Last Updated: Friday - 09/24/2010

Dignity therapy allows the dying to record memories, messages

Thomas Bouchard

OLDS - While discussion of end-of-life issues tends to emphasize the physical pain, dignity therapy focuses on the emotional and spiritual components of dying.

Dignity therapy is the brainchild of Dr. Harvey Chochinov, a Manitoba psychiatrist. The palliative intervention reaches beyond the realm of pain and symptom management.

"His aim was to address the psychosocial and existential stresses of a dying patient, so he's a psychiatrist who doesn't deal with the physical side. He deals with the mental side of things," Thomas Bouchard told the archdiocesan Catholic Women's League convention.

"He developed this wonderful system to think about the non-physical pain of end of life," Bouchard said April 16.

The 88th annual convention, with the theme Women of Peace and Hope, was held April 16-18 at Olds College's alumni centre. More than 150 CWL members attended.

Opposing euthanasia and assisted suicide is not enough, said Bouchard, who is completing his medical studies in Calgary with the goal of practising family medicine.

PRO-LIFE MED STUDENTS

In Edmonton, Bouchard worked with a neurologist studying dementia and Parkinson's disease. At the University of Calgary, he started VitaMed, the pro-life medical students club.

Euthanasia is not true compassion because it kills a person, he said. But dignity therapy does show compassion because the treatment allows an individual's achievements and life experiences to count for something, restoring their sense of self-worth.

"A therapist will invite patients to talk about issues that matter to them. These things are recorded and, with their permission, the recording is passed on to a family member or friend," said Bouchard.

Dignity therapy encourages patients to speak about their life experiences, and answer questions about themselves. The point is to develop a message or story about the person that can be read or listened to by friends and family members after the person has died.

LIFE STORY

"What are some specific things that you would want your family to know about you? Are there particular things that you want them to remember? Are there things about your life that have been forgotten? What was your life like in terms of your vocation?

"What were your most important accomplishments? What do you feel most proud of?" said Bouchard, offering examples of questions that a therapist might ask a patient.

The patient's responses are transcribed and edited as necessary, with a final version that can be bequeathed to a friend or family member.

"What happens when you use this method? These are people who are going to die whether they get dignity therapy or not. It's a method of palliative care. You're not going to cure their cancer or make them not die. That's up to God.

"But it's interesting what happens to these people."

Clinical studies have shown that 91 per cent enjoyed the process and about three-quarters felt a heightened sense of dignity.

"It's amazing that through just talking to people, you can make them feel more dignified," he said.

Most patients had an increased will to live, felt less depressed and were confident that the results would be helpful for their family.

SOUL PAIN

No medication addresses the distress, the emotional pain, that "soul pain." Medication reduces anxiety, perhaps making the dying person more comfortable, but at the cost of making them less responsive, which is not necessarily what the family wants. Dignity therapy addresses these issues with or without sedative medications.

"No medication that I know of reaches into future generations and addresses the distress of other family members in the face of death. The recorded tape is something that helps families come to terms with their loved one's death. You listen to your loved one speaking to you, perhaps profound reflections on his life, sharing them with you when maybe he hasn't been able to before. And that touches your life."

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