June 21, 2017

Legacy therapy: The new type of palliative care that helps patients tell their story

Daily Briefing

    Legacy therapy is a growing form a palliative care that encourages aging or terminally ill patients to share their stories in a way that can be captured for their friends and families, Sammy Caiola writes for the Sacramento Bee.

    Expanding the scope of end-of-life care

    "It's a real important thing to have a witness to one's life toward the end," said Connie Johnstone, the visiting hospice chaplain at Kaiser Permanente in Sacramento.

    A growing trend

    Legacy therapy—or dignity therapy, as it's sometimes called—has been gaining popularity in hospitals, hospices, and palliative care centers seeking drug-free ways to comfort patients nearing the end of their lives.

    Legacy therapy involves multiple 30- to 60-minute sessions in which a psychologist, social worker, or chaplain talks with a patient about their life, including difficult topics such as traumatic experiences or distant family members. "The therapist draws out the parts of their story that have to do with meaning and purpose and relationships so that they can leave the legacy they want," said Nathan Fairman, a palliative care psychiatrist for University of California, Davis.

     

    Legacy therapy shows promise for treating major depression, which the American Psychological Association estimated affects between 15 and 20 percent of terminally ill patients.

    A clinical trial involving 100 terminally ill patients who received legacy therapy found that 68 patients reported an improved sense of purpose after the therapy, 47 said it renewed their will to live, and 81 said their families benefited from the therapy.

    Legacy therapy in practice

    Hinds Hospice offers interview session with staff using an app by the company StoryCorps—which captures conversations using a cell phone. The sessions conducted at Hinds Hospice are then archived in the Library of Congress's American Folk Life Center.

    Jill McCarthy, the community outreach liaison for Hinds Hospice, says their main focus is working with families who want to know their loved ones better.

    "If the person dies before they get to share their story, those stories go with them," she said. "It's a chance for families to talk about things they've never talked about before, to express what they mean to one another. They don't have to be these grandiose things. It's the little things that for generations have been handed down" (Caiola, Sacramento Bee, 6/6).

    Expanding the scope of end-of-life care

     

    Research has demonstrated that hospice saves eMedicare between $2,300 and $10,800 per enrolled beneficiary compared to traditional care at the end of life. Moreover, patients and families participating in hospice report better medical and social outcomes, particularly for pain and symptom management.

    Read our white paper to understand the benefits of concurrent care, identify key considerations for developing concurrent care services, and learn about models that peer institutions have adopted.

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