Meeting existential needs in palliative care--who, when, and why?

Existential concerns are of great importance to those who are terminally ill. However, these matters are seldom brought into focus in the care of the patients. One crucial question is: who should take care of the patient's existential needs? The present study focuses on possible alternatives for dealing with such concerns, including the staff or significant others. A focus group was set up to gather and examine reflections from people having first-hand experience with this problem. The results of this study indicate that, with regard to existential needs, there are no general solutions. On the other hand, under specific conditions, several solutions can be satisfactory. Possible ways of handling the problem are suggested. Moreover, staff should pay attention to constraints operating in care settings, such as continuity and time, competent organization, and personal prerequisites.