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* Palliative Medicine
The Washington Home Center for Palliative Care Studies (CPCS) [icon]
Formerly known as the Rand Center To Improve Care Of The Dying (CICD), the new CPCS web site continues to be one of the world's leading sources for quality improvement research and consulting. The CPCS team has worked with hundreds of health care organizations to mount effective change. The web site provides educational content on quality measurement, improvement methodology, case studies, and policy analysis. CPCS has summarized its core methodology for making change happen in "Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians." You can read online extracts from this manual for quality improvement. Center Director Joanne Lynn, M.D., a leading authority in the effort to improve the quality of terminal care, was Co-Director of the $28 million SUPPORT study which drew attention to many problems in end-of-life care. CICD is a member of the Inter-Institutional Collaborating Network on End-of-life Care. You can search the IICN Public Library from this site.

By No Extraordinary Means: The Choice to Forgo Life-Sustaining Food and Water [icon]
Joanne Lynn M.D., Editor. Intended for a professional palliative care audience, this book examines the medical ethics associated with nutritional care of the terminally ill and the difficult questions surrounding withdrawing life-sustaining treatment. The New England Journal of Medicine describes it as "...thoughtfully written ...well-edited, cohesively integrated... valuable for physicians, nurses, nutritionists, attorneys, members of the clergy... and the general public." Published 1990.

Forgoing Life-Sustaining Therapy [icon]
By Margaret L. Campbell, RN, MSN, CS. Foreword by Joanne Lynn MD, MA, MS. Forgoing life-sustaining treatment can be one of the most difficult aspects of care for the dying. This concise and practical book is written for clinical care providers such as nurses and physicians. It gives sensible guidance on tough issues such as how to stop a ventilator, the use of artificial nutrition and hydration, forgoing dialysis, and management of delirium in the final days of life. Illuminating case examples draw out important clinical aspects of care while addressing ethical and legal considerations and the processes of communication and decision making. This authoritative medical resource dispels common myths about forgoing treatment, offers historical background on right-to-die cases, and provides definitions and discussions of ethical principles.

* Death With Dignity
Handbook For Mortals [icon]
By Joanne Lynn, M.D., and Joan Harrold, M.D. A comprehensive and authoritative guide to end of life care written for a general audience by a team that includes some of the world's top specialists. Offers a wealth of practical advice on all aspects of end of life care, including how to make decisions about care, where to find support and treatment resources, how to communicate with physicians, how to get effective pain management, palliative nutrition, withdrawing life-sustaining treatment, issues in hastening death, and a host of other fundamental concerns. Published March, 1999.

* Quality Improvement For End Of Life Care
ABCD - Americans for Better Care of the Dying [icon]
ABCD is one of the leading non-profit advocacy group working on improving quality of care in the United States. You can search the Growth House database from this site. Publishes Exchange, a newsletter covering news on initiatives on end of life care at the national (United States) and state levels. Each issue includes book reviews, coming events, coverage of innovative quality improvement projects, and editorial articles. ABCD is a member of the Inter-Institutional Collaborating Network on End-of-life Care.

Institute For Healthcare Improvement [icon]
Sponsors various collaborative projects for healthcare organizations that are working to improve the quality of care for dying patients. The Chair for this effort is Joanne Lynn, MD. For additional information about these Collaboratives you may also contact the Center To Improve Care of the Dying at www.medicaring.org.

The Care Of Dying Patients [icon]
An editorial intended for physicians from the Annals of Internal Medicine, 15 January 1997, (126:164-165). References the SUPPORT study, a $28 million, 5-year project designed to identify and correct problems in the care of patients approaching death. The editorial asks the question, "Why, despite our honest efforts, are we doing such an inadequate job with end-of-life care?" The SUPPORT study was Co-Directed by Joanne Lynn, M.D., and William Knaus, M.D.

* General Bereavement
GriefNet [icon]
One of the oldest grief sites on the net, founded by Cendra Lynn. Offers many grief-related email discussion lists for specialized types of bereavement. Also sells books and bereavement supplies and offers a memorial section. You can search the Growth House database from this site.

* Death and Dying Directories
The Last Dance: Encountering Death And Dying [icon]
By Lynne Ann Despelder and Albert Lee Strickland. This popular textbook for college-level death and dying courses is written for a general audience. It gives a comprehensive and readable introduction to the main issues in contemporary thanatology. Over the course of six editions this book has become a well-rounded introductory text that covers all the bases in enough detail to wet the appetite of serious students. The fourth edition places more emphasis on cross-cultural perspectives on death and the diversity of ethnic traditions in heterogenous modern societies. Other chapters are devoted to grief, bereavement, funeral practices, suicide, attitudes about immortality and the afterlife, and near-death experiences.

* Funeral and Memorial Planning
Last Wishes: A Funeral Planning Manual and Survivors Guide [icon]
By Malcom James and Victoria Lynn. This straight-forward guide to pre-planning your own funeral explains the choices you can make for funeral services, caskets, cemeteries, cremation and other burial choices. The rights of a consumer when dealing with the funeral industry are clarified. Throughout the manual there are many lists to help make choices including flowers, hymns and Bible readings. In the back of the book there is a set of forms that you can complete to create a written record of your plan. An appendix gives a listing of professional and consumer groups.

* Miscellaneous Resources
Interview with Joanne Lynn, 10 August 2002 [icon]
Hear author Jacqueline Marcell interview Joanne Lynn, M.D., Director of The Washington Home Center for Palliative Care Studies, and President of Americans for Better Care of the Dying, on issues related to improving end-of-life care for persons facing serious illness. Dr. Lynn is a leading authority on care of the dying. Originally broadcast on Jacqueline Marcell's Internet radio show Coping With Caregiving, the interview is available for IICN use with her permission. [Requires Windows Media Player]

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