Publisher's Synopsis
The staggeringly huge epidemic of Alzheimer's and related dementias presents huge challenges. Of all diseases, Advanced Dementia is the most cruel, longest and most burdensome. Those who know about Advanced Dementia dread it more than any other disease. Yet for many, it is in the "closet-within-the-closet": as a society, we tend to not talk about the disease of dementia and we especially avoid talking about how one dies with dementia. "Peaceful Transitions: Stories of Success and Compassion" provides hope as it portrays what life can be like for dementia patients and for their loved ones. (It also covers other terminal illnesses.) It summarizes recent research that reveals Advanced Dementia patients have an increased risk for NOT receiving treatment for pain and suffering. Since patients cannot verbalize their complaints, their physicians do not know they are suffering. Also, when they are in pain, their behavior is often not typical. There is a legal and peaceful way to prevent months to years of prolonged dying and possibly untreated pain after mental deterioration becomes devastating. Called "Natural Dying," this book explains how readers can select from a list of criteria that includes the symptoms, losses of function, unwanted behaviors, and conflicts with lifelong values, to create a Living Will. Then, their future decision-maker (proxy/agent) will know precisely WHEN they would want Natural Dying. Important: this specific Living Will can also prevent premature dying. Unfortunately, a powerful opposition that state laws protect, allows professionals and institutions to refuse to honor a person's wishes. Here is a "short list" of examples: certain interpretations of religious teachings; physician's moral conscience; fear of discrimination of disabled people; confusion about government regulations; and new physician order forms (POLSTs) that can override previously expressed wishes. There is also greed: others can profit from forcing patients to suffer longer. The book's stories illustrate how these challenges can be overcome so readers can attain the goal of timely and peaceful transitions. Readers can identify and learn from "A Tale of Two Mothers" and "Our Fathers, Ourselves." Some stories are composites of the author's patients. Other stories are about the author's own family, were written by guest authors such as Attorney Susan M. Wolf, and are excerpts from movies, books, and the clinical literature. The story, "To live long enough to warm the hearts of others," frankly reveals Dr. Terman's moral angst as he asks: Is it right or wrong to provide knowledge to a person about how to die? Dr. Stanley A. Terman is a psychiatrist who leads the non-profit organization, Caring Advocates, which helps people plan for... and then attain timely and peaceful transitions. The book also covers a legal option that not all doctors or institutions provide, but may be essential to relieve days to weeks of unending, unbearable pain and suffering. In demonstrating how diligent Advance Care Planning can make a big difference in how much and how long dying patients suffer, the book's stories are designed to motivate readers to action. The book is richly illustrated with line drawings and photographs. It introduces an optional, new, easy, and interactive tool to create Living Wills called "My Way Cards," as an alternative to using its list of Criteria of Advanced Dementia. Dr. Terman's writing and crafted clinical and legal strategies were subjected to extensive critical editing and numerous, practical suggestions from his colleagues who are prominent health care attorneys and clinical bioethicists. This book will help readers understand the challenges of dying well. It will also lower their anxiety about how long and how much they will be forced to suffer before they die. It will even enhance their appreciation of living--from now until it is "timely" for their peaceful transition.
