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Dying Well: Peace and Possibilities at the End of Life
From Ira Byock, prominent palliative care physician and expert in end of life decisions, a lesson in Dying Well .
Nobody should have to die in pain. Nobody should have to die alone.
This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning.
Ira Byock is also the author of The Best Care A Physician's Quest to Transform Care Through the End of Life .
Nobody should have to die in pain. Nobody should have to die alone.
This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning.
Ira Byock is also the author of The Best Care A Physician's Quest to Transform Care Through the End of Life .
299 pages, Paperback
First published January 13, 1997
218 people are currently reading
2853 people want to read
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Displaying 1 - 30 of 132 reviews
August 18, 2020
This book came on my radar years ago—I mean, seriously, like a decade ago, at least. I heard really good things about it, but I was too scared to read it, because, well, death. It wasn’t until a family member was diagnosed with lung cancer recently that I finally decided that enough was enough, death was here to stay, so I may as well get comfortable with it. I never did get quite “comfortable” with it, but reading this book definitely helped me feel calmer about dying.
Ira Byock is a prominent palliative care physician. He’s made it his mission to ensure that his patients 1) do not die in pain, and 2) do not die alone. And he’s written many books educating others on how to accomplish those goals. Dying Well isn’t a how-to guide. Byock gives general advice and guidance, but mostly the book just shares stories of patients and families he’s worked with. Each story is unique. The families he works with obviously have different personalities, and everyone experiences different levels of acceptance (or not) with their situations.
My two main takeaways from this book are that 1) death doesn’t have to be scary, and 2) emotional intelligence and connection (or lack thereof) matter BIG TIME in how a death unfolds.
First, there is always something you can do for a person who is physically suffering—and I’m not talking about a “just dope ’em up!” attitude, though there are lots of medications to ease pain and discomfort. According to Byock, there should never be a point when a physician or nurse says, “Welp, I can’t do anything else for you. My work here is done.” The patient doesn’t need to suffer, and there are all kinds of options available to help make that happen.
Second, mindset matters. This book kept making me think of giving birth. I birthed all three of my kids naturally, no pain medication at all. Giving birth is a natural part of life. It also sucks. It’s painful, like really, really painful. But your mental attitude goes a long way. If you focus on the pain, it genuinely hurts more. But if you focus on the end of a contraction, the absence of pain between contractions, it hurts less. Maybe that sounds like I’m being Pollyanna-ish about the pain, but I’m not. I did this THREE times! I don’t take it lightly. It hurt like a bitch, and it was hard work. But when I put my focus on what was helpful to me, I could manage it.
This also seems to apply to death. Death is a natural part of life, and it also kinda sucks. It’s an ending, for better or worse. And I’m guessing it’s probably not going to feel great. But how do you want to go out? Angry and lashing out at your loved ones? Or will you take the time to repair broken bonds and forge stronger connections to people in your life?
I think of that scene at the start of Iron Man, where Tony Stark is talking to his new friend, Yinsen, about escaping the prison cell they’re in:
Tony Stark: I shouldn’t do anything. They could kill you, they’re gonna kill me, either way, and even if they don’t, I’ll probably be dead in a week.
Yinsen: Then this is a very important week for you, isn’t it?
Dying is not fun. We don’t want to do it. But we don’t get to choose to not die. What we can choose, though, is our response. We can choose what we focus on, who we focus on, with the time we have left. We can make the choice to connect, to reach out, to look inward and come to terms with who we are and who we’ve been. Basically, if there’s no peace in life, there will be no peace in death.
Ira Byock is a prominent palliative care physician. He’s made it his mission to ensure that his patients 1) do not die in pain, and 2) do not die alone. And he’s written many books educating others on how to accomplish those goals. Dying Well isn’t a how-to guide. Byock gives general advice and guidance, but mostly the book just shares stories of patients and families he’s worked with. Each story is unique. The families he works with obviously have different personalities, and everyone experiences different levels of acceptance (or not) with their situations.
My two main takeaways from this book are that 1) death doesn’t have to be scary, and 2) emotional intelligence and connection (or lack thereof) matter BIG TIME in how a death unfolds.
First, there is always something you can do for a person who is physically suffering—and I’m not talking about a “just dope ’em up!” attitude, though there are lots of medications to ease pain and discomfort. According to Byock, there should never be a point when a physician or nurse says, “Welp, I can’t do anything else for you. My work here is done.” The patient doesn’t need to suffer, and there are all kinds of options available to help make that happen.
Second, mindset matters. This book kept making me think of giving birth. I birthed all three of my kids naturally, no pain medication at all. Giving birth is a natural part of life. It also sucks. It’s painful, like really, really painful. But your mental attitude goes a long way. If you focus on the pain, it genuinely hurts more. But if you focus on the end of a contraction, the absence of pain between contractions, it hurts less. Maybe that sounds like I’m being Pollyanna-ish about the pain, but I’m not. I did this THREE times! I don’t take it lightly. It hurt like a bitch, and it was hard work. But when I put my focus on what was helpful to me, I could manage it.
