"We use "mortal time" in our work to mean the experience of human beings confronting the prospect of death. This confrontation can stimulate intense feelings, a flurry of thoughts, and erratic or unusual behavior. In the broadest sense, mortal time is entered whenever death comes near, and that can happen either directly or vicariously. Hearing the words, "you have cancer," and signing a medical consent form where death is a possible medical "complication," are direct experiences of mortal time. Learning of a loved one's cancer diagnosis, losing a family member in an automobile accident, or reading about a missing child are vicarious experiences of mortal time. The power of tragedy in the theatre can brings us into the experience of mortality. King Lear's madness in the face of betrayal propels him toward an untimely death. The focus in this book is on the particular and powerful experience of entering mortal time when someone receives a diagnosis of cancer, a life-threatening illness. As we noted in our introduction to this second edition, the experience of mortal time in cancer medicine has changed with new treatments. A cancer diagnosis could mean an illness where rapid progression toward death is looming, or where there is only the distant possibility of death. Now there is a third option: the prospect of longer survival with metastatic disease due to the promise of additional therapies, facilitated by next generation genome sequencing. This means, a lengthier period of mortal time and uncertainty for many cancer patients. MORTAL TIME: HOW LONG DOES IT LAST? There are, of course, many instances in which people far exceed their statistically predicted life span. This holds true whether it be the prediction of a physician in the midst of treating an illness or the projected life span of an insurance life-expectancy table. In Part II we give an example of how misleading statistics can be when we discuss the idea of false hope. When mortal time looms with the diagnosis of cancer, it may stretch from days to years, with patients encountering both helpful treatments that lead to periods of remission and recurrences of disease requiring additional treatment. Some patients may never experience a time when it is apparent that they are dying until the last days. The interval between living and dying that we are concerned with here is not primarily chronological time, measured in days, weeks, and months. The hallmark of mortal time is the person's unique biological, psychological, social, and spiritual experience of the prospect and meaning of death, a prospect that confronts their caregivers as well. Mortal time is "kairos" time, the ancient Greek word meaning the time of decisions. When someone enters mortal time directly, their caregivers enter the same time zone vicariously. What they do together in mortal time, especially how they speak and listen to each other, affects the quality and meaning of life for all involved, in the moment and beyond"--

Human beings, regardless of age, sex, or state of health, are designed by evolution to form meaningful interpersonal relationships through verbal and nonverbal communication. The theme that empathic human connections are beneficial to the body and mind underlies all 12 chapters of this book, in which empathy is viewed from a multidisciplinary perspective that includes evolutionary biology; neuropsychology; clinical, social, developmental, and educational psychology; and health care delivery and education.

A moving memoir and an extraordinary love story that shows how an expert physician became a family caregiver and learned why care is so central to all our lives and yet is at risk in today's world. When Dr. Arthur Kleinman, an eminent Harvard psychiatrist and social anthropologist, began caring for his wife, Joan, after she was diagnosed with early-onset Alzheimer's disease, he found just how far the act of caregiving extended beyond the boundaries of medicine. In The Soul of Care: The Moral Education of a Husband and a Doctor, Kleinman delivers a deeply humane and inspiring story of his life in medicine and his marriage to Joan, and he describes the practical, emotional and moral aspects of caretaking. He also writes about the problems our society faces as medical technology advances and the cost of health care soars but caring for patients no longer seems important. Caregiving is long, hard, unglamorous work--at moments joyous, more often tedious, sometimes agonizing, but it is always rich in meaning. In the face of our current political indifference and the challenge to the health care system, he emphasizes how we must ask uncomfortable questions of ourselves, and of our doctors. To give care, to be "present" for someone who needs us, and to feel and show kindness are deep emotional and moral experiences, enactments of our core values. The practice of caregiving teaches us what is most important in life, and reveals the very heart of what it is to be human.

Praise for Freedom Found As we search for answers to prevention of violence in our communities, I believe our children will lead the way to a more peaceful world by learning to make wise choices. I strongly recommend Freedom Found, an original story dramatizing the importance of making wise choices. Paula Oliver Pell, MD, FACEP, FAAP, past president, Southern Medical Association Lessons well taught at home will endure. And young people learn best through intergenerational interactivity. So this volume is an absolute gold mine for parents who wish to homeschool their children and youth in values education. The best part is that the learning process that you choose will be fun. Freedom Found has much inspiration and many creative possibilities for your family, and even for your neighbourhood. Dont pass this one by! Rev. John Harries, MDiv, spiritual educator and family counselor, Toronto, Ontario The message of the story of Freedom Found is timely, necessary, and true. Jane Russell Geddings, choreographer Freedom Found is a story of tragedy, triumph, and the power of the human spirit. Through the use of theater, music, and movement, this drama tells a moving tale of one familys struggle for dignity and hope across three generations. Designed to inspire empathy in children, teens, and families, it describes a move from victimization to empowerment. In their homeland, the family paid a heavy price in their fight for freedom of choice. To protect the surviving members from the extremist regime that took the father, they escape to what they hope are safer lands. But in their new home, they encounter oppression of a different kind. Although they are earnest, industrious, and principled, frequent challenges arise to test their resolve. Thanks to wise decision-making, their tenacity and identity as individuals and as a family only increase. Despite tough times in their new home, the family is determined to emerge stronger, with renewed perspective, insight, and self-respect. The cost has certainly been high, but they never lose hope for a bright future. Theirs is a compelling story of struggle, pride, pain, and victory. Offering valuable life lessons, Freedom Found is a new musical journey for the stage, the story of the quest for the freedom to Choose Who to Be.TM

Christian and other nurses in the hostile modern and increasingly secular age may feel helpless in an environment that created the Liverpool Care Pathway (LCP) and continues to foster end of life 'care' through sedation and dehydration. The book aims to enlighten both health professionals and the public alike to their rights of conscience and knowledge of the needs of vulnerable patients whether related to ethical care or guidance and the law which can affect them. Indifference to patients' needs and suffering may be injurious to nurses' health all of whom have a conscience. This must be respected, protected and used as a guide to truly care for the patient's benefit, regardless of laws and professional pathways which may prove harmful to many vulnerable patients. The questioning nurse on ethical issues and dilemmas needs consideration, respect and support when attempting to act as the patient advocate. Managers at all levels need to be aware of the concerns of front line nurses and to be mindful that recruitment and retention are both equally important factors for the quality of patient care and nurse morale and work satisfaction. The NHS was a wonderful creation which is only as good as its staff at all levels. Its managers and government ministers must remember that the more authority invested in them, the more the accountability and transparency expected by both health professionals, their patients and the public.

This book provides a broad overview of quality health care for people with intellectual and developmental disabilities (IDD). It focuses on providing the reader a practical approach to dealing with the health and well-being of people with IDD in general terms as well as in dealing with specific conditions. In addition, it offers the reader a perspective from many different points of view in the health care delivery system as well as in different parts of the world. This is the 3rd , and much expanded edition, of a text that was first published in 1989 (Lea and Fibiger). The second edition was published in 2006 (Paul Brookes) and has been used as a formal required text in training programs for physicians, nurses and nurse practitioners as well as by administrators who are responsible for programs serving people with IDD. This book is considered the “Bible” in the field of health care for people with IDD since 1989 when the first edition came out.