The purpose of this study is to determine if it is feasible and acceptable to recruit for and deliver the Virtual Dignity Therapy intervention to palliative care patients with advanced cancer.

This study is an investigator-initiated, single site Mayo Clinic Rochester prospective minimal risk pilot study to determine feasibility and acceptability of Virtual Dignity Therapy. The Dignity Therapy intervention is a brief, individualized psychotherapy that aims to relieve psycho-emotional and existential distress and improve the experiences of patients whose lives are impacted by serious illness. This therapy offers patients an opportunity to reflect on their life with a trained facilitator and share their thoughts and memories with family and other people in their life. This therapy consists of a total of 3 sessions, with each session 2-4 weeks apart, in which the investigator provides questions focused on life review. The sessions are recorded and transcribed. The interventionist will work with patients to edit the document and provide a final generativity document for patient to keep and give to loved ones.

Inclusion Criteria:

• Age ≥18 years
• English fluency
• No diagnosed dementia
• Diagnosis of advanced cancer
• Expected prognosis > 6 months
• Provide informed consent
• Ability to complete questionnaire(s) by themselves or with assistance

Exclusion Criteria:

• Other psychological co-morbidities such as untreated schizophrenia, bipolar disease
• Recent suicide attempt or psychiatric illness severe enough that hospitalization has been necessary in last 6 months
• Active delirium
• Participation in concurrent legacy offerings through the palliative care clinic

Inclusion Criteria for caregivers:

• Age ≥18 years
• English fluency
• Provide informed consent
• Supported patient through Dignity Therapy