DYING, SURVIVING, AND AGING WITH GRACE


Not in that order
Resources on illness, death and dying, loss, grief, and positive aging

Selected Works

Enjoying the golden years
Including suicide and assisted suicide
Plus memorials and requiems
(resources for specific diseases, conditions, syndromes)
Narrative medicine (or medical narrative) Memoirs of illness, crisis, disability, differentness, and survival
Assisted living, nursing homes, cohousing, or living in place (with or without caregivers)

Hospice care and palliative care


Hospice and Palliative Care
I've written about my own experience with hospice in my book DYING: A Book of Comfort. When my father died, my family and I were able to help him do so with the help of a wonderful hospice in Southern California. When my mother died, at the home of my brother and his wife, they too -- Mom and Steve and Sue -- were able to get through a difficult death chiefly because a Utah hospice helped them deal with practical, emotional, and spiritual issues. No doubt there are inadequate hospices, but that has not been my personal experience.

People often wait too long to call about hospice. What hospices know how to do is alleviate pain and suffering: "The focus of hospice is on caring, not curing." As soon as pain is an issue, look into the option of palliative care or hospice care (the most comprehensive and best-known form of palliative care). For us, hospice care was provided in the home, with hospice volunteers helping our family cope --and this is fairly common. But hospice care can be provided in hospitals, assisted-living residences, long-term care facilities, and special hospice facilities. If you aren't sure that that someone is dying, let hospice experts and your physician help you figure things out. (Just realize that your doctor may hesitate to suggest hospice care, fearing you will lose hope--or maybe, subconsciously, fearing that hospice care means he has failed. So ask, and hear what your doctor has to say. ) Don't wait too long -- because what hospices are good at is helping people feel comfortable, and most professionals in the regular health care system are not nearly so good at that. Palliative care serves an important function. There are many stories of people feeling much better once they get palliative care. Following are links to resources that may be helpful for end-of-life care even if you choose not to seek the help of hospice workers.

To find a good hospice near you, ask friends if they know of a good local hospice; ask the social workers at your local hospital for a referral; check the yellow pages under Hospices; ask for referrals through the local American Cancer Society, an Agency on Aging, Visiting Nurse Association, or house of worship. Check with the National Hospice and Palliative Care Organization (click on link below, or call NHPCO’s HelpLine at 1-800-658-8898). Check with the local state departments of health or social services to learn which hospices are certified (making them eligible for Medicare and in some states Medicaid). Or Google hospices and your zip code (which may turn up hospices that do not belong to NHPCO as well as those that do).

Consider offering a person in hospice care the gift of life review--the gift of reminiscence. Helping the dying to capture their life story, whether written or recorded or simply shared with a good listener, is to let them know that they will not be forgotten. It's best not to wait till they're in hospice to offer this gift, as waning strength may make it difficult to say much, and their memories may be fading. But if they have not had that gift of life review at the point when the end is near, it can feel powerful to speak to someone who is truly listening and who will remember. And many who record these sessions are told later that this is the the only recording the family has. It is tremendously comforting, later, to be able to hear the voice of someone who has passed on. What would you give to hear the voice of your grandfather?

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Frequently asked questions


One of the chief fears people face as someone they love approaches death is the fear that providing palliative care (comfort care, not rescue care) means they are "giving up." Certainly a time comes when patients or families decide enough is enough, no more pain and suffering, let me enjoy the life I have left. Far too many families wait too late to bring in palliative care and/​or hospice care--which are focused not on saving a life but on making the life more comfortable. Getting palliative does not mean you have to give up your curative care team. But not all medical experts routinely bring in palliative care --you may have to ask for it! Hospice care, an important Medicare benefit, is palliative care for terminally ill patients who probably have only months to live. Patients who get hospice care are no longer receiving curative treatment for their underlying disease but do get treatment to keep them comfortable.

