I want to congratulate the researchers of the recent Dignity Therapy study published in the Lancet Oncology. The study demonstrates the value of recording a spoken legacy of an individual’s life reflections and hopes for the next generations to pass on to loved ones before death. It’s not easy to place a quantitative value on dignity.
Researchers conclude “based on the findings of this study, clinicians should consider dignity therapy a viable therapeutic approach, which can enhance end-of-life experience for patients and families confronting death.”
The novel psychotherapy entailed audio recording interviews with patients facing six months or less of live. The interviewers stimulated patients to share life recollections and lessons that the patient would like his or her family to remember and hopes and wishes for loved ones the patient would have to leave behind. The recorded interview is transcribed into a generitivity document for the patient to give family members.
Donna Miller, founder of the Life Review Video program at Hospice Care of the West, video records the life review interview of a patient.
This study helps us to understand the value in the life review videos, the brainchild of Donna Miller, director of volunteer services for Hospice Care of the West. For the past five years, I’ve been following Donna video record life review interviews with hospice patients. The interview is then edited with photos and music into life review video that the patient can leave behind for his family. I knew the value of what Donna was giving to patients because I video and audio recorded a series of interviews with my mother reflecting on her life in the months leading up to her death. As I write about in my book, Parting Ways: New Rituals and Celebrations of Life’s Passing, my mother exemplified a picture of dignity in motion in the last months, days and hours of her life. I also shadow Donna and another life review guides in the book to report patients improved sense of dignity because of their life stories are recorded to share with their families and communities.
In my book research, I also interviewed the Harvey Max Chochinov, the principal investigator on phase one of the Dignity Therapy study. He explained to me something I often share with families approaching end of life. One of the biggest assaults on our dignity at the end of life is that nothing of who or what I am will live on after I die.
Dignity Therapy focuses on generativity that researchers describe as “the ability to guide the next generation, encompassing how patients might find strength or comfort in knowing that they will leave behind something lasting and transcendent after death.”
Harvey Max Chonchinov, lead researcher on Dignity Therapy, discovered that the biggest assault on one’s dignity is that nothing of who or what I am will live on after I die.
The randomized study researched 326 patients with a life expectancy of six months or less, receiving palliative care in a hospital or community setting in Canada, the United States and Australia. The other two models of care in the study included testing 111 patients assigned standard palliative care and 107 in client-centered care that focuses on issues of here and now i.e. the psychological distress of the illness but not generativity. There were 108 patients assigned Dignity Therapy. This second phase of the study is a herculean effort in establishing a randomized study of comparative patient experiences across three different methods of end of life care. Chochinov and his researchers concluded that Dignity Therapy provided an enhanced sense of purpose, continued sense of self, and overall sense of dignity.
As I mentioned earlier, it’s difficult to place a value on dignity but the researchers assess that “the therapeutic effect was often ‘profound and poignant’ on those who received Dignity Therapy over those in the study who did not.”
In a couple of examples reported in the study, a 72-year-old woman with bowel cancer stated that “[Dignity Therapy] brought to the forefront that I have to prepare my family to the best of my ability.”
Another 56-year-old woman said: “Mostly, I want my family to know that I’m okay with dying and they must move on. The therapy showed me that I am not the cancer, I am still in here. I am so grateful for that because I lost myself….It really helped me remember who I am.”
In the first phase of the Dignity Therapy in 2005, Chochinov and his researchers reported significant results in the 100 terminally ill patients who participated:
- 91% were satisfied with Dignity Therapy
- 76% reported a heightened sense of dignity
- 68% an increased sense of purpose
- 67% a heightened sense of meaning
- 47% an increased will to live
- 81% that Dignity Therapy had been or would be
of help to their family
Evaluations post-interview with family members reported:
- 78% reported Dignity Therapy enhanced the patient’s dignity
- 72% reported Dignity Therapy heightened the meaning of life for the patient
- 78% said the generitivity document from the therapy session was a comfort to them in their time of grief
- 95% said they would recommend Dignity Therapy to other patients and their families.
These Dignity Therapy studies illuminate the benefits of spoken legacies and life review videos for both the patients and their families. Below are the questions used in the study.
- Tell me a little about your life history, particularly the parts that you either remember most or think are the most important? When did you feel most alive?
- Are there specific things that you would want your family to know about you, and are there particular things you would want them to remember?
- What are the most important roles you have had in life (eg, family roles, vocational roles, community-service roles)? Why were they so important to you and what do you think you accomplished in those roles?
- What are your most important accomplishments, and what do you feel most proud of?
- Are there particular things that you feel still need to be said to your loved ones or things that you would want to take the time to say once again?
- What are your hopes and dreams for your loved ones?
- What have you learned about life that you would want to pass along to others? What advice or words of guidance would you wish to pass along to your son, daughter, husband, wife, parents, or other(s)?
- Are there words or perhaps even instructions that you would like to off er your family to help prepare them for the future?
- In creating this permanent record, are there other things that you would like included?
