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The last letter

Regret is the most reported feeling by those who are close to death. This beautiful design created by Stanford University inspires patients to a loving final statement to make amends : writting a letter of recognition, love, forgiveness and farewell.


“The grieving process begins with the death of someone who is very important in our lives. Not always the important link is made only of love, and the more it is contaminated with complex feelings such as fear, anger, grief or guilt, the harder it will be to face the grieving process. ”

The passage above, taken from the book “A morte é um Dia que vale a pena Viver” “Death is a day Worthwhile Living” (Casa da Palavra Publisher), the geriatrician and specialist in Palliative Care, Ana Claudia Quintana Arantes, deals with the importance, for the one who is gone and the ones who stay, to make amends. Review life before the end, and do what really matters , it is liberating for the dying one and comforting for those who will face the pain of loss.

It was with this conviction that Dr. VJ Periyakoil, a geriatrician, Director of Palliative Care at the University of Stanford, California, had the idea to inspire her patients to write “the last letter.” During 15 years of direct contact with people near the end of their lives, the American doctor had very open conversations with her patients. And the feeling that appeared the most in every conversation was regret: regret for not having restored friendships and broken relationships; regret for not having told family and friends how much they love them; regret for thinking that they would be remembered by children as critical and authoritarian parents.

Aaron Burden Unsplash

It was in order to try to alleviate this anxiety that Dr. Peiyakoil created the Stanford Friends and Family Letter Project. With the guidance of terminal patients and their families, she developed a very simple questionnaire as a guide for a life review letter and the execution of 7 tasks:

1. Recognizing important people in your life

2. Remembering precious moment

3. Apologizing to people you may have hurt

4. Forgiving those who hurt you

5. Saying thank you

6. Saying I Love You

7. Saying goodbye

Once written, the letter can be delivered to those or be guarded by someone reliable to be delivered after death. Some patients, says the geriatrician, prefer to keep the letter in order to update it if desired, by the time they have ahead. Some of them have difficulty fulfilling the last task, to say goodbye, and are left completely free to do so or not. Others, no longer able to write, choose to record video messages.

“Reviewing the life” says the doctor, “is facing intense emotions. It requires a lot of courage but it has been transformative for patients and families in the anticipatory grieving process. ”

“Surely it is the most important letter you will write in life,” she concluded