Peace and Possibilities at the End of Life - Dying Well

Beautifully written, inspiring stories of how one might celebrate a friend or loved one's final days, assuming (a) the patient is relatively lucid and communicative, and (b) is surrounded by people who are actively engaged. As such, this book best serves readers who still have the luxury of their mental faculties to craft a meaningful death--for themselves or a cognizant loved one. Unfortunately, scant few pages are devoted to the process of "dying well" for those already ravaged by dementia or Alzheimer's Disease. Stripped of one's identity, "dying well" (even in this book) seems limited to providing basic creature comforts and pain management, but nothing celebratory, healing, or meaningful for anyone. Perhaps I was hoping for too much.

Interesting account of terminally ill patients' life near end of life. Generally the stories are just that, an accurate account, occasionally with a touch of human emotion. Nothing more. How can it be otherwise? It is perceived from the point of view of a physician. Did not add anything to my experience of life. Would not recommend it.

Ira Byock, MD
Dying Well:
The Prospect for Growth at the End of Life

(New York: Riverhead Books, 1997) 299 pages
(ISBN: 1-57322-051-5; hardcover)
(Library of Congress call number: HQ1073.B96 1997)

A hospice doctor tells in detail of the deaths 12 patients,
all very different, who met their deaths in different ways.
The dying persons are old and young, male and female,
happy as they approach their deaths and having serious problems.
But each death has some important lessons for the reader.

This book is more about the psychological processes
of preparing for death than the medical or biological processes involved.
Even tho each story is told by the doctor,
the perspectives of the patients and their families are foremost.

This is not a technical book.
Every page can be understood by anyone
who will eventually approach his or her own death.

The hospice team of nurses, social workers, volunteers, doctors, etc.
is there to help everyone handle this death as well as possible.
Because these helpers have met most situations before,
they know how to cope with problems
that most dying people are facing for the very first time.

If you are looking for more books on dealing with death,
search the Internet for: "Books on Terminal Care".

James Leonard Park, author of YOUR LAST YEAR:
CREATING YOUR OWN ADVANCE DIRECTIVE FOR MEDICAL CARE.

I consider myself very lucky that this book was published just five months before my mother died of lung cancer. The death bed moments of forgiveness, understanding and healing that are described here gave me the courage one day to say to my mother, when she was doing what she had done all her life, trying to control everything and everyone around her, "You know, you're just about dead. None of that matters anymore." She cried, hung up the phone, and the next day called back and said, "you know, you're right. It doesn't matter anymore." Being able to say what I did was a monumental experience for me and I no longer felt any of the angst and frustration about her less pleasant qualities.
The second revelation from this book that proved true is that she wanted to have in her possession whatever was necessary to control when she died. She ended up with a nurse who was an angel and one day walked her through all the unpleasant options and offered his assistance but then said, "You're not ready. You have work to do." When he left, she said, "I don't think I need to do that." She didn't, and between my moment and some other unfinished business, she needed every moment she had to get herself ready, and prepare those around her.
This book changed my perception of death and heightened my awareness of how I conduct myself. I often remember the most profound thing I heard her say in her final months: "Gee, you never know if this is going to be the last day you feel good."

Wonderful and compasionate book about death and dying. I read Elisabeth Kubler-Ross' landmark book "On Death and Dying" and this book applies most of her principal ideas into practice. The fact that book is written by a medical doctor, Ira Byock, also helps better understanding of both physiological and psychological aspects of dying and how it affect dying person and people around them. This book definitely promotes hospice and helps educate about preparation for the death and grieving process before, during and after death. One knows that this is a comapassionate physician after reading a first chapter describing death of author's own father from cancer. I was crying by the end of it - that is how moved I was about the beauty of it. In spite of Dr. Byock's assurances that pain and discomfort can be eliminated, it is very important to have a right mix of dictors, nurses, bath aids and volunteers willing and capable to make such assesments. Having family willing, understanding and able to take care of dying person is one of the best blessings one could hope for. But for people with no children, or family around (immigrants, exiles, etc.) it may be difficult to navigate modical system without adequate help. I would say - get acquanted with your local hopisce care on your own and learn about people in that office especially if you know you or someone you know is terminally ill, very old or otherwise close to dying process. If in today's world we shop for best schools, best homes, best cars why not look around for the best talent in palliative care for the purpose of making sure our last days are filled with comfort, care and best possible support? Stories in this book are very powerful, probably because people in these stories are real and in some way they have touched Dr. Byock too. There are times when I can picture them and I find myself crying. There are some good practical advices too in this book such as taking care of living will, power of attorney and getting legal things in order before death. I would strongly recommend reading this book to anyone.

