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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.
What happens to consciousness during the act of dying? The most compelling answers come from people who almost die and later recall events that occurred while lifesaving resuscitation, emergency care, or surgery was performed. These events are now called near-death experiences (NDEs). As medical and surgical skills improve, innovative procedures can bring back patients who have traveled farther on the path to death than at any other time in history. Physicians and healthcare professionals must learn how to appropriately treat patients who report an NDE. It is estimated that more than 10 million people in the United States have experienced an NDE. Hagan and the contributors to this volume engage in evidence-based research on near-death experiences and include physicians who themselves have undergone a near-death experience. This book establishes a new paradigm for NDEs.
Progress in medical science has increased our understanding of what happens when the brain begins to fail. Psychology delves ever more deeply into the nature of the self. In Dying to Live, Blackmore, a leading expert in near-death experiences, explores what psychology, biology, and medicine have to say about this extraordinary aspect of death and dying.. . . the best resource for materialist arguments that currently exists. . . . Blackmore's book is the most up-to-date catalogue of misgivings about the dualist concept of self and the religionist's desire for the afterlife vis-a-vis experiences near-death. . . . a fine book. -Journal of Scientific Exploration. . . one of the most intelligent and comprehensive examinations of the near-death experience to date. For thoroughness of treatment and tidiness of theory, the book is quite without equal. -Journal of the American Society for Psychical Research[This book is] brilliant though controversial . . . -ChoiceHer book is a model of understanding and . . . moving in its course through a sensitive subject. -New ScientistWell documented and well researched . . . The author's impartial treatment of diverse beliefs on the subject helps readers to see how scientific and spiritual points of view can coexist. There's much to think about here. -School Library Journal
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."
A compassionate, honest, and illuminating look at the dying process . . . As a long-time hospice volunteer, Jennie Dear has helped countless patients, families, and caregivers cope with the many challenges of the dying process. Inspired by her own personal journey with her mother’s long-term illness, Dear demystifies the experience of dying for everyone whose lives it touches. She spoke to doctors, nurses, and caregivers, as well as families, friends, and the patients themselves. The result is a brilliantly researched, eye-opening account that combines the latest medical findings with sensitive human insights to offer real emotional support and answers to some of the questions that affect us all. Does dying hurt? A frank discussion of whether dying has to be painful—and why it sometimes is even when treatment is readily available. Is there a better way to cope with dying? Comforting stories of people who found peace in the face of death , and some of the expert methods they used for getting there. The last few hours: What does it feel like to die? Powerful glimpses from dedicated professionals into the physical experiences of people in their final moments—plus comforting words and insights from those who are there to help.
THE NEW YORK TIMES BESTSELLER! "I had the choice to come back ... or not. I chose to return when I realized that 'heaven' is a state, not a place" In this truly inspirational memoir, Anita Moorjani relates how, after fighting cancer for almost four years, her body began shutting down—overwhelmed by the malignant cells spreading throughout her system. As her organs failed, she entered into an extraordinary near-death experience where she realized her inherent worth . . . and the actual cause of her disease. Upon regaining consciousness, Anita found that her condition had improved so rapidly that she was released from the hospital within weeks—without a trace of cancer in her body! Within this enhanced e-book, Anita recounts—in words and on video—stories of her childhood in Hong Kong, her challenge to establish her career and find true love, as well as how she eventually ended up in that hospital bed where she defied all medical knowledge. In "Dying to Be Me," Anita Freely shares all she has learned about illness, healing, fear, "being love," and the true magnificence of each and every human being!
This book introduces a process-based, patient-centered approach to palliative care that substantiates an indication-oriented treatment and radical reconsideration of our transition to death. Drawing on decades of work with terminally ill cancer patients and a trove of research on near-death experiences, Monika Renz encourages practitioners to not only safeguard patients' dignity as they die but also take stock of their verbal, nonverbal, and metaphorical cues as they progress, helping to personalize treatment and realize a more peaceful death. Renz divides dying into three parts: pre-transition, transition, and post-transition. As we die, all egoism and ego-centered perception fall away, bringing us to another state of consciousness, a different register of sensitivity, and an alternative dimension of spiritual connectedness. As patients pass through these stages, they offer nonverbal signals that indicate their gradual withdrawal from everyday consciousness. This transformation explains why emotional and spiritual issues become enhanced during the dying process. Relatives and practitioners are often deeply impressed and feel a sense of awe. Fear and struggle shift to trust and peace; denial melts into acceptance. At first, family problems and the need for reconciliation are urgent, but gradually these concerns fade. By delineating these processes, Renz helps practitioners grow more cognizant of the changing emotions and symptoms of the patients under their care, enabling them to respond with the utmost respect for their patients' dignity.
The first book to validate the meaningful dreams and visions that bring comfort as death nears. Christopher Kerr is a hospice doctor. All of his patients die. Yet he has cared for thousands of patients who, in the face of death, speak of love and grace. Beyond the physical realities of dying are unseen processes that are remarkably life-affirming. These include dreams that are unlike any regular dream. Described as "more real than real," these end-of-life experiences resurrect past relationships, meaningful events and themes of love and forgiveness; they restore life's meaning and mark the transition from distress to comfort and acceptance. Drawing on interviews with over 1,400 patients and more than a decade of quantified data, Dr. Kerr reveals that pre-death dreams and visions are extraordinary occurrences that humanize the dying process. He shares how his patients' stories point to death as not solely about the end of life, but as the final chapter of humanity's transcendence. Kerr's book also illuminates the benefits of these phenomena for the bereaved, who find solace in seeing their loved ones pass with a sense of calm closure. Beautifully written, with astonishing real-life characters and stories, this book is at its heart a celebration of our power to reclaim the dying process as a deeply meaningful one. Death Is But a Dream is an important contribution to our understanding of medicine's and humanity's greatest mystery.
This unique book recounts the experience of facing one's death solely from the dying person's point of view rather than from the perspective of caregivers, survivors, or rescuers. Such unmediated access challenges assumptions about the emotional and spiritual dimensions of dying, showing readers that—along with suffering, loss, anger, sadness, and fear—we can also feel courage, love, hope, reminiscence, transcendence, transformation, and even happiness as we die. A work that is at once psychological, sociological, and philosophical, this book brings together testimonies of those dying from terminal illness, old age, sudden injury or trauma, acts of war, and the consequences of natural disasters and terrorism. It also includes statements from individuals who are on death row, in death camps, or planning suicide. Each form of dying addressed highlights an important set of emotions and narratives that often eclipses stereotypical renderings of dying and reflects the numerous contexts in which this journey can occur outside of hospitals, nursing homes, and hospices. Chapters focus on common emotional themes linked to dying, expanding and challenging them through first-person accounts and analyses of relevant academic and clinical literature in psycho-oncology, palliative care, gerontology, military history, anthropology, sociology, cultural and religious studies, poetry, and fiction. The result is an all-encompassing investigation into an experience that will eventually include us all and is more surprising and profound than anyone can imagine.