Most hospice care is provided at home, typically with a family member serving as primary caregiver. Hospice care may also be available at local hospitals, nursing homes, assisted living facilities and dedicated hospice facilities. No matter where hospice care is provided, if the hospice care team cannot deal with a particular problem in the home setting, a hospital stay may be needed. Read up on the subject. Here are some helpful articles.

Frequently asked questions about hospice care (FAQs, NHPCO)
A Better Way to Manage Pain (Karen Rafinski, AARP Bulletin, print edition, 6-1-11). "Like hospice care, with which it is often confused, palliative care focuses on helping patients with their pain and symptoms, and offering counseling and other services. But if hospice care is about a good death, palliative care is about making the most of life with a serious illness, whether the disease is terminal or not."
What is palliative medicine? Frequently asked questions about palliative care (Palliative Doctors, "compassionate care at any stage of an illness")
Choosing a hospice and FAQs about hospice care (Hospice Foundation of America)
Frequently asked questions about end-of-life experience and care (Ira Byock, MD)
How to Choose a Hospice (Paula Span, NY Times, 6-17-14).
8 Facts to Know About Palliative Care (Sarah Baldauf, US News, 8-25-09). Misconceptions abound. Patients and families need not be afraid to ask for help.
Frequently Asked Questions (Center to Advance Palliative Care, and National Palliative Care Research Center)
Choosing a Hospice: 16 Questions to Ask
Questions To Ask When Looking For a Professional Geriatric Care Manager (NAPGCM)
Living at the End of Life: A Hospice Nurse Addresses the Most Common Questions by Karen Whitley Bell RN, who "she delivers a wealth of useful information on pain management, choosing a hospice and general day-to-day care giving in a powerful, hard-to-forget way. Straightforward and empathetic, with an easy-to-navigate style, Bell details what to expect in both physical and spiritual terms, including practical considerations as well as ways to find closure and cope with loss." (PW review)
Links to FAQs (Hospicenet.org)
Learn the Truth About Hospice Care for Advanced Illness (Frank D. Ferris, Advisor.com). The facts about how hospice and palliative care can give your family help and hope when they need it most
When is the right time? What are some signs that a person may be ready for hospice care? What are some signs that our family could benefit from hospice care? And in Frequently asked questions, Is care provided only in the homes of patients? Only for patients with cancer? The answer is no to both questions.(Hospice and Palliative Care of Greensboro)
Who decides when medicine prolongs dying, not living? (Susan Jacoby, The Spirited Atheist, Washington Post, 1-31-11)
Pet End-of-Life FAQ (helpful ASPCA articles on pet loss, including one on hospice or palliative care, to reduce your pet's suffering)
What is palliative care, how does one get it, and other FAQs (Get Palliative Care)
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Finding a hospice or hospice care



Find a care provider (National Hospice and Palliative Care Organization's directory of members and vendors) Or call NHPCO’s HelpLine, 1-800-658-8898)
Hospice Directory
Finding a local hospice (Caring Connections)
Finding a local hospice
How to find a professional geriatric care manager (National Association of Professional Geriatric Care Managers, NAPGCM). Families of patients with a complex assortment of problems often have trouble keeping everything straight. A good geriatric care manager can help you schedule procedures and visits and hire the nurses and medical aides who keep dressings clean, keep track of things like which medications to take when, and so forth.
UK hospice and palliative care services (find a hospice in UK or Ireland)
Global Partners in Care, improving access to hospice and palliative care worldwide where the need is great and the resources are few (formerly Foundation for Hospices in Sub-Saharan Africa, ie FHSSA)
Global directory of palliative care services and organizations (International Association for Hospice and Palliative Care)
Finding a hospice (Growth House)
Get palliative care (providing comfort, not cure)
Find a provider Visiting Nurse Association)
Blog directory for hospice and palliative care community
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Helpful organizations and websites


