Helping Terminally Ill Patients Do a 'Life Review'

Betty R. Ferrell, PhD, RN

Disclosures

April 14, 2016

Life Review

Hospice and palliative care professionals are committed to assisting patients in completion of unfinished business, which often includes conducting a review of their lives. Life review is an invaluable process for many patients and is commonly used as patients complete their lives.

There are many forms of life review, including "dignity therapy," developed by Dr Harvey Chochinov,[1] in which patients are guided through a process of recalling significant life events and life contributions, and are aided in finding meaning in these events. Other palliative care professionals have described such methods as journaling, storytelling, or reminiscences to help patients recall significant life events.[2] These activities may involve recognizing life accomplishments, addressing unresolved emotions, and acknowledging the need for forgiveness from others or the desire to offer forgiveness.[3] In the case of Mr H, it might be valuable to discuss his life's work as a professor, the students he mentored, and the contributions he made to his field.

Mr H describes himself as neither spiritual nor religious, but there are many opportunities to help him derive satisfaction from his life accomplishments. In patients who are religious or spiritual, life review may identify key spiritual experiences or milestones.[4,5,6] One technique for life review is to record patients telling their life stories and create transcripts from the recordings. Some patients will prefer to journal or create their own written summaries of key aspects of their lives. Looking through photo albums or family videos can support patients as they relive these experiences.

An important consideration in assisting patients with life reviews is coping with emotions, grief, or unresolved life events evoked by this activity. However, a life review can also help to release emotions, recall positive experiences, and lead to completion of life goals. As lives are reviewed, both patients and families can express important thoughts to others and seek peace within themselves. Grieving previous losses can be a valuable aspect of life review.

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