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Handbook For Mortals

Guidance For People Facing Serious Illness

Synopsis

Joanne Lynn, M.D. is Director of the Center To Improve Care of the Dying. Joan Harrold, M.D., is a Fellow, National Cancer Institute. The development of team for the book included experts in many disciplines and used input from focus groups to ensure that the content was relevant and complete. Proceeds frome the sale of this Book will be devoted to the education and reform efforts of Americans For Better Care Of The Dying, an advocacy group dedicated to quality improvement for end of life care.

There is an overall tone to the book which is encouraging without denying the difficult realities of living with serious illness. The authors understand that readers must be empowered to live life on their own terms and find opportunities for growth even in the darkest of situations. Early on the book tackles the question "How do you handle the urgent need to find meaning for yourself in what is soon to be a completed life?"

There's a wealth of sensible advice on how to make decisions about care, where to find support and treatment resources, how to communicate with physicians, how to get effective pain management, when to let go of medical treatment, issues in hastening death, and a host of other fundamental concerns. There's a discussion of the ethical issues of assisted suicide that balances arguments from several sides of the question. The book handles many specialized situations, with details on several common disease processes and types of death. A solid resource guide points readers to major sources of information for further study and support.

The book achieves all of this without looking or reading like a textbook. Sensitive photographs, poetry, and anecdotes appear on almost every page, giving support and encouragement while conveying the reality of the subject matter. The balance between content and presentation is extremely well done, making the book accessible to a general audience while still having enough detail to be of value to medical professionals.

Overall the book is a remarkable achievement and should hold a place on the "short list" of books with universal application in end of life care.

Table of Contents

Foreword by Rosalynn Carter

1. Living With Serious Illness

2. Enduring And Changing

3. Finding Meaning

4. Helping Family Make Decisions And Give Care

5. Getting The Help You Need

6. Talking With Your Doctor

7. Controlling Pain

• Types of pain
• Choosing the right pain medicine
• Different ways to take pain medicine
• Doses of pain medicine
• A few rules about pain medicine
• How often to take pain medicine
• Fear of addiction
• Side effects of pain medication
• More medications that relieve pain

8. Managing Other Symptoms

9. Learning About Specific Illnesses

• How long do I have?
• Heart disease
• Cancer
• Lung disease: chronic emphysema and chronic bronchitis
• Kidney failure
• Liver failure
• HIV/AIDS
• Dementia
• Dying while very old

10. Planning Ahead

11. Forgoing Medical Treatment

• Thinking about the issues
• Stopping treatment
• Time-limited trials
• When food seems like love
• The benefits of dehydration at the end of life
• Tube feeding and the dementia patient
• Artificial feeding and the permanently unconscious patient
• Choosing to stop eating and drinking
• Decisions about ventilators
• Decisions about resuscitation
• The many meanings of "DNR" (Do Not Resuscitate)
• Other decisions to forgo treatment

12. Hastening Death

13. Coping With Events Near Death

14. The Dying Of Children

15. Dying Suddenly

16. Enduring Loss

17. Additional Resources

Acknowledgements

Index