HOW DO WE WANT TO CARE FOR THE DYING?
586796
What could be amore basic human issues than how we might die with less fear and pain, and how we might help one another more compassionately and skillfully? If you want to explore such questions,this is the film for you.

This documentary by Terrance Youk, and produced by the Madison-Deane Initiative, profiles pioneering figures in the birth of the hospice movement in the modern society and its growth from a single hospice in England to a worldwide movement. Thanks to the pioneering efforts of people like Elizabeth Kubler-Ross, Cicely Saunders, Florence Wald, and Balfour Mount, many people all over the world have now benefitted from a more holistic, compassionate, and knowledgeable approach to end-of-life care. These individuals spurred not only the growth of the hospice movement, but the growing field of palliative care, a medical specialty focusing on the care of persons with chronic, life threatening, or terminal illness.

As the United States embarks on a debate and rethinking of our health care system, the insights and experiences of these pivotal figures shed light on how much we have progressed and how much we still desperately need to improve. The dialogue on improving the care of the dying is as relevant now as it was in the days of these visionaries, especially as our population ages and we are faced with more chronic diseases.

I have often used this film as a component of workshops I teach on a contemplative approach to facing death and helping the dying. It really opens up the dialogue on a subject that is not always easy to discuss. I find that it helps viewers look into their own issues and those of the broader society in facing the reality of death and finding a way to come to terms with our own mortality. At the same time, it challenges us to think more deeply about how to help people with terminal illness find support, meaning, and value in this stage of their life.

The personalities highlighted in this film are vivid examples of how addressing this very human reality--that we all face death--leads not to depression but to living fully and with delight, humor, and compassion. And for people interested in the broader topic of social movements and social change, this film  demonstrates the amazing social transformations the passionate work of a few individuals can spark.
3767947
This excellent book describes how we can put ourselves in charge of our end-of-life care.  Through numerous stories of patients at the end of their lives, the author movingly describes how some have attained "the better end" - one where their end-of-life care comported with their wishes - and how others have faced a tragic end of painful and unnecessary medical interventions.  The author discusses how we can take charge of our end-of-life care by completing an advance directive that reflects our values and preferences for treatments and interventions.  It is a must-read for all people, young and old.
2630581
I purchased this book to help me accept and explain the process of death and to help me understand the attitudes of the terminal patient.  I also sent it to my family members who were struggling with this type of loss.  This is a very easy read, not in the least scary or depressing.  It covers the stages of loss for both parties, the dying and those who have to live on.  An excellent source book for anyone who cares for the sick, or who is struggling with loss of friend or family member.
319310
As we will all die, this is a must read book for everyone.

In this well-researched book, Robert Orfali takes us on a tour of the American end of life system. He writes about how we die today in hospitals, ICUs, nursing homes and hospices. In this age of "slow dying and chronic disease" there is just too much unnecessary "torture" at the end...it is not a pretty picture. Orfali believes that some of this torture can be mitigated if we learn how to navigate the system and inform ourselves about our end-of-life choices. He tells us we must learn how to protect ourselves from the high-tech medical machine. We must become better consumers of death. Learning about death and the end of life system certainly will not kill us.

The modern end-of-life system appears to be a minefield filled with dangers. Even our hospices can be an unpredictable terrain. Orfali's data shows that there is only a 50/50 chance that you will receive palliative sedation in a hospice if you need it--it's all up to the attending physician. Orfali believes that terminal pain must be treated like an emergency. For example, he suggests that if you're experiencing unbearable terminal pain or suffering, why shouldn't you be able to call 911 and get hooked to a morphine pump? Orfali is a big advocate of end-of-life choices. He argues that we need all the choices that we can get at the end--including physician-assisted dying. He sees this last option can be a form of torture insurance in case all other options fail. For some, that option could be a first choice. Orfali makes a very strong case that "assisted dying complements hospice." He uses the latest data to demonstrate that, by providing both, "Oregon now has the best palliative-care system in America today." I totally agree.

