Based on therapy developed by Canadian Dr. Harvey Max Chochinov specifically for terminally ill patients, Reflections is a life review technique that allows people to take stock of their lives and what is most important to them, explained Heather Moran, an RN with Mercy Hospice.

“I’m Southern,” says Mount Shasta’s Michael Wirth in her signature drawl. “Having conversations is what we Southerners do.”

Conversations about life, death and everything in between – and preserving special memories – is the purpose of Mercy Hospice’s Reflections program, which was brought to fruition by Wirth and her husband, Joe, in 2017.

Based on therapy developed by Canadian Dr. Harvey Max Chochinov specifically for terminally ill patients, Reflections is a life review technique that allows people to take stock of their lives and what is most important to them, explained Heather Moran, an RN with Mercy Hospice.

Trained volunteers interview patients and their recorded words are transcribed and bound into a book so their final words can remain with their loved ones in written form.

Michael Wirth said she read about Chochinov’s Dignity Therapy program several years ago and found it so valuable that she decided to attend a training to learn how to implement the program herself.

The Wirths donated funding to send Moran and Mercy Hospice volunteer Jane Prestegard to a four-day training in Manitoba, Canada in order to launch a version of Chochinov’s program in south Siskiyou County.

Although the Wirths’ donation got the program off the ground, it is supported by ongoing donations, said Kristine Neel, Manager of Hospice Services. She and Wirth hope Reflections will continue to benefit Siskiyou County residents who have valuable stories to tell in their final days.

When a healthy person in the middle of their life answers the Reflections interview questions, Moran said they’ll usually talk about their various accomplishments. But in their final days, people often have a different perspective and concentrate on the value of their relationships, dreams, regrets, and the lessons they’ve learned. The process allows them to really consider the legacy they’ll leave for others and reinstills a sense of dignity and pride.

How the program works

Reflections interviews are done at bedside so patients don’t have to leave home. Many don’t have much energy, but talking with a volunteer often gives a hospice patient something important to do, said Moran.

Volunteers try to have the entire process, from the first interview to the presentation of the book, done in a week or less, so patients have the chance to enjoy the fruits of their labor.

During the first visit, volunteers learn basic information about the patient, who is given a list of questions so they can ruminate for a day or two.

The actual interview is completed in about an hour, said Moran, an amount of time found to be “just right” for most people to say everything they want to without becoming too tired or overwhelmed.

The interviews are voice recorded and transcribed word for word, said Moran. Volunteers do some light editing to ensure the final product reads like a cohesive story while preserving each person’s voice and syntax.

This process allows for the preservation of each person’s personality in the way they wish to be remembered, said Wirth, who has completed the process many times and always finds it to be a moving experience.

A voice recorder is also brought to a follow-up visit, said Moran. Patients can add anything they may have forgotten the first time around. The entire document is reviewed for accuracy and any desired edits can be made at that time.

Wirth said patients are always in control of the process. If, during that third visit, a patient decides they don’t want their words printed at all, “we’ll throw the whole thing out,” she said.

The final product is printed on quality paper and bound into a book. It’s accompanied by a photo of the patient’s choice.

While the process is time consuming for volunteers, who work collaboratively to complete the narrative, it’s a satisfying experience, said Moran

There are currently six volunteers for the program. The team is full of “empathetic, intelligent people who take the time to ask questions and listen with an open heart to each patient’s story,” said Moran.

Neel said Mercy Hospice offers the Reflections program to all of their patients. They provide up to three copies of the document and are also willing to share it digitally for families to cherish as they wish.

The questions

Patients are asked about their life history, particularly the parts that they remember most or are most important. When did they feel most “alive?”

They’re asked about specific things they want their family to know or remember about them; the most important roles they played in life and what they accomplished.

They’re asked what makes them feel most proud and if there are things they feel need to be said to their loved ones, or things they’d like to say again.

They are asked their hopes and dreams for their loved ones; what they’ve learned in life that they want to pass along to others and for words of advice or guidance.

About hospice

Hospice provides medical, emotional, and spiritual support and care for terminal patients with a prognosis of six months or less to live.

“We strive to enrich every moment of remaining life. We treat the person instead of the disease, focus on the family instead of just the individual, and emphasize comfort and quality of life,” according to Mercy Hospice’s website.

Hospice care is primarily based in the home, enabling families to remain together in peace, comfort, and dignity, and is provided by professional caregivers and volunteers.

Follow-up bereavement support is provided for surviving family members and caregivers. Support groups are offered throughout the year.

To learn more about Mercy Hospice and their Reflections program, call (530) 926-6111 or call 877-661-2713, ext. 455.