Registered Nurses' Association of Ontario

Practice Notes related to Life Reflection

The expert panel emphasized that in order to provide effective support to persons with progressive life-limiting illness and their families—and to provide opportunities for reflection—nurses and other health providers must first be provided with training to enhance their practice with the knowledge and skills needed to approach life reflection conversations. This includes trauma-informed approaches and recognizing when such conversations may not be appropriate. 
A person- and family-centred approach to life reflection includes providing flexibility, both in the timing of the dialogue and in the number of sessions offered (81). For instance, life reflection should not be introduced immediately after the diagnosis of a progressive life-limiting illness because time is required for a person to process the information and adapt. The authors of one review study also suggest that life reflection programs remain brief in duration due to the shortened life expectancy of persons at the end of life (80).
Strategies identified within the literature that were used by health providers to engage in life reflection conversations with persons with progressive life-limiting illness included the following:
 spending time with persons in a non-judgemental manner;
 establishing rapport and trust with the person (72, 78);
 acknowledging the individuality of the person;
 demonstrating compassion;
 communicating with persons with full attention;
 facilitating a safe environment (72);
 sharing in silence with the person in order to demonstrate openness and availability for support (73);
 providing persons with opportunities to discuss fears, explore hopes and dreams, remember past experiences
and reflect on meaning in life (78); 
 listening actively in an uninterrupted, open and respectful manner when the person is ready to reflect and
speak about their experiences (69); and
 supporting the person without trying to change their circumstances (69).
Clinical Management
A Palliative Approach To Care In The Last 12 Months of Life
Point of Care Resources