Changing the way we die Compassionate end-of-life care and the hospice movement

Nobody wants to die badly. With that opening line, cowriters Smith and Himmel proceed to persuasively explain why no one should ever have to. Hospice is a philosophy and program that maximizes the quality of remaining life by delivering compassionate care with a holistic approach. Its focus is on easing suffering. In addition to medical and nursing services, hospice provides assistance with practical needs, counseling, and bereavement services. Volunteers play a huge role. Over 400,000 individuals volunteer at more than 5,000 hospice programs in the United States. Hospice has grown into a $14 billion industry. Medicare, Medicaid, and many private health-insurance plans cover hospice services for individuals whose life expectancy is six months or less. Many people still wait too long to enroll. The history of the hospice mission and its evolution in America are well summarized. Smith and Himmel provide inspiring stories about patients, families, physicians, and the entire hospice experience. When the time comes, most Americans prefer to die at home, devoid of pain and surrounded by loved ones. As this book reveals, hospice can help.--Miksanek, Tony Copyright 2010 Booklist

America avoids death. From our obsession with youth to our heroic medical model, death is often viewed as giving up. Yet despite a culture of denial, the hospice movement, which helps families face the last stage of life with intention, compassion, and respect, has continually grown since 1963. Free of the often torturous medical attempts to cure old age or terminal illness, hospice offers palliative home care and seeks to restore control and dignity to the dying while providing support and respite to their loved ones. Health-care writers and activists Smith and Himmel chronicle the hospice movement and share stories of the dying and their caregivers, illuminating the benefits of this model. Also delineated are the issues associated with the encroachment of for-profit hospice-Wall Street knowing a Medicare bonanza when it sees one. By explaining the hospice alternative to the more common hospital death, the authors ask us to consider our own deaths and how we will go about making decisions when end of life is not just inevitable but imminent. They propose that hospice offers choice, freedom from pain and suffering, and perhaps even joy during those last days. Verdict This book belongs in every public and health-care library in America.-Janet Tapper, Univ. of Western States Lib., Portland, OR (c) Copyright 2014. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

Chapter 1 What Do You Want to Do with the Rest of Your Life? ALL ALONG, doctors differed on Rusty Hammer's prognosis. One told his wife, Pamela, "If he lasts five years, he'll be lucky." Another kept reassuring Rusty, "You never know. You're doing fine. Just get more rest." He did last five years, and Pamela will always wonder whether the treatment was worth the torment. Rusty was diagnosed with acute myelogenous leukemia, a rare and aggressive blood cancer. By the time he died, on Monday, Jan. 28, 2008, he had taken more than 250 medications, received more than 350 blood transfusions, had a stem cell transplant, and spent nearly 600 nights in six different hospitals. He developed severe diabetes and osteoporosis, heart and lung failure. He needed an oxygen tank to breathe and a shunt in his brain to relieve the pain. Visiting the doctor took all day, with the wheelchair, the drive, managing a hospital bed on the other end. It left them both exhausted, and hopeless that their family's suffering would ever end. But hospice care brought them comfort and calm. In the last six months of his life, Rusty enjoyed the company of family and friends. He explored his religious heritage. He wrote a book, and in a strange way he also became the author of his own experience -- a person again, not a medical record number or an object to be handed from one specialist to another for yet another blast of debilitating treatment. The hospice team listened to him. Pamela found herself becoming a better listener, too. This was not how Rusty thought of hospice when a friend first suggested it. He did not imagine an opportunity to reclaim his life, let alone do something new or grow. He thought of hospice as a place you go to die, and he was appalled. Excerpted from Changing the Way We Die: Compassionate End of Life Care and the Hospice Movement by Fran Smith, Sheila Himmel All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.