Identity and the End‐of‐Life Story: A Role for Psychologists

Abstract

Objective

Narrative approaches to identity, which conceptualise a person's identity as their life story, present a useful way for approaching support at end‐of‐life because they do not pathologise dying but rather recognise it is the final chapter of a life story. The construction of life stories is always a social process and could be supported by psychologists. Attention to issues of identity and relationships is beneficial for dying people and their carers and counteracts the medicalisation of dying.

The Caring at End‐of‐Life Research Program identified the support necessary from family, friends, community, and professionals for people to die at home, which is the preference of over 80% of Australians. Identifying the current and potential role of psychologists is the present focus.

Method

Qualitative analysis of eight service provider focus groups (88 people), 13 focus groups with carers and their support networks (n = 84), and individual interviews with carers (n = 23), and community (n = 17) was conducted in urban and rural New South Wales and the Australian Capital Territory.

Results

End‐of‐life transition was achieved without loss of identity when relationships with people, places, and objects which sustained identity were maintained. Carers required knowledge, skills, and adjustments about which psychologists have expertise such as emotional work, supporting networks, resisting pressure from medical staff, and adjustment at death. However, no psychologists attended the service provider focus groups and carers identified only three psychologists among 58 service providers.

Conclusion

Psychologists could play a valuable role by recognising end‐of‐life as a major transition and assisting with identity maintenance through that time.

Key words:

• caring
• end‐of‐life
• identity
• life story
• life transitions
• psychologists’ role

Acknowledgements

We would like to acknowledge our partner organisation Cancer Council NSW. Ethical approval was provided by the “Western Sydney University Human Ethics Committee”.