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American Journal of Hospice and Palliative Medicine®
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Meaning Construction in Palliative Care: The Use of Narrative, Ritual, and the Expressive Arts

Bronna D. Romanoff, PhD

Department of Psychology, The Sage Colleges, 45 Ferry Street, Troy, NY 12180 romanb{at}sage.edu

Barbara E. Thompson

Institute of Palliative Care, The Sage Colleges, Troy, New York

Individuals and families make sense of the world and their experiences through a process of meaning construction. Narrative is an important means of constructing meaning. The diagnosis of life-threatening or life-altering illness often forces revision in the life narrative and the reconstruction of meaning. This article discusses the process of meaning construction and highlights the use of narrative, the expressive arts, and ritual to create meaning and connection. All members of the palliative care team play an important role in helping patients and families tell the stories of their illness and their lives and find meaning and purpose at the end of life. The use of rituals is discussed along with verbal and art-based methods for eliciting patient and family narratives. The relationships among patient, family, and practitioner are seen as powerfully therapeutic and potentially transformative for all involved.

Key Words: meaning construction • palliative care • narrative • ritual • expressive arts

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 4, 309-316 (2006)
DOI: 10.1177/1049909106290246


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