end-of-life

Death. I wish the word could be removed from the vocabulary and from the dictionary. It simply does not exist, except in the human mind that was taught that it does exist. People think they are a body and they come to believe that when the body dies, everything they are will die too. It__ not true. The soul lives on. The soul of consciousness exists not only in the body but outside of the body too. We are all souls that cannot be contained or limited by time or space or the physical body. For souls there is no death.

I am constantly mystified by what John ends up remembering_ I just don__ understand why he__ able to hang on to information like that, while so many other more important memories evaporate. Then again, I suppose so much of what stays with us is often insignificant. The memories we take to the ends of our lives have no real rhyme or reason, especially when you think of the endless things that you do over the course of a day, a week, a month, a year, a lifetime. All the cups of coffee, hand-washings, changes of clothes, lunches, goings to the bathroom, headaches, naps, walks to school, trips to the grocery store, conversations about the weather__ll the things so unimportant they should be immediately forgotten. Yet they aren__. I often think of the Chinese red bathrobe I had when I was twenty-seven years old; the sound of our first cat Charlie__ feet on the linoleum of our old house; the hot rarefied air around aluminum pot the moment before the kernels of popcorn burst open. I think of these things as often as I think about getting married or giving birth or the end of the Second World War. What is truly amazing is that before you know it, sixty years go by and you can remember maybe eight or nine important events, along with a thousand meaningless ones. How can that be?You want to think there__ a pattern to it all because it makes you feel better, gives you some sense of a reason why we__e here, but there really isn__ any. People look for God in these patterns, these reasons, but only because they don__ know where else to look.Things happen to us: some of it important, most of it not, and a little of it stays with us till the end. What stays after that? I__l be damned if I know.(pp.174-175)

Life is but a breath.The end of life is the last breath of a man.

I thought that nothing enormously bad or good had happened to me during my life. All the normal things had occurred. I had lived a completely unremarkable life. I wanted only my home, and the love and safety of those around me, nothing else. I knew there was no particular reason why I was put on this earth, but here I was and I was glad to be here, awed by the beauty of it. It was a perfect moment. (p.99)

After all these years, his best friend is malaria.Even on the brink of an Alaska summer, it comes calling: a bone-deep chill one night, a ministry of sweat the next. Calling him back to old battles.

This is exactly the sort of thing that makes traveling wonderful for me, the reason I defied everyone. The two of us together like we have always been, not saying anything, not doing anything special, just on vacation. I know nothing lasts, but even when you know that things are just about over, sometimes you can run back and take a little bit more and no one will notice.

Know this: even if you__e like us and still doddering around above ground, someone out there from your past is probably pretty sure that you__e dead by now. (p.125 )

Ted," he said, "when all this started, I asked myself, 'Am I going to withdraw from the world, like most people do, or am I going to live?" I decided I'm going to live-or at least try to live-the way I want, with dignity, with courage, with humor, with composure.

Last Comforts_ was born when one nagging question kept arising early in my journey as a hospice volunteer. Why were people coming into hospice care so late in the course of their illness? That question led to many others that rippled out beyond hospice care. Are there better alternatives to conventional skilled nursing home operations? How are physicians and nurses educated about advanced illness and end-of-life care? What are more effective ways of providing dementia care? What are the unique challenges of minority and LGBT people? What is the role of popular media in our death-denying culture? What has been the impact of public policy decisions about palliative and hospice care? The book is part memoir of lessons learned throughout my experiences with patients and families as a hospice volunteer; part spotlight on the remarkable pathfinders and innovative programs in palliative and late-life care; and part call to action. I encourage readers _ particularly my fellow baby boomers -- not only to make their wishes and goals clear to friends and family, but also to become advocates for better care in the broader community.

A paradigm shift of viewing palliative care or hospice as a gift instead of seeing it as giving up has the potential to change the way we experience advanced age.

Death does not mark the end of a chapter in a man__ life, but the end of a book of man, the beautiful conclusion to his yearnings.

Without guidance and support for patients and families approaching death, there may be unnecessary conflict, confusion, and trauma that linger long after the passing of a loved one.

What would I have wanted to say if I had had the opportunity to see him one more time? I would like to think that I would have kept it simple and said, __ love you,_ then just held his hand in silence, letting that thought linger in the space of the time we had left together.

When I reflect on the stories of death supported by hospice care and contrast it with our story depicting an absence of support, I find myself dealing with envy and anger. I have channeled those emotions into this book with the hope that hearing our story might give someone else a chance to create a better ending to the life of a loved one.

I believe it__ imperative to bring the light of support and knowledge to patients and families when death is approaching.

Oh! Death! You are the savior of life.You are the shelter of life.You are the destination of life.You are the beginning and the end of life.You are the center of the circle of life.

Death is not the end of life but the beginning of eternal life.

As I enlarged my vision to see the bigger picture of my dad__ full life, I was better able to let go of being stuck in memories of its end.