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

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. Page 1 1 Page 2 2 Page 3 3 Page 4 4 Page 5 5 Page 6 6 Page 7 7 Page 8 8 Page 9 9 Page 10 10 Page 11 11 Page 12 12 Page 13 13 Page 14 14 Page 15 15 Page 16 16 Page 17 17 Page 18 18 Page 19 19 Page 20 20 Page 21 21 Page 22 22 Page 23 23 Page 24 24 Page 25 25 Page 26 26 Page 27 27 Page 28 28 Page 29 29 Page 30 30 Page 31 31 Page 32 32 Page 33 33 Page 34 34 Page 35 35 Page 36 36 Page 37 37 Page 38 38 Page 39 39 Page 40 40 Page 41 41 Page 42 42 Page 43 43 Page 44 44 Page 45 45 Page 46 46 Page 47 47 Page 48 48 Page 49 49 Page 50 50 Page 51 51 Page 52 52 Page 53 53 Page 54 54 Page 55 55 Page 56 56 Page 57 57 Page 58 58 Page 59 59 Page 60 60 Page 61 61 Page 62 62 Page 63 63 Page 64 64 Page 65 65 Page 66 66 Page 67 67 Page 68 68 Page 69 69 Page 70 70 Page 71 71 Page 72 72 Page 73 73 Page 74 74 Page 75 75 Page 76 76 Page 77 77 Page 78 78 Page 79 79 Page 80 80 Page 81 81 Page 82 82 Page 83 83 Page 84 84 Page 85 85 Page 86 86 Page 87 87 Page 88 88 Hank Dunn is an ordained healthcare chaplain, bestselling author and speaker who, since 1983, has been helping patients and their families as they struggle with end-of-life decisions