At Death's Door

End of Life Stories from the Bedside

2017 INDIES Winner
Honorable Mention, Grief/Grieving (Adult Nonfiction)

Clarion Rating: 5 out of 5

These stories are certain to make those dealing with terminal illness feel less alone.

At Death’s Door by Sebastian Sepulveda and Gini Graham Scott provides practical and compassionate insights for health-care professionals, as well as for those dealing with a terminal diagnosis as it affects their own health or that of a family member or friend. The book’s advice draws on years of professional experience with terminal patients and their families.

Fourteen chapters cover various aspects of terminal illness and death from a medical professional’s point of view. The book includes three kinds of information: medical, practical, and personal. The last includes the psychological, personality-influenced, and familial aspects of terminal illness.

On the medical front, the book addresses matters such as the need to convey information honestly and completely while clearing up misconceptions often perpetuated by television and other media. It also explains how the death experience plays out in diseases with distinctly different progressions, such as heart disease, cancer, and dementia. A cancer patient, for example, is likely to require more pain management than someone with heart disease.

On the practical front, legal issues and patient-directed choices such as filing Do Not Resuscitate and Do Not Intubate forms are covered, and caregivers and families are urged to discuss together the circumstances under which such forms might be reconsidered or even reversed. Also discussed are options such as hospice, hospital, and home care, all of which can be influenced by practical matters like insurance, availability, and the family’s ability to participate in home care or contribute financially. The book also discusses how families can support the patient’s decisions rather than creating stress by urging the patient to hang on, or by clinging to false hopes after the patient has accepted reality.

Writing is clear, free of overly technical terms, and cogent throughout, making points quickly without repetition or unnecessary elaboration. One of the most valuable features of the book is its wealth of real-life case study examples—around fifty in all. These give life to the information provided, usually approaching subjects from more than one point of view to show how different patients cope with various aspects of illness.

These stories are certain to make those dealing with terminal illness feel less alone, showing that there is no one right way to do things and emphasizing that support from caregivers should be practical and empathetic as well as medical. While written with compassion and respect for patients and their families, the book’s tone avoids sentimentality, false optimism, expressions of personal belief, and pushing one choice over another. The text is followed by a list of sources cited and a complete, well-arranged index.

Jargon-free writing, authentic case studies, and a compassionate, understanding tone make At Death’s Door a worthwhile book for health-care providers and anyone else touched by terminal illness issues.

Reviewed by Susan Waggoner

Disclosure: This article is not an endorsement, but a review. The publisher of this book provided free copies of the book and paid a small fee to have their book reviewed by a professional reviewer. Foreword Reviews and Clarion Reviews make no guarantee that the publisher will receive a positive review. Foreword Magazine, Inc. is disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255.

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