American Hospice Foundation
Canadian Hospice Palliative Care Association
CaringBridge.org (free websites to support and connect loved ones during critical illness, treatment, and recovery)
Caring Connections (tollfree help line 1-800-658-8898, National Hospice & Palliative Care Organization)
Center to Advance Palliative Care
National Hospice and Palliative Care Organization (NHPCO)
National Palliative Care Registry
Social Work Hospice & Palliative Care Network. SWHPN was created to bridge the gaps in social work’s access to information, knowledge, education, training, and research in hospice and palliative care.
Visiting Nurse Associations of America (VNAA, advancing nonprofit home healthcare and hospice)
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Issues with hospice and end-of-life care


Fighting to Honor a Father’s Last Wish: To Die at Home (Nina Bernstein, NY Times, 9-25-14)
"Hospitals, eager to clear beds, increasingly sent patients to nursing homes. The nursing homes were often too short-staffed to reliably change diapers but still drew premium Medicare rates, ordering hours of physical therapy and other treatment that studies showed was often useless or harmful.
"Even hospice was limited. Now mostly for-profit, hospice companies would provide supervision and visits at home a few times a week through Medicare if a doctor certified that Mr. Andrey had only six months to live. The hidden catch: He would lose all Medicaid home care, the daily help he needed to be home at all."
Why so many people die in hospitals instead of at home (Fred Mogul, WNYC, PBS Newshour, 9-22-14) "A year after his wife Paula died, Ron Faber still believes her oncologist at Beth Israel Hospital was strangely optimistic about her prospects. Faber acknowledges it was Paula’s decision to fight the cancer “every inch of the way,” but he thinks she might not have, if her doctors had told her more about the upsides of palliative care and the downsides of aggressive treatment."
Care of Chronically Ill Patients during the Last Two Years of Life (Dartmouth Atlas of Health Care)
Our medical system is ill-prepared for baby boomers (Katy Butler, Marin Voice 5-21-14) "A 'silver tsunami' of aging and dying baby-boomers is colliding with a medical system that pays well for long-shot tries at cure — but very little for care.... As a national health policy, it makes no sense. A single day in a hospital costs insurers roughly $1,670 — more than 10 times what hospices are paid per day, nationally. And hospitals are where people like Pete end up when they and their doctors do not know how to talk about death and keep chasing will-o'-the-wisp treatments. ... If we can pay for late-stage chemotherapies that are proven not to extend life and often create great suffering, we should pay doctors equally well to break bad news honestly."
Bounced from Hospice (Paula Span, NY Times, 1-7-14). "Hospices have lamented for years that dying patients wait too long to call, enrolling at the eleventh hour when they could have benefited months earlier. Now, we’re hearing more about patients doing as hospice believers (including me) have urged, calling earlier in the course of a terminal disease — and then, in a substantial minority of cases, getting bounced."
***How to Die (Bill Keller, Opinion, NY Times, 10-7-12). An excellent essay on a peaceful hospital death that followed the Liverpool Care Pathway for the Dying Patient . The Liverpool Pathway or variations on it are common in England and several other countries but are demonized here by people like Sarah Palin (inaccurately as "death panels"). Keller argues that we should practice it not because it is economical (palliative care does cost money), but because it is a" kinder way of death."
Care Transitions Activism for Geriatrics and Palliative Care (Dr. Joanne Lynn, MediCaring blog, on need for activism to support changing Medicare regulations in a way that allows patients for whom only palliative care will be helpful to die at home instead of in a hospital). On a similar note, see also
Agitator’s Guide to Elder Care (MediCaring.org)
How Doctors Die by Ken Murray (ZocaloPublicSquare.org, 11-30-11). It's not like the rest of us, but it should be. (This article was widely reprinted, in Time, the Saturday Evening Post, Boing Boing, the Washington Post (asking Is this true?), Wall Street Journal (as Why Doctors Die Differently). Clearly it struck a chord! It was also featured on The Bitter End (RadioLab program, 1-15-13). I quote: Ken Murray, a doctor who's written several articles about how doctors think about death, explains that there's a huge gap between what patients expect from life-saving interventions (such as CPR, ventilation, and feeding tubes), and what doctors think of these procedures for themselves.We turn to doctors to save our lives -- to heal us, repair us, and keep us healthy. But when it comes to the critical question of what to do when death is at hand, there seems to be a gap between what we want doctors to do for us, and what doctors want done for themselves. As part of the decades-long Johns Hopkins Precursors Study, Joseph Gallo found himself asking the study's aging doctor-subjects questions about death. Their answers, it turns out, don't sync up with the answers most of us give. Read some findings from the Precursors study.
Study: Doctors Choose Different Plan for Dying Patients Than for Themselves (Paul Kleyman, New American Media, 6-2-14) "[E]ven though an overwhelming majority of physicians Stanford surveyed (88.3 percent) would reject unnecessarily invasive treatment for themselves and opt instead for comfort care, patients in the United States continue to spend their last days receiving high-intensity care that is often ineffective and sometimes ordered contrary to patients’ wishes.
How Doctors Die — It’s Not Like the Rest of Us, But It Should Be (Martin Bayne, The Voice of Aging Boomers, 3-18-13)
Patients Teach Doctor How to Heal at the End of Life (Paul Kleyman, New American Media, 4-3-13) "Dr. Vyjeyanthi “V.J.” Periyakoil believes that contrary to conventional wisdom, most patients don’t simply want every medical intervention that may or may not prolong their lives. Overall people want appropriate care sensitive to their quality of life and, enabling them to experience their final days as fully as possible with minimal stress for their families. [They don't] want their families burdened by the cost of their care, or by having to struggle with troubling decisions about their treatment....On the survey’s list of 12 “Most Important Factors at End of Life,” people placed the desire “to live as long as possible” down at number 10.
Palliative & Hospice Care (New American Media articles)
Committee on Approaching Death: Addressing Key End of Life Issues (Institute of Medicine)
Immigrants Facing Death Without Home Hospice Support (Daniela Gerson, Alhambra Source/​New American Media, 2-20-14)
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Issues with for-profit hospices