I recently stumbled across "Dying Well" in the Hospice Family lounge in an in-patient unit in Indianapolis as I waited for my mother-in-law's "good death." Thanks to the "angels of death" - the hospice staff - she was able to die well (relatively speaking). While she wasn't able to confront all her issues surrounding death and she would not talk about all the unsaid things...she was able to have the pain meds she needed in order to "sleep away" forever. And we were cared for immensely well by the hospice staff. If we had only known about them two years ago when my sister-in-law was dying...she, too, could have had a better death. This book is well-written and easy to read (so to speak) about a topic that most people avoid. I'll be buying extra copies for some friends and peers who I know will read it. Death is something we will all face eventually ... wouldn't it be nice if it wasn't so scary? This book will give you hope that it doesn't have to be.

When I was quite young, with a pre-teen stepdaughter, my husband was diagnosed with terminal cancer. He was ill for the duration of my stepdaughter's adolescence. I sought vainly for guidance about caring for a loved one whose life is ebbing slowly away. Nobody ever told me a dying person might be angry or might lash out at those with whom he was most close. Now that I've read Dr. Ira Byock's "Dying Well," I understand. According to Dr. Byock, founding member of one of the most extensive hospice and palliative care groups in the United States, those with serious illnesses may lash out from pain, or from a sense that they have lost their dignity, the ability to *do.* Men and women who have devoted their healthy lives to caring more about others than about themselves feel equally angry and often humiliated. Caregivers and patients alike lack vocabulary for the entirely new language--verbal and non-verbal--of dying. Indeed, it may be a language we don't want to learn any more than the seriously ill person wants to face the unknown ahead. From his decades of hospice and palliative care, Ira Byock selects specific family groups to illuminate responses to illness, pain, and death. He details the attitudes, behaviors, and methods to preserve dignity through accurate assessment of discomfort and pain. He shows us how to listen. "Dying well" provides a narrative and vocabulary to ease our linguistic and emotional awkwardness. Byock's book belongs in every medical and home health care facility, counseling office, and home library.

I was overwhelmed with the task of helping my dear friend in the last 11 months of her life. She was diagnosed with terminal cancer and asked me for help to die "a good death." I had no experience in end-of-life issues but wanted to help her in any way I could. I was frequently overwhelmed by it all. Most of the books I found on the topic were too long or too difficult to read during this emotional time. When I found Dr. Ira Byock's book, Dying Well, I finally felt like I had a friend to support me. Each of his stories helped me in a different way. Having this book in my library has served as a valuable resource many times. If you're not up to reading the whole thing, the Question and Answer Section at the end is worth the price of the book.

Judy K. Underwood, Ph.D., Author, Dying: Finding Comfort and Guidance in a Story of a Peaceful Passing, [...]

This book is one of those rare works that combines passionate engagement with a universal issue, artful storytelling, and clinical expertise. The author allows each of the patients he describes to bless him, and thereby to bless the reader. Dying, the author argues, is not simply a holding pattern between life and death. It is a vital developmental time that holds infinite possiblities for deepening, learning to love, serving one another both as caregiver and receiver of care, and simply learning to "be" after what often has been a lifetime of mechanistic "doing." Such possibility is created when simple principles of Hospice are honored. Pain must be absolutely controlled. The patient (and the family) must be tenderly companioned. Such care, the author convinces us, is a privilege, a holy time in which human beings gather together in the face of Mystery in all of its agony and joy and wonder and transcendent meaning. We can only create human community, the author suggests, when we are willing to simultaneously look death in the face and to remain open to the gift of healing. I closed the book more alive, more thankful, less fearful, and more curious about the prospect of the adventures ahead.

