The Art of Dying Well: A Practical Guide to a Good End of Life

Should be mandatory
This book is such a gift. Well written in clean, honest language w actionable ideas. This is an excellent book to read before you need it so you don’t try to scramble to make choices in the heat of it. I gave as Valentines gifts to my loved ones this year. The gift of greater peace of mind & empowered aging.

Good reference book.
I had read a library copy, and was so impressed, I bought one for my library. Excellent, concise advice on preparing for the end of the journey as well as setting the stage as you slow down and want to “age in place” instead of a nursing home. Good jumping off points to explore further on the ‘net if you want to know more. I only wish I had read this 20 years ago.

Read it NOW and again and again.
“Dying peacefully in your own bed takes a lot of planning and preparation. Dying in an ICU, hooked up to machines, most often, is the accident.” I have said this repeatedly in my over 35 years as a nursing home, hospital and hospice chaplain. Katy Butler fleshes this out in “The Art of Dying Well: A Practical Guide to a Good End of Life.” A peaceful passing is not accomplished only by arranging for hospice and pain management in the last two or three days of life. Ms. Butler says the preparation starts years before. Of course, the obvious practical steps are important, like completing a “Living Will” and “Durable Power of Attorney for Healthcare.” I say “obvious,” but precious few people actually take the small number of minutes needed to complete these documents. So, perhaps, not so obvious, therefore, it needs to be said again, and again. Butler takes this preparation for dying well to a whole new level, way beyond pieces of paper. The book is organized in seven chapters, each covering a phase from our healthy years to our final days. The chapters are: 1. “Resilience”; 2. “Slowing Down”; 3. “Adaptation”; 4. ”Awareness of Mortality”; 5. “House of Cards”; 6. “Preparing for a Good Death”; and 7. “Active Dying”. Each chapter starts by helping the reader identify whether he or she is in this phase… “You may find this chapter useful if…” and there is a list of signs marking that particular phase. For example, if “You can’t walk a half a mile unaided, unscrew a jar, or pick up a dining room chair” you may benefit with the information in chapter 5 “House of Cards.” A recurring section in all but the last chapter is “Finding Allies in…”. These are healthcare professionals in every field from preventive medicine, physical therapy, house call programs, to hospice. Nurture your “tribe” too. While you are healthy, take care of your friends, neighbors (especially your younger ones), people in your faith community and family members—you may need to call on them someday. Omitting “Finding Allies” from the “Active Dying” (the last hours or days of life) chapter says to me, if you haven’t been developing these relationships by your last days, it may be too late. Family and friends are really needed in this last phase. Could you ask your next-door neighbor to pick up some meds at the pharmacy if you have never met them? Build your tribe long before you need them. If one waits until just a few days before dying to start preparations to have a peaceful death, it may be too late. A HUGE problem hospices face is last-minute admissions. It is a problem because it can take a several days to get all the necessary medical equipment into a patient’s home and find the best way to get pain under control. We are back to my “dying peacefully takes a lot of planning and preparation.” Not to be overlooked in preparing for a peaceful end is the spiritual side of life. This may or may not be religious in nature. Butler points the reader toward many spiritual traditions with examples of prayers and rituals. Those who do not consider themselves to be religious will find resources here. The chaplain in me really appreciates this aspect being included in a book called “A Practical Guide”. Saying goodbye at the end of life IS a spiritual journey. In the end, Butler turns to a healthcare system which makes dying well so much harder. The way our system works in the United States is doctors and hospitals are paid for doing stuff. The more aggressive the treatments… the more machines used… the more tests ordered and more needle sticks… the more providers are paid. We (through Congress and Medicare/Medicaid) have no problem spending $7,000 a day on a dying elderly patient in an ICU but cannot find the money for more physical therapy to help another old person live independently. A doctor can order pills for a frail patient that cost hundreds of dollars but can’t help them get food. Katy Butler, appropriately, encourages all of us to become activists in changing the way we care for, not just the dying, but those living with frail health throughout our declining years. Get the book. Read it now. Read it again every time you find yourself moving from one of Butler’s phases to the next.Hank Dunn, author of “Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures, and the Patient with a Serious Illness”

Ok book

Hand book for ensuring good end of life care