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."

The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.

'I am a junior doctor. It is 4 a.m. I have run arrest calls, treated life-threatening bleeding, held the hand of a young woman dying of cancer, scuttled down miles of dim corridors wanting to sob with sheer exhaustion, forgotten to eat, forgotten to drink, drawn on every fibre of strength that I possess to keep my patients safe from harm.' How does it feel to be spat out of medical school into a world of pain, loss and trauma that you feel wholly ill-equipped to handle? To be a medical novice who makes decisions which - if you get them wrong - might forever alter, or end, a person's life? To toughen up the hard way, through repeated exposure to life-and-death situations, until you are finally a match for them? In this heartfelt, deeply personal account of life as a junior doctor in today's health service, former television journalist turned doctor, Rachel Clarke, captures the extraordinary realities of ordinary life on the NHS front line. From the historic junior doctor strikes of 2016 to the 'humanitarian crisis' declared by the Red Cross, the overstretched health service is on the precipice, calling for junior doctors to draw on extraordinary reserves of what compelled them into medicine in the first place - and the value the NHS can least afford to lose - kindness. Your Life in My Hands is at once a powerful polemic on the systematic degradation of Britain's most vital public institution, and a love letter of optimism and hope to that same health service and those who support it. This extraordinary memoir offers a glimpse into a life spent between the operating room and the bedside, the mortuary and the doctors' mess, telling powerful truths about today's NHS frontline, and capturing with tenderness and humanity the highs and lows of a new doctor's first steps onto the wards in the context of a health service at breaking point - and what it means to be entrusted with carrying another's life in your hands. 'Eloquent and moving' - Henry Marsh 'There have been many books written by young doctors... but none comes close to Clarke's' - Sunday Times 'From the very heart of the NHS comes this brilliant insight into the continuing crisis in the health service. Rachel Clarke writes as the accomplished journalist she once was and as the leading junior doctor she now is - writing with humanity and compassion that at times reduced me to tears.' - Jon Snow, Channel 4 News 'Dr Clarke has written a blockbuster, a page-turner, a tear-jerker. This is a "from-the-heart" front-line account of the human cost of the wanton erosion of a magnificent ideal - healthcare free at the point of need, funded through public taxation, available to all - made real in the UK for near 70 years. It is a love-song for the wonderful National Health Service that has embodied - to an extent equalled nowhere in the world - the principle that healthcare is not a commodity but a great duty of state.' - Prof. Neena Modi, President of the Royal College of Paediatrics and Child Health 'A powerful account of life on the NHS frontline. If only Theresa May and Jeremy Hunt could see the passion behind the people in the NHS, they might stop treating them as the enemy, and understand that without them we don't have an NHS worth the name.' - Alastair Campbell

This “comforting…thoughtful” (The Washington Post) guide to maintaining a high quality of life—from resilient old age to the first inklings of a serious illness to the final breath—by the New York Times bestselling author of Knocking on Heaven’s Door is a “roadmap to the end that combines medical, practical, and spiritual guidance” (The Boston Globe). “A common sense path to define what a ‘good’ death looks like” (USA TODAY), The Art of Dying Well is about living as well as possible for as long as possible and adapting successfully to change. Packed with extraordinarily helpful insights and inspiring true stories, award-winning journalist Katy Butler shows how to thrive in later life (even when coping with a chronic medical condition), how to get the best from our health system, and how to make your own “good death” more likely. Butler explains how to successfully age in place, why to pick a younger doctor and how to have an honest conversation with them, when not to call 911, and how to make your death a sacred rite of passage rather than a medical event. This handbook of preparations—practical, communal, physical, and spiritual—will help you make the most of your remaining time, be it decades, years, or months. Based on Butler’s experience caring for aging parents, and hundreds of interviews with people who have successfully navigated our fragmented health system and helped their loved ones have good deaths, The Art of Dying Well also draws on the expertise of national leaders in family medicine, palliative care, geriatrics, oncology, and hospice. This “empowering guide clearly outlines the steps necessary to prepare for a beautiful death without fear” (Shelf Awareness).

A doctor on the front lines of hospital care illuminates one of the most important and controversial social issues of our time. It is harder to die in this country than ever before. Though the vast majority of Americans would prefer to die at home—which hospice care provides—many of us spend our last days fearful and in pain in a healthcare system ruled by high-tech procedures and a philosophy to “fight disease and illness at all cost.” Dr. Ira Byock, one of the foremost palliative-care physicians in the country, argues that how we die represents a national crisis today. To ensure the best possible elder care, Dr. Byock explains we must not only remake our healthcare system but also move beyond our cultural aversion to thinking about death. The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning life-or-death medical drama. It has the power to lead a new national conversation.

This volume was first published by Inter-Disciplinary Press in 2016. This inter- and multi-disciplinary volume examines various experiences of loss, whether we encounter it in the form of lost loved ones, lost relationships, lost opportunities or the loss of capabilities as we age. Loss is something we can experience personally, as part of a family, and as part of a community whose collective experiences of loss occasions more public displays of commemoration. We are constantly challenged to find ways of coping and surviving in the face of different types of loss. Due in part to the complexities of the concept itself and the resistance many individuals feel toward discussing painful subjects, it is often difficult to engage in the sort of robust, inter-disciplinary dialogue that is needed to explore fully the links between living, suffering, dying, and surviving loss. Thus, this volume is profoundly interdisciplinary, as it explores how loss can be expressed through cognitive, affective, somatic, behavioral/interpersonal, and spiritual grief responses.