During my long career as a firefighter and first responder in the state of Oregon, I have repeatedly witnessed death up close. I know for sure that with some preparation much of the suffering could have been avoided. Over the last thirteen years, the state of Oregon has taken great strides to improve its end-of-life system. The rest of the American end-of-life system is in need of some serious tweaking. I agree with Orfali that Oregon can serve as a proven model that works.

Death will never be easy. You must read this book to protect yourself and your loved ones. By familiarizing ourselves with how we die in America today, and with a bit of luck, we can make our deaths or those of our loved ones a little gentler. Read this book and make sure your friends also read it.  At only $0.99 for the e-book, it's a wealth of information.

Michael McGuire
Deputy Chief (retired)
4722017
If ever you have to care for a dying person, you are caring for two at the same time.  If it is a close family member, you are dying with them as you go through this journey together.  But you do get left behind.  This small book helps with those feelings of frustration and the questions of, "Am I doing this right?"

I highly recommend this no matter what faith you are.
3433250
Very thoughtful way of looking at the end of a life. The reflection of the past, the observances of the present. Will done.
4001670
This book was recommended to me by a coworker and it helps me think about the ""bottom line" when it comes to caring for the elderly or those who at the end of their lives.  The book is anecdotal in nature and talks a lot about alternatives to many of the choices we make today.

One of the things I have noticed is that our parents/elderly worry about being placed in a nursing home.  Truly, many of them are not safe in their own homes and cannot live independently.  One thing we need to discuss is what they need to stay happy and feel productive and safe.  So often our loved ones do not have choices in their lives and do nothing more than exist.

I loved that there are alternatives out there for elder care and end of life care.  The more homey and independent we can allow our loved ones to be, the happier they are.  We just need to know what they want in terms of that independence.  Do they want their pet?  Do they want to choose when to rise or when to eat?  Do they need to be able to do many of their former activities?

End of life care is handled the same way.  What is the bottom line?  What do you want the end script to be?  What do you need to have quality of life and happiness?  It may surprise you and may give you insight when fulfilling the wishes of our loved ones.

One of the things that I found interesting is that having animals, birds, cats,, dogs in care centers is one of the important factors.  The Home like atmosphere with "pods" instead of halls with a single caregiver who not only does the ADLs as well as passing meds and serving meals makes life more sustainable.

Loved that the book made me think and look at alternatives.  Our population is aging and we are aging.  We need to make better choices at the end of life.  Convenience for the family is not necessarily the right choice for the loved one.  There may be other choices.
4676556
I work at a nursing home and we give this book to people who have questions about advance directives.  This explains their choices for a living will like CPR, feeding tubes, and other issues.  Sometimes just offering comfort care can be the most humane option, but everyone should have their choices honored.
2060111
As a nurse who has worked for hospice, I found myself cheering for and empathizing with the author. We have concealed death behind the closed doors of the hospital and the funeral industry to the detriment of our loved ones and our own psyche. Death has become something to fear, something to be sanitized and cosmetized into submission. However, I we must ask ourselves what all this means to us as human beings and to our feeling as finite beings on our journey through this thing called life. Are we not missing a vital part of the human experience?
3985719
Very well written, a good prospective of palliative care and those effected by someone dying. Emotional, insight  into a childs mind on someone dying.
4891753
Caring for those at end of life is what I do for a living. This is exactly what our country needs. I hope both physicians and public heed its message.
2649737
More stories of end of physical life leading to another kind of life.  This should be proof enough that this short time we have here is not the end.  It is the doorway to something much greater.  We should all spend more time considering what comes after this.  We spend more time deciding what we want for dinner each day than we spend contemplating eternity.  We spend much more time, energy and planning on where will we go for vacation than we do wondering about what we will do and where we will go forever.
3169244
Purchased several for some nurses that work for a hospice, with my husband, who is a hospice chaplain.
I read it and I think it will be interesting
2646627
Sometimes you read a book. While reading you realize your life will never be the same. This was one of those books for me. 

