Dignity Therapy: Final Words for Final Days
Harvey Max Chochinov
Format: PDF / Kindle (mobi) / ePub
Maintaining dignity for patients approaching death is a core principle of palliative care. Translating that principle into methods of guiding care at the end of life, however, can be a complicated and daunting task. Dignity therapy, a psychological intervention developed by Dr. Harvey Max Chochinov and his internationally lauded research group, has been designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as they grapple with the reality of life drawing to a close. Tested with patients with advanced illnesses in Canada, the United States, Australia, China, Scotland, England, and Denmark, dignity therapy has been shown to not only benefit patients, but their families as well.
In the first book to lay out the blueprint for this unique and meaningful intervention, Chochinov addresses one of the most important dimensions of being human. Being alive means being vulnerable and mortal; he argues that dignity therapy offers a way to preserve meaning and hope for patients approaching death.
Dignity Therapy: Final Words for Final Days is a beautiful introduction to this pioneering and innovative work. With history and foundations of dignity in care, and step by step guidance for readers interested in implementing the program, this volume illuminates how dignity therapy can change end-of-life experience for those about to die - and for those who will grieve their passing.
way of overwhelming fatigue, depletion of energy, fewer periods of wakefulness, and eventually, the relinquishing of consciousness itself. But until then, opportunities for moments of engagement can occur, and those moments—whether banal, profound or, most often, somewhere in between—constitute the nature of life’s final chapter. An afternoon on a palliative care unit brings memories of a multitude of such moments of engagement. An elderly aboriginal woman, enjoying a pleasant visit with her son,
Factors/Subthemes Dignity-Related Questions Therapeutic Interventions Illness-Related Concerns Symptom distress Physical distress “How comfortable are you?” Vigilance to symptom management “Is there anything we can do to Frequent assessment make you more comfortable?” Application of comfort care Psychological distress “How are you coping with what Assume a supportive stance is happening to you?” Empathetic listening Referral to counseling Medical uncertainty “Is there anything further
meet with the husband of a Dignity Therapy participant about one year after his wife’s death. He had been one of the very few people who asked not only to receive the edited generativity document but also the actual Dignity Therapy audio recording. There was no ethical challenge in doing so, since the two of them had done Dignity Therapy together. His wife had been a remarkable woman, who died from complications of metastatic lung cancer. At the time of her therapy, she was so short of breath
plodding and difficult for both patient and therapist. The patient will sense that each individual thought must be retrieved independent of the previously shared thought, making the task of creating the narrative 91 Doing Dignity Therapy burdensome and, in some instances, simply not feasible. The therapist will also have to work extremely hard, helping the patient reach for each consecutive content area to be explored. For example, a critically ill elderly gentleman appeared to have very
don’t mind focusing on about her. Like that picture there with me, in happy times.” She went on to describe her daughter’s university graduation and receiving that particular graduation picture from her, together with a rose, as a gift. “She was such a wonderful, wonderful person. Some people don’t appreciate their children, but I appreciated each and every one of these little things she did for me.” Although she did not choose to deal directly with the circumstances surrounding her daughter’s