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"As an Oncologist (Cancer Specialist), I am delighted to know that this resource is available to my patients. There are many times when cancer is curable, but many others when further medical treatment is not only futile, but may cause the person undue pain or sickness. This book brings to light many of the issues I try to cover with my patients who need comfort measures and Hospice care, and does so in a way that they can understand and use. I would  recommend this book to anyone dealing with End-of-Life issues, including cancer. I will recommend it to my patients and colleagues."

Jerry Mitchell, MD                                                                                                         More Testimonials

 

 

 

"I am honored to endorse this book. I am not an educated person. High school and business school are all I claim. What I know is from dealing with Jim's dad who had colon and lung cancer, Ma Addie with dementia, and Jim's mom with dementia, diabetes and all the terrible diabetic health problems that follow. I do have common sense, and that was a tremendous help in making decisions. Jim's dad had three resections of the colon and was transported to various hospitals when there was nothing else could be done except radiation treatments for the lung cancer. This was the first time I made a decision that 'enough was enough'. We had traveled back and forth for chemotherapy treatments for over a year for an inoperable tumor...."

Daphene P. , Reader from North Carolina                                                                  More Testimonials

 

 

 

"This is by far one of the best books that I  have ever read for people who are dying and their families. It really taps into the concerns that I have as an Oncology nurse. Death is removed from our daily lives, so it is alien to most people. The grief process can be overwhelming. We need literature like this that helps those who are dying to live as fully and comfortably as possible. It answers questions that may never be asked. Thanks for facilitating a long-needed change."

Linda Carriker, RN                                                                                                         More Testimonials

 

 

 

"I highly recommend this book for the patient, family or friends of anyone touched by death. As an Oncology Nurse that has also worked in a Trauma and Emergency Department setting, I find the information to be invaluable for everyone involved. There are so many questions answered in this book. The dying process creates stress and confusion, and most people forget to ask all their questions to the health care professionals. This book helps to place everything in order. It is written from a very touching human perspective that allows all involved to move at their own pace."

Cathy L Frazier, RN                                                                                                        More Testimonials

 

 

"I purchased this book on Tuesday, Feb. 18. My former husband and the father of my children (who just happened to be very dear to me) had been diagnosed with terminal lung cancer. They told us on Tuesday that he had less than 3 months. I read the book and shared it with his girlfriend. He passed away on Saturday, Feb. 22. I cannot tell you how helpful your book actually was. With every passing day (and there weren't many) we found ourselves calmer and more in control of the situation due to your book. I would highly recommend your book to anyone forced into the unfortunate situation that I was in. It's not something you ever think that you will have to do so I was grateful for all the help I could get. Keith's doctors were very very helpful and never hesitated to return phone calls and answer any questions that we had...but having the book at our fingertips was truly a blessing."

Kimberly P., Reader from Illinois                                                                                 More Testimonials

 

 

 

 

 

"I have worked as a patient and family counselor with Hospice for thirteen years. During that time, I have attended countless workshops and have tried to read the best literature available in order to understand and to remain sensitive to what a dying person needs. I have never had available such a comprehensive and sensitive guide as this. Anyone dealing with end of life care should afford themselves the opportunity to add this to their resources and to use it readily both as a professional and a personal tool." 

Pam Hawkins, M.A., L.P.C.                                                                                            More Testimonials

 

 

 

 

"...the material is wonderful. I have had an enormous amount of guilt over my father’s death and what I could not/did not do for him. Your words have helped and I know that there will not be a repeat with my mother and the rest of us, when it is our sunset. Thanks."

Stephen S., Reader from South Carolina                                                                   More Testimonials

 

 

 

 

"I wanted to let the authors know that this was a very helpful book for me. My husband died after a 14 month battle with cancer 12/10/2004. When we knew we were facing the end of his life, I purchased the book and it certainly made the situation a bit easier to deal with. I am grateful for the knowledge this book gave me going into the final days with my husband. I think that knowledge gave us the power to bring the physicians into talking openly about the situation. The transition from hospital to hospice was more difficult for me than it was for my husband but having done my homework about hospice, funeral arrangements, etc. before hand left me in a position to spend more time with him and not worry about making such large decisions at such an emotional time. Thank you."

