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.
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 advanced illness 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 the International 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 of Canada and the Canadian Academy of Health Sciences.
Chapter 1: Dignity and the End of Life ; Why Study Dignity? ; Dignity and Empirical Research ; The Model of Dignity in the Terminally Ill ; Illness-Related Concerns ; - Level of Independence ; - Symptom Distress ; Dignity-Conserving Repertoire ; - Dignity-Conserving Perspectives ; - Dignity-Conserving Practices ; Social Dignity Inventory ; - Privacy Boundaries ; - Social Support ; - Care Tenor ; - Burden to Others ; - Aftermath Concerns ; References ; Chapter 2: Moving Dignity into Care ; How the Dignity Model Informs Dignity Therapy ; - Form ; - Tone ; - Content ; Dignity Therapy Revealed ; The First Clinical Trial is Published ; What about Families? ; Gold Standard Evidence ; Time to Move On ; References ; Chapter 3: Introducing Dignity Therapy to Patients and Families ; Patient Selection for Dignity Therapy ; Who Should Not Take Part in Dignity Therapy? ; Chapter 4: Doing Dignity Therapy ; Setting up the Dignity Therapy Session ; The Role of the Dignity Therapist ; References ; Chapter 5: The Generativity Document ; The Rationale for Editing Dignity Therapy Transcripts ; Transcribing the Audio-Recorded Interview ; Editing the Verbatim Transcript ; - Cleaning Up the Transcript ; - Clarifying the Transcript ; - Finding a Suitable Ending ; - The Patient Has the Final Say ; Chapter 6. From Start to Finish ; Chapter 7. Moving Forward