The Role of the General Practitioner in the Last Developmental Task of the Elder People About Death, Identity, Narratives and Dignity

Abstract

Contemporary Western society resists any form of existential reflection on the fact that we are mortal, whereas the media represent death as an exceptional event that takes place in situations that are very far from everyday realities. Some negative effects derive from this cultural removal. In the last decades, the debates surrounding death have taken on greater importance in both clinical and academic fields. Older people often die in retirement homes. The cultural denial of death means that tools and structured paths are rarely prepared to equip them with appropriate instruments. This chapter presents the concept of the last developmental task, which is a time when the elder people should reconstruct their sense of existence. In particular, it is considered how the dignity of the older persons can be enhanced by the general practitioner. In fact, the general practitioner is a central figure in the care of older people, because he knows their medical history and has often established a relationship of trust with them. Dignity therapy represents a valid instrument for helping terminally ill patients. The possibility for the general practitioner of utilising it with elder people has been hypothesised. In fact, the psychological literature has already shown how narrative methodologies facilitate talking about the past as a function of the future, even when one is facing death. Being able to narrate the trials that one has already overcome and remembering how the difficulties that have been overcome have affected the future may help one think beyond death.