At Death's Door: End of Life Stories from the Bedside

(Hardback)

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At Deaths Door: End of Life Stories from the Bedside tells the powerful story of Sebastian Sepulvedas experiences in working with patients at the end of their lives. In some cases, death came quickly, after the patient was first diagnosed with a terminal condition and entered the hospital. In other cases, patients had a long, progressive illness that got increasingly worse over the months or years until they were in their final days. In some cases, patients were able to fight off death for many years. Hard decisions are often madewhether to resuscitate or not, whether to choose hospice or not, who makes the decisions when a patient cannot, and whose decision to follow when several family members are involved in decision making. Written from the perspective of a medical doctor from years of experience, this personal approach to the end of life explores the many options available to patients and their families and reveals how real people have come to those decisions, and how they play out. With insight and sensitivity, Sepulveda offers families an important window into how life can end with compassion, care, control, and dignity. At Deaths Door features over fifty stories drawn from Sepulvedas experience as a doctor dealing with these patients and families. As states debate the legality of assisted suicide and other end of life rights, real people make real decisions every day regarding end of life. Their stories come to life in these pages, and readers with similar concerns will find relief, comfort, and company as they face these decisions themselves.

Reviews

At Death's Door is an attempt to provide scenarios that can occur when a patient is approaching the end of life. Sepulveda, a doctor with 30-plus years of experience, and Scott, a well-known writer, describe a variety of situations that involve decision making for end-of-life care, coping mechanisms that can hinder the decision-making process, and cultural issues that are often misunderstood or ignored. Each situation is an attempt to provide a realistic view for the reader. However, the recalled dialogue would be better replaced with a summaryan interpretation would provide far more insight than the choppiness of the report. Medical terms are defined throughout, which is beneficial for non-medical readers. Thus, the book will be best suited for laypeople seeking knowledge of the pitfalls that can occur along the end-of-life road. This book is rich in personal experiences, which afford a level of authenticity to the workthis is difficult to find. It will prove invaluable to many who are seeking information on how to navigate the uncharted waters of end-of-life care. Summing Up: Recommended. Lower-division undergraduates and general readers. * CHOICE *
[R]eading this book would allow you to reflect on how you try to assist patients and families with end-of-life issues. * International Association for Hospice & Palliative Care *
While this book could easily serve as a classroom text for medical students, families who want to avoid stressful scrambling in a crisis situation at lifes end are well-advised to invest in a copy ofAt Deaths Doorto review and keep at home. Digestingthe pages will help families prepare, which will then bring them peace of mind. It may also inspire living better. * The Caregivers Voice *
Through several chapters of gripping anecdotal evidence, Sepulveda and Scott show how different diseases affect physical systems and the ways in which they cause loss of life; how a DNR/DNI alters a care plan; and how it might save pain on both sides of the bed. The end is near in each of Sepulvedas tales; whether the DNR/DNI is in place or not, the outcome is the same. The difference: one offers less pain and more peace, he says. What would you want for yourself What would you want for your loved one Valid questions, all, from a book that forces readers to think, hard. Yes, you may be a patient someday, and youll be glad youve read At Deaths Door, in the end. * Pantagraph *
From the vantage point of a highly experienced and thoughtful physician at the bedside, Dr. Sepulveda brings clarity to the decisions confronting patients, doctors and the 21st century health care system at the end of life. Using compelling case vignettes, Dr. Sepulveda writes with clarity about the pathophysiologic processes of the common fatal diseases of our time COPD, heart disease, dementia, obesity and cancer and how patients, their families and physicians face the dilemmas and decisions to be made at lifes end. Dr. Sepulveda brings to life how a compassionate and honest physician can help guide patients and their families in the hard decisions faced at lifes end. -- Matthew S. Ellman, MD, Associate Professor of Medicine, Yale School of Medicine
Dr. Sepulveda provides an excellent overview of what we are likely to encounter in hospitals as we near death--whether our own or a loved one's death. This book is a worthwhile read for anyone preparing an advance directive or who is appointed to make end-of-life decisions for another. It also provides a useful introduction to end-of-life concepts and topics commonly encountered in U.S. hospitals. -- Anita J. Tarzian, PhD, RN, Program Coordinator, Maryland Health Care Ethics Committee Network (MHECN); Law & Health Care Program, Maryland Carey Law; Associate Professor, University of Maryland School of Nursing

Author Bio

Sebastian Sepulveda, MD, is a nephrologist in Chelmsford, Massachusetts. He is affiliated with Lowell General Hospital and has nearly 30 years experience as a doctor and professor of medicine, specializing in emergency medicine and end of life care. He has also worked as an Associate Professor of Medicine at the Medical College of Georgia, now known as Georgia Regents University in Augusta, Georgia. He has been a nephrology associate from 2000-2005 in Lowell, Massachusetts, and since then, has been in private practice, specializing in internal medicine, critical care medicine, and in nephrology, which deals with kidney problems. He has been a member of several professional organizations that deal with terminal patients, including the Society of Critical Care Medicine, the American Society of Nephrology, and the American College of Chest Physicians. He has received an award from the National Kidney Foundations North Carolina chapter, and has about a half-dozen publications in medical journals. He conducts workshops and seminars for patients with serious illnesses and family members to help them better understand and make arrangements for end-of-life care. Gini Graham Scottis a nationally known writer, consultant, speaker, and seminar leader, specializing in business and work relationships, professional and personal development, social trends, lifestyles, and criminal justice. Scott has published over 50 books with major publishers and has published 40 books under her own publishing labelChangemakersPublishing, primarily on popular business and self-help topics. She has co-authored books with numerous writers, including Preventing Credit Card FraudwithJen Grondahl Lee and American Justicewith Paul Brakke. She isa HuffPost regular columnist, she comments on social trends, new technology, and everyday life. Recent books includeThe New American Middle Ages,Scammed: Learn from the Biggest Consumer and Money Frauds Not to Be a VictimandLies and Liars: How and Why Sociopaths Lie and How You Can Detect and Deal with Them.She has received national media exposure for her books, including appearances onGood Morning America, Oprah,andCNN.