Tag: end of life care

Being Mortal -A Book Review

Dr. Gawande discusses end-of-life care- care when a disease has become terminal and a cure is no longer likely. Sometimes it is difficult to determine when that occurs. As he says, it is rare in medicine when there truly is “nothing more we can do”.

Being Mortal 

Medicine and What Matters in the End

by Atul Gawande

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I read Being Mortal by Atul Gawande, M.D. (To be exact, I listened to the audio version)

Atul Gawande- Being Mortal-book cover

Dr. Gawande is a surgeon at Brigham and Women’s Hospital in Boston, Massachusetts and professor at Harvard Medical School. He writes for The New Yorker and has authored three other bestselling books.

In Being Mortal, he explores the way most people live, age and die and for the most part it’s not a pleasant prospect.

Caring for elderly people

As people age and lose independence due to frailness, illness, mental decline and poverty, they often also lose whatever is most important to them- their home, pets, hobbies, possessions. And these losses often occur to protect them from harm as they progress into assisted living centers, nursing homes and hospice.

Dr. Gawande describes how his  family in India expected  to care for their elderly relatives, which differed from what he saw happen when they immigrated to the United States. After becoming a physician, he recognized that our care of the elderly often robs them of the well-being that he sought to promote in his practice.

He wondered how it can be done differently. To find out, he interviewed people who are developing novel ways to provide care to older people, care that preserves their independence, dignity and choices while still keeping them safe and protected.

Most of us either have relatives or friends facing these decisions, or are facing them ourselves. If not now, we all will eventually. Whichever the case, this book show”s” the ultimate goal is not a good death but a good life-all the way to the very end. “

woman sitting in a cemetery
photo from the Lightstock.com collection, an affiliate link

“ the ultimate goal is not a good death but a good life-all the way to the very end.”

Atul Gawande

Caring for dying people

Finally, Dr. Gawande discusses end-of-life care- care when a disease has become terminal and a cure is no longer likely. Sometimes it is difficult to determine when that occurs. As he says, it is rare in medicine when there truly is “nothing more we can do”.

However, just because we can do something, doesn’t mean we should. Some treatments, rather  than extending life just prolong the suffering. Still it is heart wrenching for patients and families, along with their doctors, to decide that it is time to forgo treatment and instead opt for palliative care, with or without hospice.

(Palliative care focuses on symptom management and social and emotional support for patients and families.)

Dr. Gawande poignantly describes this process by sharing in detail his  father’s cancer diagnosis, treatment, progression, hospice care and death. He shows how difficult a process this can be, given that even he and his parents, all of whom are physicians, struggled to come to terms with the reality of terminal illness and the dying process. Though they were all familiar with and experienced in dealing with the medical system, they still felt unprepared to face the decisions required at the end of life. But in the end, both he and his father felt at peace with the outcome and Dr. Gawande senior did experience “a good life-all the way to the very end.”

Atul Gawande on Priorities, Big and Small–

a podcast interview with Tyler Cowen

Other books by Dr. Gawande–

Complications : A Surgeon’s Notes on an Imperfect Science

In gripping accounts of true cases, surgeon Atul Gawande explores the power and the limits of medicine, offering an unflinching view from the scalpel’s edge. Complications lays bare a science not in its idealized form but as it actually is―uncertain, perplexing, and profoundly human.

Better: A Surgeon’s Notes on Performance 

The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be on the line with any decision.

Atul Gawande, the New York Times bestselling author of Complications, examines, in riveting accounts of medical failure and triumph, how success is achieved in this complex and risk-filled profession

The Checklist Manifesto:How to Get Things Right

Atul Gawande shows what the simple idea of the checklist reveals about the complexity of our lives and how we can deal with it.

Exploring the HEART of Health

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Dr. Aletha

Why Plan for End-of-Life

A discussion of end-of-life planning and two books on the subject that I reviewed.

updated July 1, 2026

We, meaning doctors and patients, care much about how we live, but often give little attention to how we die. But death, after birth, is the single thing we all share as humans. Still, we live like it’s not going to happen, or act surprised when it does.

Death should never be welcome, and it will never be easy, but sometimes it is more horrible than it has to be because no one planned for it. No one asked the hard questions-

  • “What if you are diagnosed with a terminal illness?”
  • “What if you can no longer swallow or eat on your own?”
  • “What if you cannot breathe unassisted?”
  • “What if you are no longer competent to make your own medical decisions?”
Fewer than 10% of persons with sudden cardiac arrest survive.
Fewer than 10% of persons with sudden cardiac arrest survive.

End-of-life planning is not synonymous with  ending care or euthanasia. It is about providing comfort, controlling pain and other symptoms, and supporting family. It’s about deciding in advance how you want to spend the last few months, weeks, days, or hours of your life.

No matter how young or old you are,it is important to consider these things, because unexpected illness and injury can happen to anyone. There are two things to do-

Dying with Ease- a book review

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

Keep reading

Talk- to your family about what you want. If you already have a life-threatening condition, talk to your doctors.

Write- down what you want. This is usually in the form of an advanced directive, living will, or medical power of attorney. You can learn how to do this here.

“Advance directives are discussions or written statements that convey a person’s wishes to his or her family and physician if he or she becomes unable to discuss such matters. They may

  1. explain the individual’s values about health, life and death;
  2. give directions to family and physician about treatment goals or the use or non-use of specific treatment modalities; or
  3.   designate a surrogate to make decisions on behalf of the individual.

After completing an advance directive, the individual should discuss its content and meaning with his or her family, surrogate, and physician. Individuals should review their advance directives periodically to assure that they accurately reflect their current values and wishes.”

My husband and I   have advance directives, and we discuss our wishes with each other periodically to confirm our preferences. We also have updated wills and funeral plans. We hope to spare our children unnecessary hardship after our passing.

A Beginner’s Guide to the End-a book review

A Beginner’s Guide to the End by B.J. Miller and Shoshana Berger offers practical advice for navigating life and death. Combining personal experiences and practical information, it covers essential topics such as planning ahead, dealing with illness, and understanding grief. The book serves as a helpful resource for anyone facing mortality.

Keep reading

Exploring the HEART of Health

I appreciate your time reading this post and invite you to follow this blog and me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha