Final Journeys: A Practical Guide for Bringing Care and Comfort at the End of Life » (Bargain)

Maggie Callanan, R.N., has specialized in the care of the dying since 1981. She lectures widely to lay and professional audiences on death and dying, bereavement, and hospice care. Maggie is the author of Final Journeys and co-author of Final Gifts. She lives on the New England coast.

For more than two decades, hospice nurse Maggie Callanan has tended to the terminally ill and been a cornerstone of support for their loved ones. Now the coauthor of the classic bestseller Final Gifts passes along the lessons she has learned from the experts—her patients. Here is the guide we all need to understanding the special needs of the dying and those who care for them.

From supporting a husband or wife faced with the loss of a spouse to helping a dying mother prepare her children to carry on without her, Callanan’s poignant stories illustrate new ways to meet the physical, emotional, and spiritual challenges of this difficult and precious time. She brings welcome clarity to medical and ethical concerns, explaining what to expect at every stage.

Designed to be your companion, resource, and advocate from diagnosis through the final hours, Final Journeys will help you keep the lines of communication open, get the help you need, and create the peaceful end we all hope for.

Dick Maxwell

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Callanan (coauthor, Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying) has worked for more than 25 years as a hospice nurse; here, she aims to offer the dying and those close to them practical advice grounded in that experience. Interspersing stories from her work and life, she examines such topics as potential family conflicts, ethical dilemmas faced by health-care workers, and the various stages of the grieving process. She emphasizes that the terminally ill should be listened to with care and compassion and that their right to comfort should not be overlooked in sometimes futile attempts to prolong life. She also stresses the need for early discussion of end-of-life issues and the documentation of any decisions reached. The advice is unblinking and useful, but it is surrounded by an excess of fairly artificial re-created dialogs. Further, some readers might find the forays into subjects like afterlife communication to be at odds with the goal of providing useful and practical advice. Dennis McCullough's My Mother, Your Mother: Embracing "Slow Medicine," the Compassionate Approach to Caring for Your Aging Loved Onesoffers similar information. Recommended for large public libraries.

Introduction: "I Don't Know How to Do This"     1
Reframing the Journey     7
"Tools, Not Tissues"     9
"Don't Tell Mom She's Dying. It'll Kill Her!"     18
Breaking the Silence     24
"We're Not Giving Up! We Have Hope!"     31
"Only the Best for My Father"     38
"I Don't Know... My Doctor Has My Records"     44
Making Difficult Decisions     49
The Right to Be Comfortable: Choosing Palliative Care     51
"I'm Dying! Of Course I'm in Pain!": Expert Pain and Symptom Control     56
Choosing Treatments-and Knowing Which Are Optional     63
It's Hard Enough to Die Once: Deciding About a Do-Not-Resuscitate Order     73
"We Can't Just Let Him Starve to Death!": Deciding About Artificial Nutrition     81
Making Ethical Decisions     92
Sharing the Journey     99
"I Love You, Mom, and I Want to Help, but I'm Not Moving to Miami!"     101
Listen to Your Body     108
Family of Birth, Family of Choice     113
How Friends Can Help     118
When Little Eyes Are Watching     127
People Die as They Live-Intensified     135
Avoiding Potholes     139
Tripping over YourRoots-and Crashing into the Family Tree     141
"Whose Death Is It, Anyway?"     145
Finding Power in a Powerless Situation     152
Caregiving in a Wounded Relationship     157
Understanding Cultural Differences     165
The Importance of Spiritual Influences     176
Don't Let the Dying See You Cry- and Other Myths     184
Long Road ... Getting Weary     193
"I Could Die Laughing"     195
Memory Making     202
"It Feels Like We're Losing Her Before She Dies!"     212
Our Pets May Know More than We Do     216
The "Final Gifts" of Nearing Death Awareness     222
Communicating Without Words     234
Coming to the End     239
What's Normal for Dying Isn't Normal     241
"It-All-Goes-to-Hell-in-a-Handbasket Day"     254
Being with, Not at, the Dying Person     260
"I Need Your Permission to Go"     268
The Final Hours     274
One Journey Ends, Another Begins     279
On the Toll Road: The Healing Power of Crying     281
Doing the Grief Work, Day by Day     285
"When I Think of Granddad, I Feel Lonely in My Throat": How Children Grieve     291
"For a Moment I Could Small Mom's Perfume"     303
Appendices     309
Your Strongest Tools Are Made of Paper: Advance Directives     311
The Dying Person's Bill of Rights     319
The Hospice Medicare Benefit     321
Recommended Reading and Resources     325
Acknowledgments     333
About the Author     337