Day 3: Applying Dignity Therapy
In dignity therapy, a completed generativity document is passed to the patients so that they can share it with their loved ones. This helps to create a conversation between patients and their family members before the patient’s death. As mentioned in the previous blog entries, dignity therapy provides a platform for individuals to explore their existential achievements and express heart-felt messages to family members or other significant individuals. What happens when the patient does not have a designated recipient for the generativity document? As Katherine said, “Sometimes people engage in dignity therapy just because they wanted to experience the journey.” The gist of dignity therapy is to provide a platform for patients to review their lives and they do not have to dedicate the document to a specific person per se.
Dr. Lori brought up an extremely important point when it was nearing the end of the training workshop: when we are conducting dignity therapy, we may tend to focus on patients’ lives before they were diagnosed; that may potentially imply that patients are more “valuable” when they were well. Thus, it is crucial to be mindful of our personal biases and acknowledge who patients are and where they are at.
Though dignity therapy question protocol is generally used to promote therapeutic alliance where patients feel they are being treated as a person, it can be adapted in various settings with a tweak in how questions are being asked. For instance, the same protocol had been used in family setting to initiate heart-to-heart conversations between patients and family members without the presence of a dignity therapist; this process was identified as helpful and has been termed as “dignity talk”. Our FDI study has also adapted the question protocol into Asian context, with additional element on family connectedness in reflection of the culture. Stay tune to our website for more updates!
At the end of the training workshop, a treasure box was passed around and we were each invited to take one piece of paper from the box. It was a parting gift made of quotes from patients who have received dignity therapy in the past. Some of the quotes belong to patients who have gone home, and some belong to patients who are still living. Regardless of which, we (referring to the facilitators and workshop attendees) now carry them with us.
It was indeed a fruitful journey traveling to Winnipeg to attend the Dignity Therapy Training Workshop. Though dignity therapy is initially used in palliative end-of-life care setting, its effectiveness and empirical support have sparked great research interests to adopt this therapy across various settings and cultures. Our FDI study is first ever attempt to expand dignity therapy into the Asian context. Informed by a rigorous body of empirical research that examined the meaning and constructs of dignity in Asia palliative care, we are incorporating a number of family-focused and cultural-specific elements into the therapeutic process and question protocol. When one of the training workshop participants asked Dr. Harvey whether he has ever anticipated dignity therapy to draw on such great interest in healthcare and research settings, he humbly said no, yet, such interest should not come as a surprise given the potential benefits dignity therapy offers to patients and families.
It has been a week since I returned from Winnipeg, but I vividly remember Dr. Harvey’s and other dignity therapists’ facial expressions as they were sharing their experiences interacting with patients and family members; there were signs of tears in their eyes reflecting the light from ceiling lights overhead, their faces flushed pink and their gazes wandered into the distant past as they were recalling their memories. Those expressions reflected the mixed feelings they each had in remembrance of the patients and family members they have encountered in the past and present. In my eyes, taking up the role as a dignity therapist and engaging in the therapy process with patients and family members could be one of the significant memories in the facilitators’ lives; I find that beautiful and I wish to embark on similar journey with our FDI research. At the end of my life, I know being part of FDI study and building rapport with the patients and family members will definitely be one of the most significant memories I’ve had. This marks the end of my sharing on my dignity therapy training experience and learning outcomes, but it also signifies the beginning of our FDI journey. Stay tune!