Life Review as a Clinical Tool

We live life forward, but understand it

backward.

Soren Kierkegaard

Kay McFarland, MD & Donna Rhoades, PhD, 2004

CommunicationStrongly affects

patient & physician

satisfactionand

health outcomes

Copyright © 2004 by the University of South Carolina.  All Rights Reserved.

Purpose of Life Review

in the Medical Setting To enhance the physician patient

relationship To understand the meaning of illness To reduce suffering and promote healing

To amplify successes and joys by sharing them To diminish fears and sorrows by naming them

Copyright © 2004 by the University of South Carolina.  All Rights Reserved.

Life ReviewCan Use

Open-ended questions

Structured formats

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Ideas for Life Review

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6 Steps for ClinicalUse of Life Review

L earn from open-ended questions

I ntegrate using a diagram or visual

S ummarize for accuracy & completeness

T alk about omissions and meaning

E mpathize by validating

N egotiate recommendationsCopyright © 2004 by the University of South Carolina.  All Rights Reserved.

Step 1. L earn FromOpen-Ended QuestionsYour life, like a tree or river, has had

branching points. Tell me about your life. What events, experiences, or circumstances have most affected your life - have been branching points that shaped your life?

The Branching QuestionCopyright © 2004 by the University of South Carolina.  All Rights Reserved.

Follow-Up Questions What health relatedhealth related events

caused your life to branch (to take another course)?

What stressesstresses caused branching points or life altering courses for you?

What successes or happysuccesses or happy times caused branching points?

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Step 2. I ntegrate & Illustrate

with Words, a Diagram, or Visual

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Step 3. S ummarize To Check Your Understanding

Check for Completeness Accuracy Understanding Meaning

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Summarizing

Let me see if I understand what you’ve told me so far…

How did I do? What have I missed? What do you want to correct or

add? Adapted from Ken Resencow, PhD

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Step 4. T alkAbout Omissions & Meaning Talk about omissions

How would you revise this diagram? What would you add or omit?

Ask about interpretations & meaning What do you think are the roots of your life? Where did your strength come from – what

gives your life meaning?

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Step 5. E mpathize

Validate Understand

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Step 6. N egotiateTreatments & Interventions

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L-I-S-T-E-N !Copyright © 2004 by the University of South Carolina.  All Rights Reserved.