Not a phrase I would have anticipated using to describe a book about the end of life; yet, I found the narrative so compelling that I literally dropped everything else to finish. The comppassion, humor and eloquence of Dr Byock illuminate what could easily have been a maudlin collection of sad stories. Instead, I found them inspirational and extremly moving. This is a book for everyone, read it when you have time to absorb the wisdom and, hopefully, well before you're facing the end of your life or that of someone dear to you.

This is an immensely valuable book for anyone with a friend or family member (or one's own self)dealing with end of life issues. With deeply moving personal stories of patients treated by a hospice physician, the book often reads like a novel. But integrated into these stories is a very important message about the value of the dying process, both to the dying person and his or her loved ones. While not an overtly religious book, the author makes a strong case for hospice care for the dying, including effective pain management and maintaining dignity for the dying person. This becomes a strong refutation of the euthanasia movement.

Many of these stories will create a strong emotional response in the reader, but there is never a maudlin or overly sentimental tone to any of the stories. An incredible amount of wisdom is imparted by the author, and will provide much that can help families working through life and death issues. Particularly valuable are insights on the appropriateness of forgoing treatment, including feeding tubes, the effects of the dying process on the body (including the transition to "other-worldliness" that is often seen in the dying who let go of their attachments to the things of this life), and the reminder that the dying are, in fact, still living. Dealing with physicians, who are trained to "cure disease" versus provide "dying care," is, in itself, reason to read this book.

This is a "must-read" for those who are interested in hospice care issues, who want to be able to have an intelligent conversation about end of life issues in a personal or academic setting, or those who just want to know what it means to die well. The fact that the poignant stories remain in the reader's mind well after they have been read put a human face (so to speak) on the issue. If it can be said (and, many would argue, aptly so) that Americans have an ingrained avoidance of thinking about dying (except to fear it or deny it), a widespread reading of this work will help us to deal with the inevitably of our death more wisely.

I first heard Dr. Byock interviewed on the Diane Ream(?sp) show on NPR when his book was just out. I knew I had to read it for myself and I was not disappointed. The way the information about how things can be handled in a supportive respectful way for all of those involved at the end of life is the best written guide for many of the difficult situations out in the real world that I have found. If we would take advantage of this kind of informed material and spread the good news that death and dying are not to be feared but that we can be helped through it to the benefit of our own well-being and at the same time relieving the suffering of those who are in the last stages of this life, the support for "assisted suicide" would be revealed as the feeble sham that it is. Hospice is a poorly understood and underutilized organization which deserves a second look as well as our support both in time and resources. I had to read this book in small "doses" to take it all in and it was well worth the effort! CF

As a Lutheran minister, author (Project 314), and long-time Hospice spiritual care volunteer, I can heartily recommend Dying Well. Dr. Byock's stories of patients at the end-of-life is a must-read for all families. It informs the reader of the challenges and opportunities that face the patient and caregiver, and of the role of the Hospice organization. His book also challenges all of us who work with Hospice families to do our best.

I bought this book to obtain more information about how Hospice works, and this book fulfilled that goal, but It seemed that Dr. Byock Tryes to fit all his cases into a set formula for support and treatment. He also repeatedly made promises that he couldn't keep about pain and comfort during the dying process. It seemed that every time he promised that there would be no pain, the person went through periods of uncontrolled intense pain. Doctors usually know better than make promises like that.

Overall, I enjoyed this book and would recommend it to friends, in fact, I'd like to lend my Kindle copy, but it doesn't look like that is possible. It just got a little repetitive near the end.

incredible book if you change your beliefs about death you change your beliefs about how the universe works..this book made me believe in karma...completely changed my life recommended by david deangelo who i strongly recommend along with blueprint decoded

A most beautiful book that brought me to tears more than once. It helped me in writing my healthcare power of attorney. As written above, a must-read for all families who want to have something better than a fearful hospital death drenched in agony - I've seen a few of those and that's not what I want!

I have been a certified hospice nurse for many years and have experienced many of the same situations. It is nice to read a well written book that validates the multitude of feelings one experiences in this profession and as a family member of one who is dying. Very enriching reading.

Wow amazing and wonderful book about dying. I am a hospice nurse and this one of the best books I have ever read on death and dying. I really like reading about the author's own personal experience with this subject and was inspired by his insight.