Reflections on using biographical approaches in end-of-life care: dignity therapy as example

Area of Science:

• Gerontology
• Palliative Care
• Qualitative Research

Background:

• Nonpharmacologic interventions, particularly biographical approaches, are gaining recognition for their therapeutic potential in end-of-life (EoL) care.
• Less attention has been given to the practical challenges and processes that impede the full realization of this potential.

Purpose of the Study:

• To critically examine the practical application of dignity therapy (DT), a biographical approach, in EoL care within the Swedish context.
• To identify and discuss the frictions and complexities encountered during the implementation of DT, including participant recruitment, data collection, and biography creation.

Main Methods:

• The study involves a reflective and problematizing approach by Swedish and Australian researchers.
• Experiences with dignity therapy (DT) in EoL care in Sweden are used as a case example.
• Focus on critical examination of practical application, including recruitment, data collection, and biography creation.

Main Results:

• Frictions were experienced in recruiting participants for dignity therapy (DT).
• Challenges were identified in the processes of data collection and the creation of a final biography.
• Issues concerning participant agency and power differentials within the interactive process of eliciting and crafting stories became evident.

Conclusions:

• Implementing biographical approaches like dignity therapy (DT) in end-of-life care involves significant practical challenges.
• Addressing issues of agency and power differentials is crucial for the ethical and effective application of these interventions.
• Further research and practice should aim to better integrate the complexities of everyday life into biographical approaches in EoL care.