Psychotherapy at the End of Life Helps Patients and Grieving Families

A study at University of Manitoba-Winnipeg, Canada, has tested an addition to the approach to end-of-life care for terminally-ill patients that seems to greatly increase a patient’s quality of life and reduce end-of-life distress.

Unlike traditional palliative care, which focuses on the physical comfort of a terminally-ill patient at the end of life, dignity therapy is concerned with the psychosocial health of patients. This brief psychotherapy usually consists of just an hour-long conversation, in which time patients discuss and answer questions about their roles throughout their lives, and what they have learned that they would like to pass on. The conversations are recorded and later transcribed into a document, called a “generativity document”, which is passed on to family members after the patient’s death.

The benefits of the therapy are still officially being assessed, but studies are showing positive results. Dignity therapy has the potential for two-fold benefits, for the grieving family as well as the patient. Patients have a chance to discuss and document things that they want remembered or known, and their families receive a memento of the deceased.

The study measured the spiritual well-being, dignity, depression, and quality of life of patients undergoing dignity therapy, versus patients who were not. Patients reported that the therapy improved their quality of life, changed how their family saw them, enhanced their dignity at the end of life; and patients who participated in the therapy showed a reduced sadness and depression over traditional palliative care patients.

Dignity therapy allows patients a chance to face issues that may have plagued them throughout their lives and helps them through the existential distress associated with the end of life. In a very touching example, reported by USA Today, one man, estranged from his family and battling alcoholism much of his life, wanted his grandchildren to know who he was and avoid his mistakes. In another case, one man wanted his wife to know that she could remarry with his blessing, because he wanted her to be happy.

For family members, the therapy creates a generativity document, “generativity” defined by the study as the ability to guide the next generation. The document allows family members to retain memories, or to reconnect with loved ones they may have lost touch with. By passing on the recollections and the sentiments of the deceased, the documents can act as a source of comfort through the grieving process.