The concept of “palliative cure”, despite the negative meaning that we are socially used to attributing to him, is not to be considered “useless” or to be interpreted as a “placebo effect”.
The term palliative then has its etymological root in the Latin “Pallium” = cloak and, in fact, the sense of covering, wrapping, protecting (as inside a cloak) is the one that is closest to the meaning that today we want to attribute to the palliative term.
In palliative care, the control of pain, other symptoms and psychological, social and spiritual problems is of fundamental importance, as well as limiting the bureaucratic procedures to the maximum.
They propose to improve the quality of life as much as possible both for patients and for their families, in particular:
- they affirm life and consider death as a natural event;
- They do not accelerate nor delay death, consequently they are contrary to any form of therapeutic fury and any form of euthanasia;
- provide for pain from pain and other symptoms;
- integrate the psychological, social and spiritual aspects of assistance;
- They offer a support system to help the family during illness and during mourning.
Palliative care have been defined by the World Health Organization as “… an approach that improves the quality of life of the sick and their families who face the problems associated with incurable diseases, through the prevention and relief of suffering by means of an early identification and an optimal treatment of pain and other physical, psychophysical and spiritual problems.”
In this perspective, especially in recent decades, psychotherapy has assumed a central role in the panorama of palliative care for terminal patients and their loved ones. Some research carried out in recent years have highlighted how psychotherapeutic work on a terminal patient, although not having the effect of decreasing his physical pain or all the inconveniences connected to it, can at least improve the experience and quality of the moment defined as “end-life”.
It is an individual short psychotherapy, also known as “dignity therapy”, precisely because the patients who have benefited from it, underlined how the sessions have increased their sense of dignity to a considerable and significant extent, often underestimated in people suffering from terminal pathologies, and therefore improving their quality of life ..
In this therapy, the therapist follows a protocol of questions and commits the terminal patient in a conversation, rather than in a clinical interview structured on the important aspects of his life and on what he would like to be remembered after his death. The session is recorded and transcribed. The transcription is then given to the patient, who will decide if he will have to be shared with friends and family.
It now remains to be understood the effect that these transcriptions can have on family members, in particular those with whom the patient had lost contacts or on children who lose a parent. “We must find a way to measure these equally important aspects, to demonstrate that we are making the difference,” said one of the researchers.
A particular study (Harvey Max Chochinov, University of Manitoba, Winnipeg), had the primary purpose of understanding if psychotherapy was really able to reduce the patient’s stress in the last phase of his life: the response obtained is that the therapy of dignity does not achieve this goal, as researchers on The Lancet Oncology write.
The researchers involved 441 patients with a life expectancy of six months (or not) who received palliative care in a hospital, in a hospice structure, or home. Although, as already mentioned, the intervention has absolutely not influenced the level of stress felt by the patients, a subsequent study indicated that the “dignity therapy” still presents some advantages with respect to the standard treatment of palliative care or care centered on the customer.
Compared to the other two interventions, in fact, the patients who received the “dignity therapy” judged it “useful”, both for them and for their family members, claiming that:
- has improved their quality of life;
- has increased their sense of dignity;
- changed the way family members have related to them.
The results show that “dignity therapy” has been significantly better than the therapy centered on the customer to improve emotional well -being, as well as compared to standard palliative care, to relieve the sense of sadness or depression, usually present in these patients. Compared to palliative care, a greater proportion of patients who underwent “dignity therapy” reported that the study group had been satisfactory.
“Further research will have to be done to explore the beneficial effects of dignity therapy”the researchers concluded “To reveal the psychological, spiritual and existential complexity that concerns an individual in the face of death, and understand which is the best way to support patients with an advanced or terminal disease, as well as their families”.
