Peaceful Transitions: Stories of Success and Compassion

Can you maximize end-of-life pleasure? Yes, but fear of death makes us reluctant to discuss dying. Advanced Dementia is a ''closet-within-the-closet'': few people talk about dementia; even fewer discuss what it is like to die in its end-stage. The goal of this book is to attain timely, peaceful transitions, starting with a Living Will that can effectively avoid both PREMATURE DYING and PROLONGED DYING with unnecessary pain. This book shows how planning CAN maximize pleasure and reduce suffering--for yourself and loved ones--for any terminal illness.

Two out of three patients cannot make medical decisions before they die so take these steps NOW while you still can:

1) Learn about end-of-life scenarios such as Advanced Dementia.

2) Decide what you would want if you were in these conditions.

3) Memorialize your wishes to inform your future caregivers and physicians.

Why are Advanced Dementias so feared? Compared to other diseases, they are the

...cruelest (they rob victims of memory and personality),

...longest (can last three to ten years),

...most frustrating (patients' quality of life continues to decline), and

...most costly (a predicted three-fold increase by mid-Century may devastate world economies).

What makes dementia so challenging?

A) There is no prevention and no cure. At best, available medications slow down symptom progression--but only partially and temporarily.

B) Often there is NO life-sustaining medical treatment to withhold--even after all concerned agree the patient would say, ''It's enough.''

C) It is NOT possible to ask patients what treatment they want when their suffering is unbearable because by then, they cannot speak intelligibly.

This book presents views of spouses, patients, and clinicians--to help you understand what suffering from Advanced Dementia is like. Since patients cannot use words to complain and may not ''act'' like they are in pain, physicians may not recognize their pain and suffering. Patients may thus suffer UNTREATED, for years.

The book explains why the three steps of Advance Care Planning--to learn, to decide, and to memorialize--are so challenging:

Most Living Wills and Proxy Directives do not consider Advanced Dementia.

Some disability activists groups strive to prevent you from learning about this legal option.

Forms rarely offer the option of Natural Dying--a way to prevent prolonged and possibly painful dying that is a comfortable alternative to dying slowly... from starvation, serious infection, heart attack, or stroke.

Some ''authorities'' discourage Natural Dying; for example, some Catholic Popes and the second Bush-appointed President's Council on Bioethics.

Physicians traditionally act to delay death, and some ignore advance directives.

While physicians hold the ultimate power to write orders, many are limited by their institutions' policies; others simply lack the knowledge to correctly inform patients and loved ones about Natural Dying.

New Physician Orders for Life-Sustaining Treatment forms (POLST) may not reflect your wishes, may not establish your decision-making surrogate as your legal spokesperson, and may even expose you to the worst possible abuse: dying earlier than you would want.

Reading this book should motivate you to plan diligently as its stories also provide hope. Examples:

A proxy and physician prudently shared decision-making to benefit a patient.

Natural Dying is peaceful for both patients and family members.

Planning can determine how long and how much you may suffer before you die. You can attain the goal of a timely, peaceful transition. Once motivated to plan, you can either get professional help or read the companion book, Peaceful Transitions: Plan Now, Die Later--Ironclad Strategy. A hardbound, ''combined book'' is also available.