Dear Barbara, how do you guide a patient through a life review and what is the aim of a life review?
That is an interesting question in that I don’t specifically set out to have a person do a life review. I do believe that when we begin to die we automatically ask ourselves what life has been about, who have we touched, and what have we done with our years.
This process begins months before death on a sometimes conscious, but mostly unconscious, level. Most often these thoughts are not shared. It is like a private, very personal, processing meant just for one. These are soul searching moments, so personal that they can’t be shared honestly with others.
I think in the months before death, reminiscing, looking at scrapbooks, telling family and life stories is a way for us, the onlookers, to help facilitate the conscious/unconscious journey of a life review.
What is the aim of a life review? As a caregiver my aim is not to direct a life review but to be a presence, a listener, and a friend. If life review becomes a subject the patient wants to pursue (whatever words may be used to convey that search) then certainly we can help facilitate that discovery. I just don’t see, as part of our role, to introduce the subject of doing a life review.
Dear Barbara, during Palliative Care is it too late to deal with purpose, forgiveness, and meaning?
It depends upon when the person comes to Palliative Care. If you are lucky enough to get them months before death, when the dying process has begun, but they are still alert, interactive, and verbalizing then certainly they can have a dialog about life. Remember they are processing meaning, purpose, and their life on many levels (conscious and unconscious) during the months before death from disease. Some share, others do not.
As the dying process progresses from months to weeks and the person becomes more withdrawn you will probably not be able to get them to interact with you on any kind of deep level. I say probably because there are always people who don't play by the rules.
My best answer is to monitor the person's level of awareness and interaction. That will be your guide.
Something More... about Purpose, Forgiveness and Meaning at End of Life
I wrote A Time To Live to help the person living with a life threatening illness to make the most of their "gift of time". The questions above, plus many others are addressed in the book. Do you have someone who is facing the end of their life and could use this book?