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."

For readers of Atul Gawande and Paul Kalanithi, a palliative care doctor's breathtaking stories from 30 years spent caring for the dying. Modern medical technology is allowing us to live longer and fuller lives than ever before. And for the most part, that is good news. But with changes in the way we understand medicine come changes in the way we understand death. Once a familiar, peaceful, and gentle -- if sorrowful -- transition, death has come to be something from which we shield our eyes, as we prefer to fight desperately against it rather than accept its inevitability. Dr. Kathryn Mannix has studied and practiced palliative care for thirty years. In With the End in Mind , she shares beautifully crafted stories from a lifetime of caring for the dying, and makes a compelling case for the therapeutic power of approaching death not with trepidation, but with openness, clarity, and understanding. Weaving the details of her own experiences as a caregiver through stories of her patients, their families, and their distinctive lives, Dr. Mannix reacquaints us with the universal, but deeply personal, process of dying. With insightful meditations on life, death, and the space between them, With the End in Mind describes the possibility of meeting death gently, with forethought and preparation, and shows the unexpected beauty, dignity, and profound humanity of life coming to an end.

By comparing the findings from Kalish's and Reynolds's landmark 1970's Death and Ethnicity Study to their own present study, Hayslip and Peveto examine the impact of cultural change on death attitudes. With a focus on African-American, Asian-American, and Hispanic-American subpopulations, with Caucasians treated as a comparison group, the authors come to several conclusions, including: the shift toward more interest in being informed of one's own terminal prognosis a more personal approach to funerals and mourning observances a greater focus on family and relationships

AriA]s traces Western man's attitudes toward mortality from the early medieval conception of death as the familiar collective destiny of the human race to the modern tendency, so pronounced in industrial societies, to hide death as if it were an embarrassing family secret. -- Newsweek

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.

This innovative and informative new text bridges the fields of gerontology and thanatology.

Death Across Cultures: Death and Dying in Non-Western Cultures, explores death practices and beliefs, before and after death, around the non-Western world. It includes chapters on countries in Africa, Asia, South America, as well as indigenous people in Australia and North America. These chapters address changes in death rituals and beliefs, medicalization and the industry of death, and the different ways cultures mediate the impacts of modernity. Comparative studies with the west and among countries are included. This book brings together global research conducted by anthropologists, social scientists and scholars who work closely with individuals from the cultures they are writing about.

This work provides an up-to-date examination of the ways people face dying and bereavement. In this third edition previous chapters are throrughly revised, and new contributors expand areas that have changed significantly. Reflecting the field's complex interdisciplinary character, the chapters cover such diverse areas as psychology, nursing, medicine, AIDS, family studies, sociology, education, philosophy, law, religion, the humanities and political science, whilst highlighting thanatology's core psychological and therapeutic caregiving dimensions. First, the text offers broad examinations of death systems from the vantage points of various cultural, historical and disciplinary perspectives. The second section represents the core of the book, offering detailed surveys of the "data" of death, dying and bereavement as they relate to different phases of our encounter with death as an abstract possibility and concrete reality. Next are chapters addressing a cluster of death-related issues and challenges that confront us at both a societal and individual level - such as AIDS - and finally the volume closes with a few reflections on the complexity of contemporary thanatology, framing some issues and recommendations that deserve greater attention by scholars, researchers, policy makers and practitioners. Also included is a comprehensive resource bibliography on the topic. This text is intended to be of use as a resource for all those interested in reading about death studies, both professionals and students alike.

Every living thing must die, but only human beings know it. This knowledge can bring to the living, anxiety and despair or new richness and meaning. This volume explores the problems and possibilities of coping with this universal experience.