How Dying Became A Multibillion-Dollar Industry (Ben Hallman, Huffington Post series, 6-19-14) Offending companies "focused on maximizing Medicare reimbursement for as many patients as possible while disregarding patients’ medical needs" -- in one case, "bumping her up from routine care to 'crisis care,' a level of more expensive, continuous coverage, even when records show she wasn’t in pain." Hospices need to be inspected as often as nursing home are for violations in safety and patient care. With some for-profit hospices "it's all about money." "Many hospice employees are being pressured into wrongfully enrolling patients and adjusting health records in order to obtain more government funding, while health care staff, who object and whistleblowers are punished."
Terminal neglect? How some hospices treat dying patients. (Peter Whoriskey and Dan Keating, Washington Post, 5-3-14, part 1 of an ongoing series, "Business of Dying"). "While many home hospice patients require little more than weekly nursing visits, some encounter crises in which their symptoms — pain, breathing troubles, seizures and so on — flare up in ways that cannot be controlled without sustained attention. For those cases, hospices are supposed to be able to provide either “continuous” nursing care at home or inpatient care at a medical facility. But about one in six U.S. hospice agencies, serving more than 50,000 of the terminally ill, did not provide either form of crisis care to any of their patients in 2012..."
Is that hospice safe? Infrequent inspections mean it may be impossible to know. (Peter Whoriskey, Washington Post, 6-26-14, part two of a series, "Business of Dying"). It is impossible to say precisely how many hospice companies might be cited for violations if there were more scrutiny, but a significant portion of them appear to be providing scant care, Medicare statistics and interviews show.
Huffpost misses palliative care forest for hospice trees (Generations Beat Online news) Huffpost confuses "mean" with "median." "People who may be over-treated in acute hospital care before spending their final 18.7-days in hospice, long after they might have benefited from good palliative care, face a reality quite different from the fraudulent and painful story told by HuffPost in “Hospice, Inc.” But it’s a story that needs to told along with the fear-factor reporting, lest the horrors lead merely to more “death panel” policy fallout."
Hospice firms draining billions from Medicare (Peter Whoriskey and Dan Keating, Washington Post 12-26-13) Medicare rules have encouraged for-profit hospice companies to seek out patients who aren't actually dying. Part of a special report and series: The cost of healing: How America puts the wrong price on healthcare.
NHPCO Responds to Washington Post 12-27-13
Differences in Care at For-Profit Hospices (Paula Span, NY Times, 3-3-14) "The patterns in this Mount Sinai/​Yale study suggest that, as the Washington Post reported in December, for-profit hospices aggressively recruit patients, keep them enrolled longer, then evict them when costs begin to endanger reimbursement."
Hospice Care: For-Profit Has Pluses, Minuses (Michael Smith, MedPage Today 2-24-14)
Changing the Way We Die: Compassionate End of Life Care and The Hospice Movement by Fran Smith and Sheila Himmel. Speaking on an NPR program, Smith said the commercial firms that operate hospice operations tend to "cherry-pick" the most profitable customers (long-term dementia patients).
Hospice Care and Roto-Rooter—What Happens When For-Profits Run Hospice Care? (Ruth McCambridge, Nonprofit Quarterly, 1-9-12)
In Hospice Care, Longer Lives Mean Money Lost (Kevin Sack, NY Times, 11-27-07) With patients living longer, the government is making hospices repay hundreds of millions of dollars to Medicare.
Hospices Under Feds' Microscope (Bob LaMendola, Health News Florida, 7-2-13) Vitas, the nation’s largest hospice, has been accused of collecting “tens of millions of taxpayer dollars” through unjustified and inflated bills. (Vitas also owns Roto-Rooter.)
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Stories about hospice and palliative care