Kris C., Reader from Colorado                                                                                    More Testimonials

 

 

 

"Dying is a personal experience and this is a personal book. More than that, it is a gift from the hearts and minds of two authors who respect each other, as they alternate in sharing their experiences and knowledge about all the areas of the dying process. Never haughty or condescending, this book is a must read to reduce your fears, to understand your options, and to put your individual experience in context of what others have gone through. It offers a practical approach -- the five principles -- and illustrates its main points by stories of patients told from these professionals' perspective. In addition it offers a pragmatic chapter on financial planning and an honest discussion of sharing of responsibility and stewardship of resources..."

Stanley A. Terman, Ph.D., M.D., Diplomate in Psychiatry                                          More Testimonials

 

 

"I have just finished reading the book and I am very impressed with it. It is quite evident after reading  the book that you are very caring men. I ordered the book to learn more about dying with dignity. My mother-in-law has terminal stomach cancer and perhaps has two or three months to live. She is a wonderful, gracious woman who has decided to forgo surgery, chemo and radiation. She is living her life as fully as she can to the very end. We have amazing hospice care and I am her primary caregiver. I am a healthcare provider myself, and like you, have witnessed too many families unable to let their loved ones die peacefully, as nature intends it. Instead their loved ones suffer so. I promised her I would never let this happen to her. This promise will be my last gift to her. Thank you both for writing this book. My only wish it that more people would read it before they actually need it."

Diane L., Reader from Maine                                                                                       More Testimonials
 
 
 

Get The Book Now!

Table Of Contents

The eBook and print versions follow this table of contents. The audio version includes all of this information and an interview with the authors which sets the stage for the discussion.

 

Forward

The Story of a Doctor and a Patient

How to Use This Book

Acknowledgments

Introduction

            The Active Management of Dying

            Questions for Reflection

            Death: Well-Managed vs. Chaotic

            Principles of The Active Management of Dying (Chart)

Chapter 1. Accept the Reality of the Situation

            Moving Through Fear to Hope

                      Despair, Denial, Hope

            Doctor Shopping

            Anticipatory Grieving

Chapter 2. Identify the Decision-Makers

            Informed Consent

                      Informed Consent Requires Capacity

            Advance Directives

                      Health Care Power of Attorney; Living Will, Out-of-Hospital/EMS DNR Order

            The Role of the Suurogate

            How the Process Works

            Summary of the Process

            Moral Decision-Making

                        Objective Factors; Subjective Factors; Obtaining Help

Chapter 3. Discuss the Ultimate Goals of Care

            Start with Attitudes

            Defining Ineffective Treatment

            The Ultimate Goal of Care

                        How Far Should Doctors Go in Assisting Death?; A Graded List of Medical Interventions

            Myths about Dying

Chapter 4. Create an End-of-Life Care Plan

Chapter 5. Implement the Care Plan You Created

            Roles Assigned to Various Team Members

Chapter 6. Financial Planning

            Medicare, Medicaid, Private Insurance, VA, Long Term Care

Chapter 7. Narrative Case Examples

            Case #1: Mr. Miller

            Case #2: Mr. Smith

            Case #3: Rev.. Fisk

            Case #4: Ms. Pinchon

            A Personal Note

Chapter 8. Specific Advice for End-of-Life Care

            For Patients

            For Families

            For Health Care Professionals

            Dementia

Chapter 9. Grieving

            “Sweeping up the Heart and Putting Love Away”

            After Death Has Occurred

Chapter 10 End-of-Life Issues in the Nursing Home

            Nursing Home Resources

                        Social Workers; Nurses; Aides/Technicians; Rehabilitation Services;                            

                        Medical Directors; Primary Physicians; Nutrition Services

            Strategies for Optimizing Nursing Home Care

            Specific End-of-Life Issues

                        Hospice in the Nursing Home; Documentation

            The Bottom Line

            A Note to Caregivers

            The Hospice Perspective

Chapter 11. End-of-Life Care Issues in the Intensive Care Unit

            ICU Pitfalls

            Strategies for Optimizing ICU End-of-Life Care

            Withdrawal of Support

            Other Ethical Issues in the ICU

            The Bottom Line

Chapter 12. End-of-Life Care Issues in the Emergency Department

            Optimizing End-of-Life Care in the ED

Chapter 13. Special Considerations

            Organ Donation

            Stewardship

Chapter 14. Medications Commonly Used in Terminal Care

            Narcotics

            Sedatives

Afterward

Appendix A-Explanation of Terms

Appendix B-Sample Orders

Appendix C-Suggested Reading

About the Authors

Notes Section

            Patient Information

            Record of Meetings

            General Notes from Reading

 
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