Dignity Therapy gives patients the opportunity to leave behind a spoken legacy of their life reflections and hopes for the next generations.I want to congratulate the researchers of the recent Dignity Therapy study published in the Lancet Oncology. The study demonstrates the value of recording a spoken legacy of an individual’s life reflections and hopes for the next generations to pass on to loved ones before death. It’s not easy to place a quantitative value on dignity.
Researchers conclude “based on the findings of this study, clinicians should consider dignity therapy a viable therapeutic approach, which can enhance end-of-life experience for patients and families confronting death.”
The novel psychotherapy entailed audio recording interviews with patients facing six months or less of live. The interviewers stimulated patients to share life recollections and lessons that the patient would like his or her family to remember and hopes and wishes for loved ones the patient would have to leave behind. The recorded interview is transcribed into a generitivity document for the patient to give family members.
Donna Miller, founder of the Life Review Video program at Hospice Care of the West, video records the life review interview of a patient.This study helps us to understand the value in the life review videos, the brainchild of Donna Miller, director of volunteer services for Hospice Care of the West. For the past five years, I’ve been following Donna video record life review interviews with hospice patients. The interview is then edited with photos and music into life review video that the patient can leave behind for his family. I knew the value of what Donna was giving to patients because I video and audio recorded a series of interviews with my mother reflecting on her life in the months leading up to her death. As I write about in my book, Parting Ways: New Rituals and Celebrations of Life’s Passing, my mother exemplified a picture of dignity in motion in the last months, days and hours of her life. I also shadow Donna and another life review guides in the book to report patients improved sense of dignity because of their life stories are recorded to share with their families and communities.
In my book research, I also interviewed the Harvey Max Chochinov, the principal investigator on phase one of the Dignity Therapy study. He explained to me something I often share with families approaching end of life. One of the biggest assaults on our dignity at the end of life is that nothing of who or what I am will live on after I die.
Dignity Therapy focuses on generativity that researchers describe as “the ability to guide the next generation, encompassing how patients might find strength or comfort in knowing that they will leave behind something lasting and transcendent after death.”
Harvey Max Chonchinov, lead researcher on Dignity Therapy, discovered that the biggest assault on one’s dignity is that nothing of who or what I am will live on after I die.The randomized study researched 326 patients with a life expectancy of six months or less, receiving palliative care in a hospital or community setting in Canada, the United States and Australia. The other two models of care in the study included testing 111 patients assigned standard palliative care and 107 in client-centered care that focuses on issues of here and now i.e. the psychological distress of the illness but not generativity. There were 108 patients assigned Dignity Therapy. This second phase of the study is a herculean effort in establishing a randomized study of comparative patient experiences across three different methods of end of life care. Chochinov and his researchers concluded that Dignity Therapy provided an enhanced sense of purpose, continued sense of self, and overall sense of dignity.
As I mentioned earlier, it’s difficult to place a value on dignity but the researchers assess that “the therapeutic effect was often ‘profound and poignant’ on those who received Dignity Therapy over those in the study who did not.”
In a couple of examples reported in the study, a 72-year-old woman with bowel cancer stated that “[Dignity Therapy] brought to the forefront that I have to prepare my family to the best of my ability.”
Another 56-year-old woman said: “Mostly, I want
my family to know that I’m okay with dying and they must move on. The therapy showed me that I am not the cancer, I am still in here. I am so grateful for that because I lost myself….It really helped me remember who I am.”
In the first phase of the Dignity Therapy in 2005, Chochinov and his researchers reported significant results in the 100 terminally ill patients who participated:
91% were satisfied with Dignity Therapy
76% reported a heightened sense of dignity
68% an increased sense of purpose
67% a heightened sense of meaning
47% an increased will to live
81% that Dignity Therapy had been or would be of help to their family
Evaluations post-interview with family members reported:
78% reported Dignity Therapy enhanced the patient’s dignity
72% reported Dignity Therapy heightened the meaning of life for the patient
78% said the generitivity document from the therapy session was a comfort to them in their time of grief
95% said they would recommend Dignity Therapy to other patients and their families.
These Dignity Therapy studies illuminate the benefits of spoken legacies and life review videos for both the patients and their families. Below are the questions used in the study.
Tell me a little about your life history, particularly the parts that you either remember most or think are the most important? When did you feel most alive?
Are there specific things that you would want your family to know about you, and are there particular things you would want them to remember?
What are the most important roles you have had in life (eg, family roles, vocational roles, community-service roles)? Why were they so important to you and what do you think you accomplished in those roles?
What are your most important accomplishments, and what do you feel most proud of?
Are there particular things that you feel still need to be said to your loved ones or things that you would want to take the time to say once again?
What are your hopes and dreams for your loved ones?
What have you learned about life that you would want to pass along to others? What advice or words of guidance would you wish to pass along to your son, daughter, husband, wife, parents, or other(s)?
Are there words or perhaps even instructions that you would like to off er your family to help prepare them for the future?
In creating this permanent record, are there other things that you would like included?