September 22, 2005

“Dignity” therapy aids dying patients: study

By Amy Norton

NEW YORK (Reuters Health) - Helping dying patients to
relive and record important memories and thoughts may ease the
distress many feel at the end of life, according to a new

Researchers found that this "dignity" therapy that they
used in a study of 100 Canadian and Australian patients
increased most patients' sense of purpose and meaning in life,
and eased some of their suffering and depression.

The therapy offers patients the chance to talk about their
lives and accomplishments, and to say anything they feel their
friends and families should know. The process is recorded and
transcribed to be given to a family member or friend.

The therapy aims to fill a gap in end-of-life care. While
recent years have seen improved treatment of patients' physical
symptoms, depression and anxiety, little is known about how to
ease other types of suffering, such as "spiritual or
existential anguish," the study's lead author, Dr. Harvey Max
Chochinov, told Reuters Health.

The researchers developed dignity therapy, Chochinov said,
after years of study in which they asked dying patients what
dying with "dignity" meant to them, and how end-of-life care
supports or undermines that ideal.

Of the 100 dying patients who underwent the therapy as part
of hospice or home-based care, 91 percent said they were
satisfied with it, the researchers found. In addition, 81
percent said it would help or had already helped their
families, while more than two thirds said it had enhanced their
sense of meaning and purpose in life.

The findings are published in the Journal of Clinical

Besides increasing patients' sense of purpose and easing
suffering, dignity therapy showed patients that they "are still
valued," and that their words will live on, according to
Chochinov, a professor of psychiatry at the University of
Manitoba in Winnipeg, Canada.

He noted that patients who believed the therapy would help
their families were particularly likely to report greater
feelings of meaning and purpose, and a stronger will to live.

"Whether you are living or dying," Chochinov said, "so long
as in some way you are able to look after those you care about
most, there is still reason to wake up in the morning."

The study makes a "major contribution to advancing care for
the terminally ill," according to an editorial published with
the report. "Dignity of great importance and shows
promise as a novel intervention," writes Betty Ferrell of the
City of Hope National Medical Center in Duarte, California.

A larger study of dignity therapy, in Canada, Australia and
the U.S., is planned.

SOURCE: Journal of Clinical Oncology, August 20, 2005.