Implementing support based on life review in palliative care

The psychology of the end of life remains to be developed. The accompaniment of the dying deserves to be the subject of scientific research to consolidate its foundations, understand its inter-individual specificities, and increase its effectiveness in terms of the serenity of the deceased and those around them. While the psychology of bereavement is well developed (Bacqué, 1997, 2000; Bourgeois, 2003; Freud, 2004, 2013), the psychology of death from the perspective of the profound emotional and cognitive experience of the end of life is sadly lacking. Our project is part of this new field of research. Our project aims to provide support at the end of life, by embedding it in the life story through the life retrospective. Life retrospection or life review refers to the evocation of memories of personal events and the systematic analysis that follows. Rather, it is a structured process of reinterpretation of the whole of existence, supported by the will of the subject (Haber, 2006). Life retrospection is traversed by emotional and cognitive work. Early work using life hindsight (Butler, 1963) is essentially based on Erickson's model of psycho-social development (1950, 1959), which presents life hindsight as a kind of psychological bridge (emotional and cognitive) linking the past to the present. Life retrospection enables the subject to review his or her life as a coherent whole, and to perceive himself or herself as the same despite the transformations and threats to his or her physical integrity to which he or she is subject, thus contributing to the psychological well-being of the aging individual, or to the serenity of the dying person in our project (K'Delant, Gana, & Mezred, 2012). The use of life hindsight to support the dying has given rise to a number of scientific studies (Canada, Japan, Switzerland, USA) that deserve to be cross-validated and replicated. These studies compare randomized controlled groups of patients and consider the impact of the intervention on variables linked to quality of life. However, few focus on cognitive factors or subjective perceptions such as feelings of gratitude or life satisfaction. End-of-life support through life retrospective has never been evaluated in a French palliative care population, which limits the scope for comparisons between the various international studies.