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        9-13+

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        Seven Songs for a Long Life | Lesson Plan: Living and Dying with Dignity

        In this lesson, students will use the documentary Seven Songs for a Long Life by Amy Hardie to explore the experience of living with a terminal illness or providing care for someone with a terminal illness. In doing so, students will also examine their own attitudes toward death and dying. Through the stories of nurses and patients at Strathcarron Hospice, students will learn about the challenges of balancing physical care with quality of life and reflect on the value of arts and music in palliative care.

        Lesson Summary

        In this lesson, students will use the documentary Seven Songs for a Long Life by Amy Hardie to explore the experience of living with a terminal illness or providing care for someone with a terminal illness. In doing so, students will also examine their own attitudes toward death and dying. Through the stories of nurses and patients at Strathcarron Hospice, students will learn about the challenges of balancing physical care with quality of life and reflect on the value of arts and music in palliative care.

        Time Allotment

        One 50-minute class period plus homework

        Learning Objectives

        • Examine social and cultural attitudes toward death and dying
        • Understand the function and value of palliative care and hospice care for chronically and terminally ill patients and their communities
        • Compare and contrast the experiences and priorities of patients featured in Seven Songs for a Long Life
        • Research local services and/or policies related to hospice care and write essays assessing the quality and accessibility of care for people in their community

         

        Prep for Teachers

        VOCABULARY

        The following are abbreviated versions of definitions from the Merriam-Webster Dictionary

        • Art therapy: therapy based on engagement in artistic activities as a means of creative expression and symbolic communication
        • Hospice: a facility or program designed to provide a caring environment for meeting the physical and emotional needs of the terminally ill
        • Music therapy: therapy based on engagement in musical activities: the therapeutic use of music that typically involves listening to music, singing, playing musical instruments or composing music
        • Occupational therapy: therapy based on engagement in meaningful activities of daily life (as self-care skills, education work or social interaction) especially to enable or encourage participation in such activities despite impairments or limitations in physical or mental functioning
        • Palliative care: medical and related care provided to a patient with a serious, life-threatening or terminal illness that is not intended to provide curative treatment but rather to manage symptoms, relieve pain and discomfort, improve quality of life and meet the emotional, social and spiritual needs of the patient
        • Physical therapy: the treatment of disease, injury or disability by physical and mechanical means

        FACILITATOR NOTE: This lesson plan focuses on issues surrounding palliative care and social and cultural responses to death and dying. Educators and facilitators are strongly encouraged to review all of the materials and film clips to be sure the topic and lesson are appropriate for their curricula and students. At the teacher’s discretion, a preliminary discussion with the class may be required, as it may be advisable to identify students who might be personally and/or adversely affected by this material. Teachers should also consult with school counselors, social workers and/or administrators to provide students with support or the option of not participating in the lesson where appropriate. Some students may not be open to talking about death and/or may have recently experienced the deaths of loved ones. Please be sensitive about their desire to communicate when ready.

        Supplies

        -Film clips from Seven Songs for a Long Life and equipment on which to view them
        -Official trailer for Seven Songs for a Long Life
        -Computers with Internet access
        -Student handouts

        Teacher handout

         

        Introductory Activity

        Step 1: Talking About Death

        In this activity, students will examine their responses to death and dying and discuss some of the factors that shape attitudes toward this topic.

        Do Now Think-Pair-Share: Write the following quote by Jok Church (writer, educator, animator, cartoonist) on the board:

        Death is a part of life… And you know, that part of life needs everything that the rest of life does.

        Have students rewrite the quote in their own words and share their responses with partners. Ask for volunteers to share their responses with the class and then hold a discussion.

        Discussion prompts:

        • Do you agree with this quote? Why or why not?
        • When do we typically encounter conversations about death and dying? In what context does this topic come up?
        • What are some factors that shape how we respond to the topic of death and dying? (Family, tradition, culture, movies, music, news, religion and so on.)
        • What benefit, if any, is there in discussing death and dying?

        Explain to students that they are going to have a conversation about how we respond—personally and culturally—to the process of dying and how we care for people who are living with terminal illnesses.

        Have students complete the following sentence in writing. (Note: Students may share their responses now or keep them private until the end of the lesson, when they will refer to them again as part of a journaling activity.)

        When we talk about death and dying, I feel ____________________________, because _______________________________________________________.

        Learning Activities

        Step 2: Understanding Hospice Care

        In this activity, students will explore and discuss palliative and hospice care through the experiences of nurses treating chronically and terminally ill patients at Strathcarron Hospice in Scotland.

        Introduce the lesson plan vocabulary (palliative care, hospice, physical therapy, art therapy).

        Explain: Today, we will be watching clips from the film Seven Songs for a Long Life, which follows the stories of several hospice patients at Strathcarron Hospice in Scotland as they confront the challenges of living with terminal illness.

