TABLE OF CONTENTS

**The e-book and print versions follow this table of contents.  The 9-CD audio version includes all of this information  and an interview with the authors which sets the stage for the discussion.

     
 

                                                                             

Forward

The Story of a Doctor and a Patient

How to Use This Book

Acknowledgments

Introduction

            The Active Management of Dying

            Questions for Reflection

            Death: Well-Managed vs. Chaotic

            Principles of The Active Management of Dying (Chart)

Chapter 1. Accept the Reality of the Situation

            Moving Through Fear to Hope

                      Despair, Denial, Hope

            Doctor Shopping

            Anticipatory Grieving

Chapter 2. Identify the Decision-Makers

            Informed Consent

                      Informed Consent Requires Capacity

            Advance Directives

                      Health Care Power of Attorney; Living Will, Out-of-Hospital/EMS DNR Order

            The Role of the Suurogate 

            How the Process Works

            Summary of the Process

            Moral Decision-Making

                        Objective Factors; Subjective Factors; Obtaining Help

Chapter 3. Discuss the Ultimate Goals of Care

            Start with Attitudes

            Defining Ineffective Treatment

            The Ultimate Goal of Care

                        How Far Should Doctors Go in Assisting Death?; A Graded List of Medical Interventions

            Myths about Dying

Chapter 4. Create an End-of-Life Care Plan

Chapter 5. Implement the Care Plan You Created

            Roles Assigned to Various Team Members

Chapter 6. Financial Planning

            Medicare, Medicaid, Private Insurance, VA, Long Term Care

Chapter 7. Narrative Case Examples

            Case #1: Mr. Miller

            Case #2: Mr. Smith

            Case #3: Rev.. Fisk

            Case #4: Ms. Pinchon

            A Personal Note

Chapter 8. Specific Advice for End-of-Life Care

            For Patients

            For Families

            For Health Care Professionals

            Dementia

Chapter 9. Grieving

            “Sweeping up the Heart and Putting Love Away”

            After Death Has Occurred

Chapter 10 End-of-Life Issues in the Nursing Home

            Nursing Home Resources

                        Social Workers; Nurses; Aides/Technicians; Rehabilitation Services;                            

                        Medical Directors; Primary Physicians; Nutrition Services

            Strategies for Optimizing Nursing Home Care

            Specific End-of-Life Issues

                        Hospice in the Nursing Home; Documentation

            The Bottom Line

            A Note to Caregivers

            The Hospice Perspective

Chapter 11. End-of-Life Care Issues in the Intensive Care Unit

            ICU Pitfalls

            Strategies for Optimizing ICU End-of-Life Care

            Withdrawal of Support

            Other Ethical Issues in the ICU

            The Bottom Line

Chapter 12. End-of-Life Care Issues in the Emergency Department

            Optimizing End-of-Life Care in the ED

Chapter 13. Special Considerations

            Organ Donation

            Stewardship

Chapter 14. Medications Commonly Used in Termainal Care

            Narcotics

            Sedatives

Afterword

Appendix A-Explanation of Terms

Appendix B-Sample Orders

Appendix C-Suggested Reading

About the Authors

Notes Section

            Patient Information

            Record of Meetings

            General Notes from Reading

 

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