This article discusses the psychological symptoms, in particular depression, experienced by Fiona (a pseudonym), a 23-year-old woman with end-stage ependymoma who was admitted to the author’s hospice. The admission was originally to manage her physical symptoms, which included headaches, disorientation, reduction in mobility and worsening eyesight, but she was subsequently diagnosed with depression. In palliative and end-of-life care, depression is often under-recognised and under-treated. The case highlighted in this article was challenging for members of the multidisciplinary team, particularly the nursing staff who felt that they were unable to form a therapeutic relationship with Fiona at the end of her life due to her mental state. This article will discuss depression in palliative and end-of-life care and the difficulties associated with recognising the condition. It will also examine its assessment and diagnosis, before going on to highlight issues related to pharmacological and non-pharmacological interventions. Conflicts of interest: none
- Brain tumour
- Clinical skills
- End-of-life care
- Multidisciplinary role
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