A Different Kind of Miracle (Anita Fry, Pulse, 10-11-13). Her father's terminal cancer diagnosis leaders her to realize, the hospital she is associated with needs palliative care for cancer outpatient care.

A Dying Person's Guide to Dying (Roger C. Bone, Hospice.net)

As Nurse Lay Dying, Offering Herself as Instruction in Caring (Abby Goodnough, NY Times, 1-10-13). With less than two months to live, Martha Keochareon teaches students about cancer and dying. "Perhaps more than anything, the students were learning about the challenge of managing late-stage cancer pain in a patient who had outlived her prognosis."

As Need for Palliative Care Grows, So Do Innovations (Elyse Salend, in an excellent AgeBlog story, from the American Society on Aging )

Because You've Never Died Before: Spiritual Issues at the End of Life by Kathleen J. Rusnak, who writes of the Brick Wall that separates the living from the dying--the knowledge of impending death changing the way you feel about things.

Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death (by Joan Halifax with foreword by Ira Byock)

The Beneficial Effects of Life Story and Legacy Activities by Pat McNees (Journal of Geriatric Care Management, Spring 2009). Get PDF file of journal article here (61.9KB)

Blog directory for hospice and palliative care community

Buchwald, Art. Heaven Can Wait (Buchwald's classic essay on hospice care, Washington Post 5-23-06)

A Calling for Care of the Terminally Ill (Andi Rierden, NY Times, 4-19-98, writing about Florence Wald, who spent two years talking to officials, inmates and health-care providers in Connecticut to learn the needs of dying prisoners and their families)


'Dignity therapy' gives comfort to dying patients. Helping terminally ill patients pass on their final thoughts may help give them a better quality of life, reports Harvey Chochinov, head of a Canadian research study (Jonathan Shorman, USA Today 7-11-11, on study published in Lancet Oncology)

End of Life and Palliative Care (Robert Wood Johnson Foundation, which provides strong support for sounder policies and practices)

End of Life Care (Alan Meisel, The Hastings Center, summary of key issues in From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns, ed. Mary Crowley )

Engage with Grace and the One Slide Project. To help ensure that all of us--and the people we care for--can end our lives in the same purposeful way we lived them. • Watch the Engage with Grace Story (Video, Za's Story) • Download the One Slide (PDF)

Facts about end-of-life care. Helpful and interesting information and quotations, collected by Gil Porat, MD, author of The Other Face of Murder, a novel mixing mystery and humor, which conveys the complexity of end-of-life issues.

