Restricted accessResearch articleFirst published online 2017-7
‘This is my story,how I remember it’: In-depth analysis of Dignity Therapy documents from a study of Dignity Therapy for people with early stage dementia
Dementia is a progressive condition that impacts on individuals, families and care professionals. Maintaining quality of life through engagement with the person with dementia is an important part of their care. Dignity Therapy is an interactive, psychotherapeutic intervention that uses a trained dignity therapist to guide the person with dementia through an interview that then creates a written legacy called a generativity document. This can provide knowledge to inform care, as the condition progresses.
Generativity documents were analysed using framework analysis. Main themes from the analysis were origin of values, essence and affirmation of self, forgiveness and resolution and existentialism/meaning of life. These themes provide evidence of the type, scope and contribution that information generated from Dignity Therapy can make to the care and support of people with dementia. They provide information about the values, self-identity and the people and events that have been important to them and influenced their lives.
AglliasK. (2013) The reunification expectations of estranged elders towards the end of life. British Medical Journal Supportive and Palliative Care3: 240.
2.
Alzheimer’s Society (2014) A good life with dementia, London, England: Alzheimer’s Society.
3.
Alzheimer’s Society. (2015). ‘This is me’ – Tool for people with dementia receiving professional care. Retrieved from www.alzheimers.org.uk.
4.
ChochinovH. M.HassardT.KristjansonL.McClementS.HarlosM. (2005) Dignity Therapy: a novel psychotherapeutic intervention for patients near the end of life. Journal of Clinical Oncology23: 5520–5525.
5.
Chochinov, H. M., Kristjanson, L. J., Breitbart, W., McClement, S., Hack, T. F., Hassard, T., … Harlos, M. (2011). Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. The Lancet Oncology, 12, 753–762.
6.
ChochinovH. M.McClementS.HacjT.McKeenN.RachA.GagnonP.Taylor-BrownJ. (2013) Health care provider communication: An empirical model of therapeutic effectiveness. Cancer1: 1706–1713.
7.
EarnshawS. (2006) Existentialism: A guide for the perplexed, London, England: Continuum.
8.
HeywoodS. (1997) Family conflicts and Alzheimer’s disease. Assignment3: 3–8.
9.
Johnston, B., Pringle, J., Gaffney, M., Narayanasamy, M., McGuire, M., & Buchanan, D. (2015a). The dignified approach to care: Using the PDQ as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting. BMC Palliative Care. DOI:10.1186/s12904-015-0013-3.
10.
Johnston, B., Lawton, S., McCaw, C., Law, E., Murray, J., Gibb, J., & Pringle, J. (2015b) (in process). Living well with dementia: Enhancing dignity and quality of life using a novel intervention: Dignity Therapy. International Journal of Older People Nursing.
11.
ManthorpeJ.IlliffeS.SamsiK.ColeL.GoodmanC.DrennanV.WarnerJ. (2010) Dementia, dignity and quality of life: Nursing practice and its dilemmas. International Journal of Older People Nursing5: 235–244.
12.
MaslowA. (1954) Motivation and personality, New York: Harper.
13.
McClementS.ChochinovH. M.HackT.HassardT.KristjansonL.HarlosM. (2007) Dignity Therapy: Family member perspectives. Journal of Palliative Medicine10: 1076–1082.
14.
McDonaldW. (2009) “Søren Kierkegaard.”. In: ZaltaE. N. (ed.) Stanford Encyclopedia of Philosophy, Stanford, CA: University of Stanford.
15.
McGheeG.AtkinsonJ. (2010) The carer/key worker relationship cycle: A theory of the reciprocal process. Journal of Psychiatric and Mental Health Nursing17: 312–318.
16.
PellegrinoE. E. (2005) Some things ought never be done: Moral absolutes in clinical ethics. Theoretical Medical Bioethics26: 469–486.
17.
ReisbergB.FerrisS. H.de LeonM. J.CrookT. (1982) The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry139: 1136–1139.
18.
RitchieJ.LewisJ.NichollsC. M.OrmstonR. (2013) Qualitative research practice: A guide for social science students and researchers, London, England: Sage.
19.
RokeachM. (1968) Beliefs, attitudes, and values: A theory of organization and change, San Francisco, CA: Jossey-Bass.
20.
RokeachM. (1973) The nature of human values, New York: Free Press.
21.
RollandJ. S. (1989) Chronic illness and the family life cycle. In: CarterB.McGoldrickM. (eds) The changing family life cycle, London, England: Allyn & Bacon.
22.
SteeleC. M. (1988) The psychology of self-affirmation: Sustaining the integrity of the self. Advances in Experimental Social Psychology21: 261–302.
23.
TaitG. R.SchryerC.McDougallA.LingardL. (2011) Exploring the therapeutic power of narrative at the end of life: A qualitative analysis of narratives emerging in dignity therapy. BMJ Supportive and Palliative Care1: 296–300.
24.
TayL.DienerE. (2011) Needs and subjective well-being around the world. Journal of Personality and Social Psychology101: 354–365.
Wolf-OstermannK. (2013) People with dementia living in German shared-housing arrangements: Family engagement to promote quality of life. Alzheimer’s and Dementia9: 516.
27.
WolversonE. L.ClarkeC.Moniz-CookE. (2010) Remaining hopeful in early-stage dementia: A qualitative study. Aging & Mental Health14: 450–460.
