Cover image for Dignity therapy : final words for final days
Title:
Dignity therapy : final words for final days
Author:
Chochinov, Harvey Max.
Personal Author:
Publication Information:
Oxford ; New York : Oxford University Press, [2012]

©2012
Physical Description:
xv, 199 pages : illustrations ; 24 cm
Summary:
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, Japan, Scotland, England, Denmark, and Portugal, dignity therapy has been shown to benefit not only 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 the end-of-life experience for those about to die--and for those who will grieve their passing.
Language:
English
Contents:
Dignity and the end of life -- Moving dignity into care -- Introducing dignity therapy to patients and families -- Doing dignity therapy -- The generativity document -- From start to finish -- Moving forward.
ISBN:
9780195176216
Format :
Book

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Central Library R726.8 .C483 2012 Adult Non-Fiction Non-Fiction Area
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Summary

Summary

Congratulations to Dr. Harvey Chochinov, winner of the Canadian Medical Association's Frederic Newton Gisborne Starr Award 2012.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 Chochinovand 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 inCanada, 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 patientsapproaching 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 changeend-of-life experience for those about to die - and for those who will grieve their passing.


Author Notes

Dr. Harvey Max Chochinov is an international leader in palliative care. He is Distinguished Professor of Psychiatry at the University of Manitoba and Director of the Manitoba Palliative Care Research Unit at CancerCare Manitoba. His seminal publications on psychosocial issues in advancedillness have helped define core competencies and standards of palliative end-of-life care. Dr. Chochinov has also been a guest lecturer in many major academic institutions around the world. He has been lauded for his contributions to palliative care, with awards and recognitions coming from theInternational Psycho-oncology Society, the Canadian Association of Psychosocial Oncology, the Canadian Cancer Society, the Canadian Psychiatric Association, the Academy of Psychosomatic Medicine, and the American Association of Hospice and Palliative Medicine. He is Fellow of the Royal Society ofCanada and the Canadian Academy of Health Sciences.


Reviews 1

Choice Review

This detailed, practical book explains "dignity therapy," a therapeutic approach that renowned palliative care expert Chochinov (Univ. of Manitoba, Canada) used with individuals nearing the end of life. The approach focuses on interviews with patients about important events in their lives and things they wish to tell those whom they leave behind; this information is transcribed and edited into a "generativity document" that patients leave as a legacy to those who survive them. The interview process, when employed in a number of different cultural and medical settings, has been shown to decrease depression and despair for most patients and their families. By explaining dignity therapy step by step and providing useful case studies and full interview transcripts, the book will be incredibly helpful for those learning this approach. The book distinguishes between the goals of psychotherapy and those of dignity therapy, each of which requires a different approach. This work is primarily for clinicians, but it will also be useful for students of counseling, pastoral care, and psychology. Both audiences will find it an informative guide to a tested approach that represents an already much-lauded contribution to the field of end-of-life care. Summing Up: Highly recommended. Graduate students, researchers/faculty, and professionals/practitioners. A. W. Klink Duke University


Table of Contents

1 Dignity and the End of Lifep. 3
Why Study Dignity?p. 3
Dignity and Empirical Researchp. 5
The Model of Dignity in the Terminally Illp. 8
Illness-Related Concernsp. 9
Dignity-Conserving Repertoirep. 13
Social Dignity Inventoryp. 27
Referencesp. 34
2 Moving Dignity into Carep. 36
How the Dignity Model Informs Dignity Therapyp. 37
Formp. 37
Tonep. 40
Contentp. 42
Dignity Therapy Revealedp. 42
The First Clinical Trial Is Publishedp. 43
What About Families?p. 46
Gold Standard Evidencep. 48
Time to Move Onp. 51
Referencesp. 52
3 Introducing Dignity Therapy to Patients and Familiesp. 54
Patient Selection for Dignity Therapyp. 54
Who Should Be Approached to Take Part in Dignity Therapy?p. 56
Who Should Not Take Part in Dignity Therapy?p. 58
A Typical Dignity Therapy Introductionp. 61
Some Common Questions and Responsesp. 62
The Dignity Therapy Question Protocolp. 70
Referencesp. 73
4 Doing Dignity Therapyp. 74
Setting Up the Dignity Therapy Sessionp. 75
Answering Remaining Questionsp. 75
Arranging the Therapeutic Settingp. 75
Using an Audio Recorderp. 76
Family or Friend Participantp. 77
The Role of the Dignity Therapistp. 77
Referencesp. 99
5 The Generativity Documentp. 100
The Rationale for Editing Dignity Therapy Transcriptsp. 101
Transcribing the Audio Recorded Interviewp. 102
Editing the Verbatim Transcriptp. 107
Cleaning Up the Transcriptp. 108
Clarifying the Transcriptp. 110
Correcting Time Sequencesp. 112
Finding a Suitable Endingp. 113
The Patient Has the Final Sayp. 114
6 From Start to Finishp. 118
Dave's Dignity Therapyp. 119
Dave's Generativity Documentp. 138
Bill's Dignity Therapyp. 145
Bill's Generativity Documentp. 164
7 Moving Forwardp. 173
Is There Currently Sufficient Evidence to Support the Application of Dignity Therapy?p. 174
How Do I Become Skilled Enough to Implement and Improve My Abilities to Deliver Dignity Therapy?p. 175
How Much Does Dignity Therapy Cost and How Can Resources to Support It Be Found?p. 176
What If Family Members or Volunteers Want to Take on This Work? Is That an Option?p. 177
Can Dignity Therapy Be Done by a Therapist Who Knows the Patient Well?p. 179
Are There Still Things About Dignity Therapy Worth Studying? If So, How Might Researchers Take Up This Work?p. 181
What About Other Modes of Generativity?p. 183
What About Dying Children? Does Dignity Therapy Have a Role to Play?p. 183
What About the Issue of Culture and
Dignity Therapy?p. 184
How Should Dignity Therapy Be Evaluated?p. 185
Closing Thoughtsp. 185
Referencesp. 187
Indexp. 189

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