Legacy activities with adults can focus on creating a tangible product or creating fond memories which can help the patients’ loved ones to cope after the death event. It can offer healing to terminally ill patients themselves, allowing them an opportunity to review their lives, pass on life lessons, create memories that can help to ease the pain (physical and emotional), and give them a sense of dignity at the end of life.
Dying does not mean giving up. Everyone will experience death. However, how one approaches the death of a loved one or their own impending death is an individualized response. Honoring dignity during such a vulnerable time can help individuals face their end of life journey. A relatively new intervention, Dignity Therapy helps people with terminal diagnoses to work through their psychosocial and existential distress when faced with their mortality. It is usually a brief form of therapy focused on helping terminally ill individuals reflect on topics which are important to them and encourages them to pass on their values and life lessons to their loved ones. Dignity Therapy has been found to help decrease feelings of depression and anxiety when facing terminal prognosis.
Numerous factors impact the ability and the ways in which adults grieve. These factors include the individual’s relationship with the person who is ill, their age, and other life hardships which they have had to overcome. Often, hospice professionals witness how terminally ill individuals and their families grieve the lack of time that they have left together.
For patients and families, the decision to utilize hospice services is a difficult one and is often delayed until they are certain that the patient’s prognosis is a poor one. These patients elect hospice services when they are truly at the end of their lives when there are only weeks, days, or hours left. During these moments of limited time, having a toolkit of easy-to-complete legacy projects available is key. These situations become opportunities to create a lasting memory and turning this vulnerable time into a healing moment, full of love, support and closure.
Often, adults require convincing or explanation about legacy projects and the benefits of them. Family caregivers tend to be more focused on physical symptom management and caregiving tasks. While these issues are important, the psychosocial considerations of the dying process often become neglected. For example, the family caregiver’s ability to be present in the moment can have a huge impact on the end of life experience and how they will cope after the death event. Having a legacy toolkit available enables the hospice professional to build therapeutic rapport and create a lasting memory with the family.
Legacy projects for adults who are losing a parent:
- Recipe books: Often, families pass on long traditions of great food—from grandma’s pasta sauce to Uncle Bob’s cherry pie. Finding the time and creating an opportunity to write down a family recipe is a great way to facilitate life review and have a baking session to relive some of those memories. These family recipes can be shared from one generation to the next. (Appendix A)
- Helping a parent write their obituary: This was also listed under the legacy project for children. Though some may find this activity to be morbid, it is empowering to understand one’s mortality and to ensure that the story to be told is one that the parent would be proud of. Usually, obituaries contain the person’s accomplishments as part of the story. What better way to know a parent’s biggest accomplishment than to have them write it down? One may assume it was their career of 50+ years at the same company but for the parent, their greatest accomplishment may have been to watch their grandchildren graduate from high school.
- Fingerprint mementos: There are several methods of taking a person’s fingerprint and turning it into jewelry or memento. (Appendix A)
- Writing down a parent’s life story: This is about engagement in storytelling. Find a nice journal and ask the parent(s) to tell stories about their childhood or adulthood. Help them to record stories that the family have not heard before.
- Listening to music and making a legacy CD of parent’s favorite tunes
Legacy projects for adults who are losing a sibling:
- Recreating old photos from a time period when the siblings were younger (Appendix A)
- Going to an event such as a sports game, movie theater, play, or concert
- Fingerprint mementos (see examples in the links provided below)
- Writing the speech for the future wedding of a sibling to be read at the time of the reception
- Creating greeting cards which celebrate milestones and having someone deliver it to the intended recipient upon the occasion. Examples of milestones include 21st birthdays, high school/college graduations, weddings, baby showers, etc. When writing milestone notes, it is important not to focus only on the success of recipient. That is, including phrases like “I hope you became a doctor, are married and have 3 children by now” could inflict a sense of failure if the recipient has chosen a different life path.
- Going on a road trip (pending health condition) to bucket list spots together
Legacy projects for adults who are losing a spouse:
- Renewing wedding vows
- Celebrating an upcoming event a bit early
- Milestone cards and having someone deliver it upon the occasion
- Photography projects (see links below)
- Setting up deliveries for special occasions. Stories can be found of spouses setting up deliveries (such as flowers) to be received by the surviving partner during special occasions (e.g., birthday, wedding anniversary, holidays, etc.) throughout the first year of bereavement. There is usually a last delivery containing a note about grief, moving on, or hope of finding love again.
- Creating a playlist of favorite music or concerts attended together. This can include the couple’s wedding song or albums from the year the couple met.
Legacy projects for adults who are losing a child:
- Attending a sporting event of a favorite team or the concert of a favorite singer/music group
- Travelling to a special place (such as a beach, favorite city, or amusement park)
- Creating a foundation or scholarship in the child’s memory
- Creating a walk to fundraise for a foundation. If the child is still alive, this could be impactful for the child to witness the community’s support
- Creating memory bracelets
- Writing a story together
- Photography (Appendix A)
There are numerous ideas of legacy projects that can be completed as a family. Hospice professionals may assist families in navigating the logistics of a legacy project, especially if time is limited. For example, if there is an upcoming wedding in the family, there may be a way to move up the wedding date so that the patient can take part in the special day. Other examples include celebrating holidays earlier, such as Christmas in July or Halloween in March. Most importantly, never underestimate the power of simple conversation. Being present at the bedside and spending valuable time with a loved one can often be the most precious legacy left behind.
Martínez, M., Arantzamendi, M., Belar, A., Carrasco, J. M., Carvajal, A., Rullán, M., & Centeno, C. (2017). ‘Dignity therapy’, a promising intervention in palliative care: A comprehensive systematic literature review. Palliative medicine, 31(6), 492–509. doi:10.1177/0269216316665562
For homemade fingerprint jewelry:
Video tutorial/suggestion: https://www.youtube.com/watch?v=Z21wwV-Og1U
Recreating old family photos: