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End-of-Life Handbook, The

By: David B Feldman, Ph.D., S. Andrew Lasher, Jr., MD

Course Description

A Practical and Emotional Guide

The miracles of modern medicine allow us to live longer with serious medical conditions than ever before. Following a terminal diagnosis, patients may live for months or years before passing away. A side effect of this reality is that patients and their families are facing unprecedented choices about the end of life. If you have a loved one nearing the end, you’ll face many difficult questions. You may need to help him or her choose between extraordinary treatments that may extend life and hospice care that focuses on comfort. In the process, you may encounter numerous medical opinions yet receive little guidance about how to decide among them. This practical guide offers you caring, compassionate, and practical advice on dealing with the process of a loved one’s death.

In the first section, the book offers practical advice, clearly explaining medical information, treatment options, and practical decision that you may need to make in a terminal-care situation. In the second half, the book guides you toward opportunities for hope, personal control, and loving family connection during this difficult period.

About the Authors

David B. Feldman, Ph.D., is assistant professor of counseling psychology at Santa Clara University.

S. Andrew Lasher, Jr., MD, is currently director of palliative medicine at California Pacific Medical Center in San Francisco, CA.

Learning Objectives

After completing this course you’ll be able to:

  1. Define prognosis.
  2. Compare chronic and acute illness.
  3. List five reasons to seek a second opinion.
  4. Define attendings, resident physicians and interns.
  5. Compare a psychotherapist and a psychiatrist.
  6. List three reasons family meetings are often held.
  7. Define metastatic cancer and why surgery is less of an option.
  8. Describe heart failure.
  9. Describe pulmonary disease.
  10. Define dementia according to Weissman.
  11. State the symptom that is feared most by the dying patient.
  12. List four causes of nausea.
  13. State a common solution to urinary problems.
  14. State the most significant advantage of hospitalization for the terminally ill.
  15. State why most patients wish to die at home.
  16. State the first physical change families notice at the end of life.
  17. List ways to resolve the “death rattle.”
  18. State what families should do when a loved one dies at home while under hospice care.
  19. List several emotions people normally experience when facing illness of a loved one.
  20. List and describe four ways negative feelings can get out of hand and require help.
  21. State why a person’s mere presence can be helpful to patients.
  22. List a few phrases that shut down conversations and words that open up a conversation.
  23. List two ways to honor advance directives.
  24. Define the role of an executor of a will.
  25. List the differences between a funeral and a memorial.
  26. List the five important tasks by Dr. Byock.
  27. Describe the five categories of growth, according to Tedeschi and Calhoun (1996).
  28. State why rituals are so powerful.
  29. Describe a life review and its purpose.
  30. List the five stages of dying according to Kubler-Ross.

Course Contents

  1. Could the Doctors Be Wrong?
    Understanding and Coming to Terms with Bad News
  2. Who Are All These People?
    Making Sense of the Medical System and Its Many Faces
  3. What Treatments Are Available?
    Making Sense of Disease and Medical Interventions
  4. What Can I Do About My Loved One’s Pain and Suffering?
    Addressing Symptoms and Difficulties
  5. Where Will It Happen?
    Choosing the Right Place for Your Loved One
  6. How Will It Happen?
    Dispelling Myths About the Final Days of Life
  7. How Should I Be Feeling?
    Facing Your Feelings About Caring for and Losing a Loved One
  8. What Should I Be Saying?
    Learning to Talk with Someone Who is Dying
  9. What Should I Be Doing? Part I
    Attending to Practical Matters
  10. What Should I Be Doing? Part II
    Attending to Matters of the Heart
  11. What Is the Meaning of It All?
    Considering the Spiritual Aspects of Dying
  12. Will I Ever “Get Over” Losing My Loved One?
    Discovering Life After Loss

Comments

“The End-of-Life Handbook brings life and clarity to the process of dying. This book explains in clear, non-technical language what happens to the dying and what to do to help them and those who care for them. If a loved one is ill or dying, keep this book handy and follow its sound advice.” — David Spiegel, MD, Willson Professor and associate chair of the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, author of Living Beyond Limits, and coauthor of Group Therapy for Cancer Patients.

“The End-of-Life Handbook illumines the opacity which cloaks life’s final chapter. Acknowledging the universal fear of the unknown, Feldman and Lasher light the trail which leads patients and families to reconciliation with life’s last challenge.” — Walter M. Bortz II, MD, clinical associate professor of medicine at the Stanford University School of Medicine and author of We Live Too Short and Die Too Long, Dare to Be 100, and Living Longer for Dummies.

“The End-of-Life Handbook is a rich practical guide for meeting the medical, social, and emotional challenges that accompany the serious illness of a loved one. Feldman and Lasher’s wise and sensitive suggestions make this book required reading for everyone negotiating life’s most intimate passage.” — Dale G. Larson, Ph.D., author of The Helper’s Journey

“This book shines a light into the dark forest of dying. It’s all here — how we tend to feel, what we might want to say (or not), how to deal with doctors and diagnoses, how to come to terms with our own soul’s desires. The book is a down-to-earth distillation of the wisdom and experience we need to care for someone we love at the end of life and to care for ourselves.” — Brad Stuart MD, Senior Medical Director of the Sutter Visiting Nurse Association and Hospice

“This is a practical road map for finding a way through the challenges of care-giving, illness, and loss. Anyone who has questions will find useful information and helpful recommendations here.” — Marcia Lattanzi Licht, MA, RN, LPC, cofounder of HospiceCare in Bolder, CO, educator, psychotherapist, and author of The Hospice Choice

“Acknowledging a diagnosis of a terminal illness and recognizing that difficult choices and different approaches to a loved one’s care may be necessary are enormous hurdles for most people. Confusing medical information, frightening hospital routines and widespread misconceptions in our culture add to families’ burdens. The End of Life Handbook offers refreshing clarity to anyone confronting a loved one’s terminal illness, breaking down basic issues and medical jargon in easy-to-read language. Most importantly, it reminds caregivers that a ‘soft landing’ is possible for their loved one and that they can still count their blessings, despite the difficult straits they are negotiating.” — Larry Beresford, author of The Hospice Handbook and consulting writer with the National Hospice and Palliative Care Organization and Center to Advance Palliative Care

“This publication is truly the first of its kind. Feldman and Lasher have reached out to families and caregivers to provide a comprehensive guide to the care of a loved one with a terminal illness. It answers every question of need with emphasis on the physical, emotional, and medical issues that encompass this most complicated and stressful phase of life.” — Jules Sherman, DO, board-certified specialist in medical oncology and palliative medicine and chief medical officer of the Hospice of Dayton