Creating a safe space is integral to providing emotional and spiritual support to patients and families. What does this mean in practice? Firstly, that you respect the private space of the patient or family that you are entering; whether in a hospital, a private home or frail care unit.
Conveying respect to patients means being aware of their immediate needs, their level of comfort and physical ability, and a willingness to engage in a conversation. Furthermore, counsellors need a skilled level of awareness of the boundaries that are signalled by the patient during a professional assessment. These may also be communicated non-verbally by the patient.

The above form the basic foundation of establishing a professional relationship with the patient or family member from which you can provide support and care. Within this safe space, which includes a non-judgemental attitude, confidentiality and giving your total attention, you listen to the needs expressed. You also listen out for what is not expressed; you ask before you do and tenta-tively suggest before you tell.

In this safe space of support you might just need to be present with the patient, holding their hand or allowing them to reminisce. It might include suggesting practical guidelines to help a grandchild understand the processes that a grandparent and they them-selves are facing during a terminal phase. Allowing each patient and family member to be comfortable with their individual illness process, in the time that they need; supporting their engagement with their own religious and spiritual world view to find meaning can create a safe space for adjustment and hopefully, patients and families finding peace when settling with a life threatening illness. Fransil Kotze, Social worker.