Fellow Inmates Ease Pain of Dying in Jail (John Leland, Months to Live series, NY Times, 10-17-09)

For Dying People, A Chance To Shape Their Legacy (Julie Bierach, Weekend Edition, NPR, 4-9-11). Imagine that you've just been told you have only a short time to live. What would you want your family and community to remember most about you? In St. Louis, a hospice program called Lumina helps patients leave statements that go beyond a simple goodbye. At the website of BJC Palliative Home Care and Hospice you can download a patient handbook and/​or a caregiver instruction manual (PDFs), and a PDF of Courtney Strain's What you can do when a friend (like me) faces the end of life.

Future Elder Caregivers Should Learn Life Histories. The social work and history departments at the University of South Florida designed a project to introduce the concept of "person-centered care": Working with a class of 22 undergraduates, 23 participants from a residential facility for seniors shared their life stories in various ways (talking, creating a scrapbook, being videotaped for an oral history, etc.). It makes a difference!

** Gawande, Atul. Letting Go. What should medicine do when it can’t save your life? "All-out treatment, we tell the terminally ill, is a train you can get off at any time—just say when. But for most patients and their families this is asking too much. They remain riven by doubt and fear and desperation; some are deluded by a fantasy of what medical science can achieve. But our responsibility, in medicine, is to deal with human beings as they are. People die only once. They have no experience to draw upon. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come—and to escape a warehoused oblivion that few really want." ~ Atul Gawande, writing about hospice medical care for dying patients (New Yorker, 8-2-2010, and in a follow-up discussion with readers).

Helping dying patients offers Canadians life lessons (Carmen Chai,National Post, Canada 12-6-10)."Canadian hospice care workers say their daily experience caring for dying patients has changed their personal lives — but in a positive way, according to a new study that looks at how people are shaped by exposure to death." Listening to dying patients "helped health-care professionals realign themselves to live as meaningful a life as possible."

Helping Patients Face Death, She Fought to Live (Anemona Hartocollis, NY Times, 4-3-10, profiles the unexpected denial of death a palliative care doctor showed when cancer ended her own life all too soon). Part of the Times' Months to Live series, examining the promises and challenges of extending, or ending, the lives of very ill patients.


Jane Brody's Guide to the Great Beyond: A Practical Primer to Help You and Your Loved Ones Prepare Medically, Legally, and Emotionally for the End of Life -- a practical book, with explanations and to-do lists for everything from advance directives and why a living will is not enough to funeral plans, living with a bad prognosis and dealing with uncertainty, caregiving, hospice, communicating with doctors, assisted dying, organ donation, autopsy, and legacies.

Liverpool Care Pathway for the Dying Patient (LCP)
--LCP website of the Marie Curie Palliative Care Institute
--Wikipedia entry

Life in the End Zone (Dr. Muriel Gillick's blog about topical issues for anyone concerned with the final phase of life). See also her book The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies. Besides caring for two aging parents, she is a geriatrician, palliative care physician, and writer.

Making Plans for the Last Chapter of Life (Talk of the Nation, 8-31-09--listen or read transcript). Sherwin Nuland and Ira Byock tell Neal Conan how they talk with patients who are facing the ends of their lives.

Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat by David Dosa (about a cat who senses death and stays to comfort the dying, but also about Alzheimer's and geriatric care and nursing homes and being there, at the end of life)


The Medicare Hospice Benefit: A Good Fit with Managed Care (Naomi Naierman, American Hospice Foundation).

Months to Live. A New York Times series, examining the promises and challenges of extending, or ending, the lives of very ill patients. Includes Weighing Medical Costs of End-of-Life Care by Reed Abelson, 12-22-09; Fellow Inmates Ease Pain of Dying in Jail by John Leland, 10-17-09; Sisters Face Death With Dignity and Reverence by Jane Gross, 7-8-09 (a group of convent sisters rely on social networks rather than aggressive medical care);Fighting for a Last Chance at Life, by Amy Harmon, 5-16-09 (A family’s campaign for access to an unproven drug (Iplex, for ALS, or Lou Gehrig's disease) highlights the challenges terminally ill patients face in the search for treatment; and At the End, Offering Not a Cure but Comfort (Anemona Hartocollis, 8-20-09 on what palliative care specialists do during patients' last months).

