Impact: Quality of life impacts
In the current Hong Kong hospital system palliative care patients are often socially isolated from family and friends in their final weeks and months of life as a result of weakness and physical deterioration, a situation which has been exacerbated by strict COVID-19 social distancing measures. These circumstances often leave patients in states of psychological, emotional and spiritual distress before death, which also increases their experience of physical pain. According to a recent systematic review on the unmet supportive care needs of advanced cancer patients and their caregivers, the most commonly reported domain was lack of psychological support, with the absence of family and friends (9.9–96.5%) and emotional assistance (10.1–84.4%) accounting for the largest share of unmet needs, with an additional frequently collected response being patients inability to communicate with the outside world (7.7–87.9%). Since unmet needs have a detrimental effect on well-being, an innovative intervention that is able to address all of these psychological problems while overcoming the constraints of physical isolation is of pressing demand. Palliative care plays an essential role in these circumstances, providing holistic care which aims to manage physical symptoms while addressing the psychological and emotional needs of the patient using various therapeutic methods to help them ‘prepare for death and affirm the patient as a human with a unique life.’ One novel and effective technique used by clinical psychologists is ‘life review’ and ’reminiscence’ therapy, which involves the systematic examination of various life experiences with the aim of resolving conflict and completion of life tasks in order to help the patient come to terms with death. Examples of the therapeutic outcomes of ’life review’ and ’reminiscence’ therapy are the writing of texts in collaboration with a therapist and the production of picture books, audio recordings or cookbooks as a ’legacy’ gift for family members after the patients death.