ABSTRACT
Hope of realistically achieving something good in the future is at the heart of coping with advanced illness and enabling a good quality of life. Unlike denial or optimism, hope needs people to be realistic, since one can only successfully hope for something that is possible, not something that can never be achieved. It is about being open to possibilities. It is not about being unrealistic or being in denial, it is different to optimism, and it is not about finding the meaning of life. Hope is very difficult to keep going in the presence of persistent psychological symptoms, example anxiety, anger or a clinical depression. Hope is difficult to foster if a person's life has been one of neglect, rejection or abuse. Some people are practical in their hope, example hoping to avoid pain, tie up loose ends, or going home to die. Hope is soon damaged by persistent physical symptoms, example pain, nausea, vomiting.
