Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures, and the Patient with a Serious Illness, 6th Ed. (English Edition)

Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures, and the Patient with a Serious Illness, Sixth Edition is a guide to help patients and families with end-of-life decisions. Millions of families have been helped and comforted by the common sense and practical advice found in these pages. Hank Dunn draws on his extensive experience as a chaplain in a nursing home, hospice program, and hospital. In Hard Choices for Loving People he shares stories of many of the patients and families he has helped guide through this most difficult time. Living with a life-threatening illness presents challenges and difficulties few can imagine, or even think about. Family members are confronted with making extraordinarily difficult decisions, often in the midst of emotionally-draining circumstances. The book is also based on research, offering reliable, relevant medical advice from top medical journals and experts. In the very first pages, the reader is encouraged to first consider the goals of medical care. What is the appropriate medical goal for this patient at this phase of life? Is it to (1) cure, (2) stabilize functioning or to (3) prepare for a comfortable and dignified death? The first chapter deals with CPR, resuscitation attempts. Research has shown that this treatment offers little if any medical benefit to patients who have more than one or two serious medical problems, who cannot live independently, or those who are in the final stages of a terminal disease. Chaplain Dunn is convinced that patients in those conditions or their families choose ineffective resuscitation attempts for emotional and spiritual reasons, not because the treatment offers hope of saving the life. The second chapter addresses the issues surrounding artificial feeding tubes. Receiving nutrition and hydration through a tube may help patients who have lost the ability to swallow. Some of these patients live otherwise normal lives except for receiving food and water through a tube. But for many people, the treatment offers little if any benefit. There is a growing body of research that clearly shows that an artificial feeding tube for an advanced dementia patient (like Alzheimer s) has no medical benefit and can actually harm the patient. Chaplain Dunn also reviews the evidence supporting the fact that dying without artificial hydration is the compassionate, natural, and peaceful way to leave this world. Also covered in Hard Choices for Loving People are medical treatments such as palliative care, hospice, hospitalization, respirators (breathing machines), dialysis, antibiotics, pacemakers and implanted defibrillators, and pain control. In several places throughout the book, special attention is given to making these decisions for people with dementia. The concluding pages of the book address the emotional and spiritual concerns at the end of life. People of any faith or of no faith tradition have found these words helpful. Chaplain Dunn feels the journey at the final stages of life is a journey to letting go and letting be. As end-of-life care expert Ira Byock, MD, says on the back cover of the book, This slender book is packed with practical wisdom for people facing life s most difficult decisions. It is clear and concise, yet sensitive to the emotional turmoil of the people who hold it in their hands. Over the years, Hard Choices for Loving People is the book I have recommended most often to families confronting the complexities of medical treatments for loved ones with serious illnesses. Since the book was first published in 1990, more than 3.5 million copies have been sold. The Spanish version of this book is titled Decisiones Dificiles para los Seres Queridos.