The Book

WHAT’S IN THE BOOK

At Death’s Door includes the following chapters and topics as listed in the Table of Contents.

INTRODUCTION

FOREWORD
The Hospitalist: Doctors Who Provide In-House and End-Of-Life Care
The Role of the ICU
The Hospital-Doctor Relationship
Working with Palliative Care Teams
When Doctors Disagree
The DNR/DNI Controversy
The Types of Cases that Are Most Common in End-of-Life Care
Respiratory and Pulmonary Diseases
Cardiovascular Conditions
Strokes
Cancer
Other Facilities and Housing for End-of-Life Care
Dying at Home
Who Decides

PREFACE
Correcting Common Misconceptions
How the Medical Staff Responds to Provide End-of-Life Care
How Doctors and Medical Team Members Help Patients and Families
Explaining Key End-Of-Life Issues
What Happens in a Cardiac Arrest?
What Causes a Cardiac Arrest?
The Low Rate of Surviving a Cardiac Arrest
When a Cardiac Arrest Is Due to What Happens in the Hospital
The Effectiveness of Resuscitation Methods

CHAPTER 1: CLOSE FAMILY, CLEAR MIND

CHAPTER 2: ALONE AND IN DENIAL

CHAPTER 3: LAUGHING TILL THE END

CHAPTER 4: COMPLICATIONS

CHAPTER 5: KEEPING IT SIMPLE
The Story of Mrs. Kimball
The Story of Mrs. O’Donnell

CHAPTER 6: DEATH IN THE ICU UNIT

CHAPTER 7: DEALING WITH DEMENTIA
Explaining What to Do for a Patient with Dementia
Dealing with a Patient with Dementia Who Seemed Normal
When a Seemingly Normal Patient with Dementia Agrees to an Operation Resulting in Complications
The Far Reaching Effects of a Dementia Ruling

CHAPTER 8: FAMILY, CULTURE, AND RELIGION
Families with Unrealistic Expectations
Taking Back the Option to Choose From the Family
Negotiating the Family Triangle to Decide What to Do
When Religion Affects the Family Decision about Treatment
When a Death Draws Back an Estranged Family
When a Family Member’s Personal Situation Affects a Choice
Who’s in Charge?
Summing Up – the Problem with Dealing with Families

CHAPTER 9: A LACK OF UNDERSTANDING
I Don’t Know What It All Means
I Don’t Have Enough Information or Have Incomplete Information
It’s Complicated
But It’s Not Written Down
Reassuring the Patient and Family that This Is the Right Thing to Do
A Case of Denial
The Complications of Technology

CHAPTER 10: LEGAL CONSIDERATIONS
Deciding What to Do In Light of Legal Restrictions
How Much Is Too Much?
Dealing with Potential Lawsuits When Patients Can’t Decide What to Do
Dealing with an Emergency
Dealing with the Assisted Suicide Issue

CHAPTER 11: A QUESTION OF WHEN
Determining When a Patient Is Terminal
When a Hope for Recovery Turns into a Terminal Case
Deciding When a Progressive Illness Becomes Terminal
A Nice Lady with Kidney Cancer
A Patient with Cancer and Diabetes
It’s an Emergency – and a Change of Heart
Getting Prepared after a Cancer Diagnosis

CHAPTER 12: DENIAL, DISAGREEMENT, AND A CHANGE OF HEART
Denying When the End Is Inevitable
Another End-of-Life Denial
The Difficulty of Deciding What to Do
A Change in Plans
When the Patient Isn’t Really Terminal – and Doctors Disagree
How Aggressive Should the Treatment Be?