Firstly, let us define wellbeing. There are many definitions available, and each person may have their own sense of what wellbeing means to them. Generally, definitions of wellbeing seek to point to a sense of contentedness or happiness with life. According to the Dynamic Model of Wellbeing, wellbeing is defined by the extent to which people are flourishing in their lives. This includes a sense of feeling in control, feeling valued, connected, and safe, as well as being able content in their lives. One’s ability to experience positive wellbeing, according to this model, is influenced both by external factors (such as the workplace, housing, and relationship) and personal resources, such as resilience.
This can be further understood by looking at the ten broad dimensions of wellbeing that have been shown to matter most to people in the UK as identified through a national debate. The dimensions are: the natural environment, personal well-being, our relationships, health, what we do, where we live, personal finance, the economy, education and skills and governance. Personal wellbeing is a particularly important dimension which we define as how satisfied we are with our lives, our sense that what we do in life is worthwhile, our day-to-day emotional experiences (happiness and anxiety) and our wider mental wellbeing. More broadly, as researched by the What Works Centre for Wellbeing, wellbeing is about ‘how we are doing’ as individuals and communities.
If considering wellbeing prompts a consideration of how someone is doing, this matters even if they have a terminal diagnosis or are dying.
That is because the end of life is often a period of time which can extend from days to even over a year for people, and in that time, how they are experiencing their life matters, including beyond their physical or biological functioning and managing symptoms. Even when their death is more imminent, there is scope to consider how their wellbeing – and that of those around them - can be fostered. Here we propose several ways in which challenging the cultural assumptions terminal illness can be done by considering the dimensions of wellbeing.
- Enable people to do activities that give them a sense of purpose and enjoyment. For some people, this can include work or volunteering. This link has more information about what is meant by a sense of purpose and how it links to wellbeing.
- Support people to spend time in natural environments to boost their sense of wellbeing. Spending time in nature has been shown to improve one’s mood. It is not a coincidence that many hospices have nice garden spaces for people to enjoy and connect to a world wider than themselves.
- Offer time and space for people who are terminally ill to be with others. Social activities, relationships and connections to other people – whether they are families, friends, neighbours or part of a social group – can foster one’s resilience and help combat feelings of isolation and worthlessness. They can also provide opportunities for self-expression and focal points for discussions that are beyond one’s own illness or caring responsibilities.
- Encourage physical activity and exercise were possible. Like being outdoor, movement has been shown to boost people’s moods and sense of wellbeing. There are a range of exercises that can be done when sitting in a chair, or even when laying in a bed, which can improve flexibility, balance and strength. Movement can help manage certain symptoms as it promotes improved digestion and sleep.
- Provide financial support. Thinking about money, especially if they have had to stop work due to illness or caring, can be worrying. Organisations can examine their policies for sick pay and communities can support individuals with grants. If you live in the UK and have an illness or disability, this link provides information about what financial resources are available.
This approach to wellbeing during terminal illness is an approach supported by palliative care, which seeks to understand what matters to the person and those around them in addition to managing symptoms. However, even if someone is not currently supported by palliative care there can be steps taken to improve their wellbeing during terminal illness. If you’re looking for more tips to boost wellbeing, check out this poster from Action for Happiness with 10 keys to happier living and resources on the What Works Centre for Wellbeing website.