Oral Presentation COSA-IPOS Joint Scientific Meeting 2012

Conversations for my daughter: Opportunities to explore the narrative and meaning in haematology at end of life. (#52)

Annette E Polizois 1
  1. St Vincent's Hospital, Darlinghurst, NSW, Australia

Objectives: This presentation aims to explore therapeutic practice in the context of haematology and end of life care. The nature of haematological malignancies, complexity of treatment and emphasis on cure mean that patients infrequently receive referral to formal palliative care services and are more likely to die in context of active treatment. Thus making navigation of end of life journeys and exploration of existential meaning complex for psycho-oncology practitioners in this setting. The case study presented will discuss the therapeutic relationship, exploration of meaning and development of a legacy work.
Method: Therapeutic process in this case is explored from the acute to the advanced treatment stages. The patient’s life stage and place in the family life cycle is given consideration in the themes which emerge and the importance of the development of a legacy work for this patient’s young child. The meanings attributed to the patient’s life story and illness journey are demonstrated throughout this process undertaken, and techniques utilised are discussed.
Results: Reflection on this case highlighted a) recognition of opportunities to engage with patients in this context, and providing range of options for patient’s to create legacies for their children; b) the process of developing themes of significance to the patient for inclusion in the recording for his child, and the counselling and narrative process which underpin this; c)the process of creating the recording, the dilemmas raised and the responses of the patient and the family to this process.
Conclusions: The outcomes in this case included: a) the patient’s creation of a legacy for his daughter b) the patient’s exploration of existential meaning c)the practitioners conceptualisation of existential practice in the process of active treatments and d)the identification and challenging of barriers to working with patients in the end of life trajectory in haematology.

  1. Lethborg, C (1994), “Shaping our ends: Creative ways of working with those facing the end of their lives, Australian Social Work, 47:1,27
  2. Chochivnov, H et al (2005) “Dignity Therapy: A Novel Psychotherapeutic Intervention for Patients Near the End of Life”, Journal Of Clinical Oncology 23:24,5520
  3. Allen, R et al (2008), “Legacy Activities as Interventions Approaching the End of Life”, Journal of Palliative Care Medicine, 11:7,1029