Can we be honest for a second, how often do you think about aging? How often do you think about your own aging?

Gawande talks about the things we don't often talk about. Are Nursing Homes really nursing our loved ones back to health (as they were originallydesigned to do) Are Assisted Living Facilities really assisting with the living? Are they helping our loved ones live or are they just helping them get their meds on time? Gawande pulls from his experience as a doctor and his experience as his father was dying to give us and all sides picture of how things might be. Sometimes doctors do everything they can to get rid of the ailment, and patients want to just get back to normal. But what do you do and say when a patient is going to die soon and sometimes the treatment will leave them as bad off as the disease itself? 

One chapter that was highly informative for me was Gawande's take on hospice. Hospice is not just there because you are dying. Hospice is there to make your life the best it can be as you are dying. Many people didn't use hospice service because it was sort of like giving up. But in the last few years accordingto studies more and more people have started using it. Gawande points out that this saves lots of money because people aren't signing up for the $200,000 procedures that tend to not work at that stage. He points out that often after 2 rounds of Chemo patients show little if any improvement after the 3rd round. Often the 3rd round takes their system down and speeds up the dying process. 

I highly recommend this book for everyone. We do not have the hard discussions about dying, what we want most in life as we are dying, and how we want to be treated as we die. We tend to just try to keep people living, and don't always take the time to find out what they really want. 

So if you are looking for a happy read. This is not it. If you are looking for something to ease your mind about dying. This is not it. If you are looking for real suggestions for real problems then this book might be just what the Doctor ordered.
216019
When death visits, there are problems left behind. Love can face any thing and bring a guiding destiny to bear with the help of a true medium.

Give it some thought and a good read!!
3191083
Hospice doesn't care for dying patients; it cares for living patients! It cares for patients who need not just pain management and vital information, but compassionate, personal, heartfelt care.

I met one of the co-authors of "The End of Life Advisor," Susan Dolan, at a hospice conference where we were both speakers, before I ever read her book. I was impressed by her outlook, her passion, her eagerness to make a difference in people's lives, and I was determined to read the book!  Granted, I was also a bit apprehensive: I expected a grim, depressing, encyclopedic book that would be informative, but difficult (and unpleasant) to read.  And I was wrong.

"The End of Life Advisor" is certainly informative, but it's neither grim nor depressing.  How can that possibly be, you ask?  It's because this book is full of uplifting, exciting, sometimes even funny stories that celebrate life! Surely it's a book that's informative about important issues, such as managing pain, the value and experience of hospice, creating a will or planning a funeral.  But it's also a book full of dialogue so compelling it often reads like a novel!  You'll eavesdrop as Vincent tells Ira, a hospice volunteer, about storming Omaha Beach on D-Day; you'll chuckle at Art Buchwald's experience with hospice; you'll almost taste the raspberry tea with honey as you visit with Big Bess and Little Bess!  It's clear that this is a personal, intimately written book by two authors with a wealth of experience with hospice care.

Who should read "The End of Life Advisor"?  Hospice staff and volunteers will definitely grab a copy; they'll see themselves and their patients through the pages, and reaffirm the importance and meaning of everything they do.  Family members of loved ones who had the good fortune of being in the care of hospice angels will laugh, cry, and celebrate their family members' lives in every page.  But this is truly a book for everyone with a friend or family member who died from an illness, and a book for everyone who may one day die themselves (I'm stubbornly avoiding death myself, but I suspect my turn might eventually come too).  The information will make a world of difference, and the stories will help anyone look at life (not just death) in a different light. What a great read!
931481
Remember:  This is Death with Dignity, NOT, Assisted Suicide.  Big difference.  These people are in pain and are suffering and their is no more that the doctors can offer them.  If you are not suffering their pain, you cannot know the agony.  There is great nobility in knowing when to let go and how to let go.

Beautiful documentary - beautiful souls - those who departed and the families and loved ones left behind.