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Dying in America

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-03-19

Total Pages: 638

ISBN-13: 0309303133

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Approaching Death

Author: Committee on Care at the End of Life

Publisher: National Academies Press

Published: 1997-10-30

Total Pages: 457

ISBN-13: 0309518253

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When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Approaching the End

Author: David Albert Jones

Publisher: OUP Oxford

Published: 2007-08-30

Total Pages: 256

ISBN-13: 0191536911

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David Albert Jones considers two basic questions: how can we live well in the face of death? and when, if ever, is it legitimate deliberately to bring human life to an end? He focuses upon the distinct theological approaches to death shown by four outstanding Christian thinkers: Ambrose of Milan, Augustine of Hippo, Thomas Aquinas, and Karl Rahner. Jones's aim is not primarily to make a contribution to the history of theology, but rather, through engagement with the thought of theologians of the past, to reflect on some of the practical and existential issues that the approach of death presents for all of us.

Sedation at the End-of-life: An Interdisciplinary Approach

Author: Paulina Taboada

Publisher: Springer

Published: 2014-10-21

Total Pages: 190

ISBN-13: 9401791066

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The book’s main contribution is its interdisciplinary approach to the issue of sedation at the end-of-life. Because it occurs at the end of life, palliative sedation raises a number of important ethical and legal questions, including whether it is a covert form of euthanasia and for what purposes it may legally be used. Many of the book chapters address the first question and almost all deal with a specific form of the second: whether palliative sedation should be used for those experiencing “existential suffering”? This raises the question of what existential suffering is, a topic that is also discussed in the book. The different chapters address these issues from the perspectives of the relevant disciplines: Palliative Medicine, Bioethics, Law and Theology. Hence, helpful accounts of the clinical and historical background for this issue are provided and the importance of drawing accurate ethical and legal distinctions is stressed throughout the whole book. So the volume represents a valuable contribution to the emerging literature on this topic and should be helpful across a broad spectrum of readers: philosophers, theologians and physicians.

The Four Things That Matter Most - 10th Anniversary Edition

Author: Ira Byock

Publisher: Simon and Schuster

Published: 2014-06-10

Total Pages: 272

ISBN-13: 1476748535

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"With a new introduction and additional stories"--Jacket.

Extreme Measures

Author: Dr. Jessica Nutik Zitter, M.D.

Publisher: Penguin

Published: 2021-08-24

Total Pages: 353

ISBN-13: 0525533419

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For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.

Values at the End of Life

Author: Roi Livne

Publisher:

Published: 2019

Total Pages: 361

ISBN-13: 0674545176

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Once defiant of death--or even in denial--many American families and health care professionals are embracing the notion that a life consumed by suffering may not be worth living. Sociologist Roi Livne documents the rise and effectiveness of hospice and palliative care, and the growing acceptance that less treatment may be better near the end of life.

Caring for the Dying

Author: Henry Fersko-Weiss

Publisher: Conari Press

Published: 2017-03-01

Total Pages: 244

ISBN-13: 1633410366

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Caring for the Dying describes a whole new way to approach death and dying. It explores how the dying and their families can bring deep meaning and great comfort to the care given at the end of a life. Created by Henry Fersko-Weiss, the end-of-life doula model is adapted from the work of birth doulas and helps the dying to find meaning in their life, express that meaning in powerful and beautiful legacies, and plan for the final days. The approach calls for around-the-clock vigil care, so the dying person and their family have the emotional and spiritual support they need along with guidance on signs and symptoms of dying. It also covers the work of reprocessing a death with the family afterward and the early work of grieving. Emphasis is placed on the space around the dying person and encourages the use of touch, guided imagery, and ritual during the dying process. Throughout the book Fersko-Weiss tells amazing and encouraging stories of the people he has cared for, as well as stories that come from doulas he has trained and worked with over the years. What is unique about this book is the well-conceived and thorough approach it describes to working skillfully with the dying. The guidance provided can help a dying person, their family, and caregivers to transform the dying experience from one of fear and despair into one that is uplifting and even life affirming. You will see death in a new light and gain a different perspective on how to help the dying. It may even change the way you live your life right now.

Care of the Dying Patient

Author: David A. Fleming

Publisher: University of Missouri Press

Published: 2010-04-15

Total Pages: 172

ISBN-13: 0826272215

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Although the need for improved care for dying patients is widely recognized and frequently discussed, few books address the needs of the physicians, nurses, social workers, therapists, hospice team members, and pastoral counselors involved in care. Care of the Dying Patient contains material not found in other sources, offering advice and solutions to anyone—professional caregiver or family member—confronted with incurable illness and death. Its authors have lectured and published extensively on care of the dying patient and here review a wide range of topics to show that relief of physical suffering is not the only concern in providing care. This collection encompasses diverse aspects of end-of-life care across multiple disciplines, offering a broad perspective on such central issues as control of pain and other symptoms, spirituality, the needs of caregivers, and special concerns regarding the elderly. In its pages, readers will find out how to: effectively utilize palliative-care services and activate timely referral to hospice, arrange for care that takes into account patients’ cultural beliefs, and respond to spiritual and psychological distress, including the loss of hope that often overshadows physical suffering. The authors especially emphasize palliative care and hospice, since some physicians fear that such referrals may be viewed by patients and families as abandonment. They also address ethical and legal risks in pain management and warn that fear of overprescribing pain medication may inadvertently lead to ineffective pain relief and even place the treating team at risk of liability for undertreatment of pain. While physicians have the ability to treat disease, they also help to determine the time and place of death, and they must recognize that end-of-life choices are made more complex than ever before by advances in medicine and at the same time increasingly important. Care of the Dying Patient addresses some of the challenges frequently confronted in terminal care and points the way toward a more compassionate way of death.

Approaching the End

Author: Stanley Hauerwas

Publisher: SCM Press

Published: 2015-02-17

Total Pages: 269

ISBN-13: 0334052181

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In this book Stanley Hauerwas explores the significance of eschatological reflection for helping the church negotiate the contemporary world. In Part One, ‘Theological Matters’, Hauerwas directly addresses his understanding of the eschatological character of the Christian faith. In Part Two, ‘Church and Politics’, he deals with the political reality of the church in light of the end, addressing such issues as the divided character of the church, the imperative of Christian unity, and the necessary practice of sacrifice.