Music, used in care of the dying (Growthhouse.org)

Music Therapy in Palliative Care: New Voices edited by David Aldridge, who has done a parallel book for use of music in dementia care



Pallimed (a hospice and palliative care blog). Entries include The Unspoken (a short film about father-son communication), What Happens When the Patient Stops Fighting Cancer?

Patient with Chronic Lung Cancer Becomes Hospice Caregiver. (ABC News, Good Morning America 3-18-11). Jim Stanicki has not only accepted his fate, but has become a leading voice on how to enjoy life, whether you know the end is coming or not.

PBS Series: The End of Life: Exploring Death in America. Transcripts and audiotapes of excellent programs on topics ranging from palliative care and the afterlife to do-it-yourself funerals and burial societies.

Readings, prayers, and spiritual resources for those keeping vigil and giving care (Hospice.net)

Signs and Symptoms of Approaching Death (Hospice Patients Alliance)

Therapy dog provides comfort to hospice patients (David Caddell, AnnArbor.com 4-16-12)

203 days (click here to view free, online). A video by documentary filmmaker Bailey Barash. A woman makes peace with dying. 23 minutes.

The Unspoken Diagnosis: Old Age (Paula Span, The New Old Age, NY Times 12-29-11)





The quieter you become, the more you can hear.” ~ Ram Dass

“I once asked a man who knew he was dying what he needed above all in those who were caring for him. He said, ‘For someone to look as if they are trying to understand me.'

Indeed, it is impossible to understand fully another person, but I never forgot that he did not ask for success, but only that someone should care enough to try.”
~ Dame Cicely Saunders, who died July 2005, at age 87, in the hospice she founded. This quotation is from the BBC obituary for her, which speaks of her belief that dying is a phenomenon "as natural as being born," at the heart of a philosophy that sees death as a process that should be life-affirming and free of pain.

“I have seen in you what courage can be when there is no hope.”
~May Sarton

"I’m told our hospice experience was a good one. Looking back I realize that once we called hospice, everything went smoothly—social services, medical care, bereavement counselor—everything. I learned that hospice isn’t just about the patient and pain relief. It’s also about the family and everything else connected with end-of-life. I think one of the reasons our experience was so good was because we called hospice early.

"When should you call hospice?
"Call before you think you need to."

~ Tony Levelle, from "Our Hospice Experience" (click on this link to download PDF copy of story)

"I read what the Hospice guidebook has to say about the last stages of life, as the body and mind shut down: how death is a gift for both the person dying and those taking care of him. But the gift for me is Hospice itself.
"My country can seem so shameful, with its warmongering and imbalance of wealth, and neither the military nor any politician ever stirs me to patriotism. But Hospice does. That there is a group like this, that these people have helped so many die with grace, makes me proud of my beautiful nation and everyone in it. I know that Hospice started in England and exists in many other countries--but this is the Hospice and palliative care I know, one recognized by our government and largely paid for by Medicare. So now I sing praises to my country."
~ John Thorndike, writing about his father's final year, in in The Last of His Mind: A Year in the Shadow of Alzheimer's

Engage with Grace and the One Slide Project. To help ensure that all of us--and the people we care for--can end our lives in the same purposeful way we lived them. • Watch the Engage with Grace Story (Video, Za's Story) • Download the One Slide (PDF)

"You matter until the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die."
~ Dame Cicely Saunders, the nurse and physician who founded the modern hospice movement, a pioneer in palliative care


"This remarkable collection, coming from personal experience and wide reading, will help many find the potential of growth through loss."
~ Dame Cicely Saunders, founder of the hospice movement