therapy, reminiscence therapy, and life review
- creative arts-based therapies
- music therapy
- counselling
- mindfulness
- education.
These interventions can improve quality of life by fostering purpose and reducing distress. [4,11-13,17] Activities such as creating a photo book or documenting life stories allow individuals to focus on their legacy, their life’s value, and the contributions they have made. This can promote comfort and meaning by reassuring the older person that a part of them will continue beyond their lifetime. [4,19]
Loss and grief occur throughout the aged care journey, not just after death. Families and carers may experience emotional challenges during the person’s care, and offering support during these times can improve emotional wellbeing for everyone involved.
Care of people with dementia
Psychosocial care for people with dementia prioritises dignity, autonomy, and meaningful connections. [12,20] Person-centred approaches, such as reminiscence therapy, life story work, and music therapy, help individuals feel valued, allowing them to be seen beyond their dementia diagnosis and engage in meaningful activities. [12,20] These approaches can also assist care staff in responding more sensitively by deepening understanding of the person’s experiences. [12]
Supporting carers is also important, as they often face significant stress and emotional burden. Family members and carers may find activities such as life story creation and video biographies therapeutic as well as the person with dementia. [12]
Cultural considerations
Cultural beliefs about illness, death, and social roles influence psychosocial care. [15,21] Care should be culturally safe, involving interpreters or cultural liaison officers where needed. [3,21] Culturally tailored assessments help address the specific needs of diverse older people. [15,21] Providing culturally appropriate care before and after death ensures respectful support for older people and families. [22]
Implications for families
Families may experience emotional challenges when supporting an older relative nearing the end of their life. Psychosocial care can help them navigate grief, role changes, and decision-making, while promoting positive coping strategies. Structured family meetings and support groups encourage open communication and shared understanding, reducing emotional distress and enhancing family wellbeing. [23,24] Acknowledging the care and support provided by family members is also important. [25]
Emerging evidence suggests that digital tools such as mobile apps, video calls, and online counselling platforms and self-help programs can support the psychosocial needs of families and carers. [26] Australian digital resources include the HELP app (Healthy End of Life Program), CarerHelp website, Carer Gateway Counselling Service, and Carers Australia Mindfulness on Demand.
Specific tools for assessing carers’ needs over time can be the first step in providing them with relevant information and connecting them to appropriate services, including help from health providers. These include the NAT-C (if the person cared for has cancer) (268kb pdf) and the NAT-CC (for carers of people with a chronic condition) (269kb pdf). [27]
Caring for a relative at the end of life is an emotionally complex experience, with feelings of loss and grief arising at different points along the aged care journey. Supporting these experiences can improve the emotional wellbeing of families and carers. [28-30] While grief after the death of the person can be intense and destabilising, most people adapt to their loss over time without formal bereavement support. [31,32]
Considerations for home care
Psychosocial support in home care focuses on providing emotional security for the older person and their carers. Families can use care plans, daily routines, and freely available resources to manage psychosocial needs. [25] Useful information includes Self-care for carers (207kb pdf), Carer Gateway (e.g. Looking after your mental health), and CarerHelp (e.g. Relationships and Health & Wellbeing). Connecting older people with local support groups or spiritual communities can provide additional comfort and engagement. Regular check-ins with the GP and other healthcare professionals can help identify unmet needs and provide ongoing support. Some older people, particularly those who are vulnerable or face barriers to accessing care, may need assistance from someone who can liaise with palliative care services, mental health support, disability services, and social services. [25]
Many older people would prefer to stay at home in their final days, but this requires clear communication across the care team, advanced planning, and appropriate carer support. Families and carers can discuss these preferences with aged care providers and the person’s GP so that the necessary resources and care can be put in place. [33]
Page updated 02 January 2025