Dignity defended

 Editor-in-Chief and Editorial Director, in a “Laborcare Journal” article, talk about “ethics in care”

(By Gianluca Favero and Mariella Orsi)

“Shadow and grace, heaviness and lightness, darkness and light, soul pain and morning star, wounded dignity and rescued dignity are experiences that intertwine with each other, and are part of each of our lives: in their dizzying alternations and mysterious alliances …”[1].

With these words, which introduce the reading of Eugenio Borgna’s book, “Wounded Dignity,” we open the editorial of this issue 21 of Laborcare Journal.

It is an issue that we consider important precisely because the choice of the theme coincided with the approval of Law No. 219 of December 22, 2017, which, and this is our hope, should bring, at last, the sick person to the center of care not only in demagogic terms but by recognizing in it the founding principles expressed in Article 32 of the Italian Constitution.

The articles that make up this issue “touch” the reader whether he or she is a health professional, volunteer, caregiver or sick person.

Ensuring dignity is the common thread that connects the various contributions: a right that, in the words of Harvey Max Chochinov, “ … touches a chord that resonates very deeply with most health professionals …”.

The authors of the article opening this issue 21 point out how much the terminal phase of illness, very often “evokes unique scenarios of suffering, loss of interest in life, and isolation. For those who work in Palliative Care, if careful observers, there emerges instead an unimaginable attachment to life and to the affirmation of that identity as a ‘person,’ which would seem to be lost. In reality, the person-patient must be ‘facilitated’ to bring out the vitality and personality, always present but often relegated to a corner of that bed, that room, often barely ‘perceivable’ . in a light makeup matched to the color of the pajamas, in the accuracy of the bedside table set-up, in the drawing left half-drawn next to the bed: all details to hold on to in order to open a relationship, that precious and true relationship that we often neglect, focusing attention only on symptoms and drugs…”

It is with these assumptions that, at the Hospice of Grosseto since February 2017, an experience of Dignity Therapy has been conducted, which, starting from the foundations laid by H. M. Chochinov, has been designed and implemented “a model of narrative therapy aimed at improving the awareness and needs of the person in the path of terminality.”

The authors of the article opening this issue 21 point out how much the terminal phase of illness, very often “evokes unique scenarios of suffering, loss of interest in life, and isolation. For those who work in Palliative Care, if careful observers, there emerges instead an unimaginable attachment to life and to the affirmation of that identity as a ‘person,’ which would seem to be lost. In reality, the person-patient must be ‘facilitated’ to bring out the vitality and personality, always present but often relegated to a corner of that bed, that room, often barely ‘perceivable’ . in a light makeup matched to the color of the pajamas, in the accuracy of the bedside table set-up, in the drawing left half-drawn next to the bed: all details to hold on to in order to open a relationship, that precious and true relationship that we often neglect, focusing attention only on symptoms and drugs…”

It is with these assumptions that, at the Hospice of Grosseto since February 2017, an experience of Dignity Therapy has been conducted, which, starting from the foundations laid by H. M. Chochinov, has been designed and implemented “a model of narrative therapy aimed at improving the awareness and needs of the person in the path of terminality.”

Laura Brunelli, in her contribution “But You, How Would You Have Wanted to Die?” tells the story of an encounter between two nursing students on internship and a foreign woman who, far from home, spent the last days of her life in a hospital bed … alone.

This article is full of gestures, feelings, emotions: “… every time Gabriele and I went to her, she sought our hand; she sought a form of affection and, in spasms of constant pain, she asked us not to leave her alone.”

Laura tells us that, even today, years later, she cannot forget that this lady died alone and “… alone, she was buried in the same clothes she was wearing at the time of her admission, without the presence of any relative or friend.”

The question, at this point, arises: “How prepared, today, are health professionals to deal with the terminal stages of illness and to accompany their patients to death not as an exclusively biological event – to be managed with techniques and procedures – forgetting the Person (son – daughter – father – mother …)?”.

Luciana Coèn, nurse – educator attentive to the issues of the end of life – in her article “That of death” writes: “The passage (…) that the operator must make is to always consider the person bearer of need/requirement of attention and care of his own dignity, of respect and listening to the experience, which, however, remains in those who have known and shared with her and which, in every way, has marked her, making her unique even to herself. This is the knowing how to become, the attention to personal emotions and, at the same time, the attentive listening to the other person (not only with the hearing but with the heart and soul) and to the one death that passes through him or her and causes him or her to close his or her earthly life.

This very delicate and challenging passage should arouse, stimulate, accompany the formation, the formator …”

Defending and ensuring dignity through attentive listening to the other is Care!

There is a place where all this is everyday: hospice.

Anna Maria del Balzo, a volunteer with the Italian Foundation of Lenitrapy (FILE), in her article “Volunteering in hospice, a way of life,” writes, “Hospice is a place where asking these questions is part of everyday life. To look life in the face and be reconciled with death, looking at it not as a failure of medicine or existence, but as a necessary part of it.”

The spirit of donating one’s time to “be there for each other” is, as Laura Bargelli (FILE volunteer) points out in her contribution, an opportunity to learn to “love life and appreciate the small daily joys, to take nothing for granted, to value the present and live it more intensely because life is unpredictable and everything can change in an instant. In the end what we volunteers do is this, to give importance to the present, to the here and now.”

We entrust the final reflections to you because we are convinced that, even this issue of Laborcare Journal, takes the reader “far away” finding meaning, not only in the daily work routine but, above all, in the story of each of us.

• It is possible to view the full issue of the magazine at http://www.laborcare.it”

• Read other published articles

Source

• Laborcare Journal (Editorial No. 12)

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• Image digitally created by spazio + spadoni