You are visiting the 2019 PCC4U website. Throughout 2020 there will be two active PCC4U sites. Please check with your education provider that you are on the correct site. For access to the 2020 PCC4U site, go to



Print this page

Learning modules

Activity 9: Understanding sources of distress

People with life-limiting illnesses face many losses which can make them distressed and sad.

Giving people the chance to express how they feel about their losses and concerns can often help them cope. Sometimes, helping people to focus on what's important to them and emphasising what can be done, can also help.

A life-limiting illness affects not only the person with the illness, but his or her family and friends. People with life-limiting illnesses can also become concerned about their appearance and body image and about changing relationships with those close to them, including sexual relationships.

Traditionally, in western societies, personal issues, such as spirituality, intimacy and sexuality, have not always been easy to discuss yet can be very important to people nearing the end of their life. As a health care professional, you need to let people with life-limiting illnesses know that you're prepared to talk with them about any concerns they have about these issues.

It's important to understand how the supportive communication skills discussed in the previous section of this module can be used to identify an individual's specific concerns.

The Patient Dignity Inventory (PDI) is an example of an assessment tool designed to help clinicians detect end-of-life dignity-related distress. Using such tools can help to identify the particular sources of a person’s distress. This helps caregivers to individualise supportive interventions. [1]

Thinking points


1. Chochinov, H.M., Hassard, T., McClement, S., Hack, T., Kristjanson, L.J., Harlos, M., Sinclair, S., Murray, A. (2008). The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care. Journal of Pain & Symptom Management, 36(6), 559-571.