        Screen and discuss Clip 1, the official trailer for Seven Songs for a Long Life and Clip 2, featuring Strathcarron palliative care nurse Mandy explaining her personal experience as an end-of-life caregiver and the value of art and music therapy. Have students take notes while watching the clip with a focus on the following prompt: “What are the responsibilities of a palliative care nurse?”

        (Facilitator note: Explain that Clip 2 is short, so students will need to engage in proactive viewing.)

        After screening Clip 2, review the students’ notes and discuss:

        • How did Mandy’s attitude toward her roles and responsibilities change over time?
        • What did Mandy highlight as her most important responsibility?

        Explain: Palliative care professionals (doctors, nurses and other staff members) have to balance two very important priorities when working with patients: treating physical illness and caring for wellbeing. Sometimes what is good for the body can be hard on the patient and the patient’s quality of life (for example: some treatments cause extreme pain and discomfort) and vice versa (for example: minimizing difficult treatments could limit opportunities for improvement). In each case, outcomes are uncertain, so no guarantees can be given. This situation requires caregivers to work with the patients to make difficult decisions about the physical and emotional cost and benefits of each treatment.

        Ask for volunteers to read the Teacher Handout: Curing and Caring to the class and discuss:

        • How does Mandy balance curing and caring?
        • Mandy says, “We can’t fix everything and what we have to learn to do is listen. And sometimes you have to sit on your hands because all you want to do is fix it, and you can’t fix it, you just listen. And listen properly.” What does she mean by this? Why does she stress the importance of listening “properly”? How does this relate to what we read about curing and caring?

        Screen Clip 3 and have the class record scenes and quotes that demonstrate Mandy and her colleagues curing, caring and listening.

        After viewing the clip and before the class discussion, have students free-write for one minute using the following prompts and share their feedback with the class:

        Discussion prompts:

        • What feelings did you have when the patients and nurses started singing? What was your first response?
        • Why do you think we reacted the way we did to the patients and nurses singing? Why do you think singing inspires so many emotional responses in us? How might these complex reactions be beneficial for patients and caregivers in a hospice?
        • What surprised you most in this clip?
        • How does Mandy balance curing and caring in her work with patients?
        • Can you give an example of Mandy “listening properly”?
        • How does this strategy help to balance her responsibility to both cure and care for Dorene?
        • What personal reason does Mandy give for why she chose to incorporate music into her patients’ therapy?
        • What benefits do you think music can offer to people who are experiencing illness?
        • Can you share an example from your own life of music or art helping you through a difficult time?

         

        Step 3: Living and Dying with Dignity

        In this activity, students will compare and analyze the goals and priorities for end-of-life care through the case studies of patients featured in Seven Songs for a Long Life.

        Organize students into small groups. Assign each group a patient — Nicola, Iain, Julie, or Alicia — as a case study and have each group view their patient’s video clip.

        Distribute a copy of Student Handout A: Case Studies to each student and instruct the groups to collaborate on completing the viewing and discussion worksheet. (Although the students will collaborate on the handout, each should complete a worksheet for use later in this activity.)

        Facilitator note: If there are not enough computers available for each group to view its case study clip independently, play Clips 4 through 7 (12:01 min. total) for the class, then divide the students into their case study groups.

        When all the groups have completed their worksheets, reorganize the class into new groups of four or more students, so that each new group has at least one representative for each case study patient.

        Distribute one copy of Student Handout B: Group Discussion to each new group. Instruct the new groups to review their case study worksheets with each other and share what they learned from their patients’ stories. They should then use the prompts in Student Handout B to discuss further the similarities and differences in their patients’ experiences.

        Facilitator note: To save class time, teachers can go straight from the case study groups to a class discussion. Ask a representative from each case study group to share that group’s findings with the class, followed by a class discussion using prompts from Student Handout B.

        Culminating Activity

        Step 4: Reflection

        Conclude the lesson by asking students to write journal entries using one of the following prompts (this can also be completed as a homework assignment):

        • Revisit how you described your feelings about death and dying in step 1. In what way, if any, has your response changed and why? 
        • If you were one of the patients (or caregivers) at Strathcarron, what would be your “song for a long life”? Why would you choose this song? How do you think music and art help to reinforce the rights and dignity of patients in hospice?

        Step 5: Hospice in My Community

        Have students research and report on palliative care services in their community, including the quantity and quality of options available; the resources and services provided; and the average cost of care for inpatient services over the course of one year. Students should also:

        • Identify opportunities for improvement
        • Explain how they could personally contribute to improving care in their community

        Conclude the assignment by having students draft descriptive essays detailing what they have learned and how they can personally contribute to improving care in their community.

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