This also seems to apply to death. Death is a natural part of life, and it also kinda sucks. It’s an ending, for better or worse. And I’m guessing it’s probably not going to feel great. But how do you want to go out? Angry and lashing out at your loved ones? Or will you take the time to repair broken bonds and forge stronger connections to people in your life?
I think of that scene at the start of Iron Man, where Tony Stark is talking to his new friend, Yinsen, about escaping the prison cell they’re in:
Tony Stark: I shouldn’t do anything. They could kill you, they’re gonna kill me, either way, and even if they don’t, I’ll probably be dead in a week.
Yinsen: Then this is a very important week for you, isn’t it?
Dying is not fun. We don’t want to do it. But we don’t get to choose to not die. What we can choose, though, is our response. We can choose what we focus on, who we focus on, with the time we have left. We can make the choice to connect, to reach out, to look inward and come to terms with who we are and who we’ve been. Basically, if there’s no peace in life, there will be no peace in death.
May 12, 2013
Many people, myself included, today don't really believe that we will die. Death is something that happens to other people somewhere else that appears as if it can be avoided. This aversion to death, an event that is basic to all life and is completely natural, amplifies our everyday fears and may cause us to shun people with illnesses and create innocent pariahs when they need us the most.
This book will give you the experience of dying many deaths and what it is like to face different situations, thoughts, emotions, fears, and pain. Each chapter pulls you in and lets you try on different characters such as a father, mother, sister, brother, child, husband, wife, friend of someone who is facing their final moments.
This book will give you many tools that you can use for others in their time of need as well as your final moments so you can "Die Well".
This book really got me thinking. Why does it take a terminal illness for you and me to decide to make our relationships right and find meaning in our lives? This book has taught me to appreciate life even more.
I have learned that when I fully accept the fact that I will die and that it is natural, there is no need to fear it. The side affect of losing my fear of death has erased many of my fears in life.
This book will change your life and teach you to life more everyday.
This book will give you the experience of dying many deaths and what it is like to face different situations, thoughts, emotions, fears, and pain. Each chapter pulls you in and lets you try on different characters such as a father, mother, sister, brother, child, husband, wife, friend of someone who is facing their final moments.
This book will give you many tools that you can use for others in their time of need as well as your final moments so you can "Die Well".
This book really got me thinking. Why does it take a terminal illness for you and me to decide to make our relationships right and find meaning in our lives? This book has taught me to appreciate life even more.
I have learned that when I fully accept the fact that I will die and that it is natural, there is no need to fear it. The side affect of losing my fear of death has erased many of my fears in life.
This book will change your life and teach you to life more everyday.
June 13, 2018
ok good, but very, very old. 20 years old. That's a hell of a long time in palliative care, medical science, and attitudes to death. A good conversation starter, but yeah, outdated.
January 25, 2015
The author of this book, Dr. Ira Byock, has dedicated his life as a hospice director to make sure that no one should have to die in pain, or die alone. He is prominent spokesperson for the hospice movement. In this book, he shares the true stories of dying patients, and how important emotional work can be accomplished in the final months, weeks, and even days of life.
Through the stories of the patients, families and those that are dying that can learn to deal with doctors, how to talk to friends and relatives, and how to make the time towards the end of life meaningful.
I chose this book because I am now in palliative care for metastatic breast cancer; I'm not at that point yet where I need hospice care, but learning as much as I can about the death and dying process helps me to fear it less. I have learned something from every family that I read about in this book. It's a comfort to know that there are things that can be done to ease suffering, especially with pain, right up until the very end.
The hardest story in this book to read, but the most rewarding, was that of 8 year old Michael Merseal, being cared for at home by his dedicated single father, and an equally dedicated hospice team. Michael's story is also featured in the HBO documentary Letting Go: A Hospice Journey. (Dr. Byock is also in this film.) You can watch this 90 minute film for free on You Tube, and I highly recommend it as a companion to this book.
I highly recommend this book to anyone facing a terminal illness, and those who may have to deal with the terminal illness of a family member or friend.
Through the stories of the patients, families and those that are dying that can learn to deal with doctors, how to talk to friends and relatives, and how to make the time towards the end of life meaningful.
I chose this book because I am now in palliative care for metastatic breast cancer; I'm not at that point yet where I need hospice care, but learning as much as I can about the death and dying process helps me to fear it less. I have learned something from every family that I read about in this book. It's a comfort to know that there are things that can be done to ease suffering, especially with pain, right up until the very end.
The hardest story in this book to read, but the most rewarding, was that of 8 year old Michael Merseal, being cared for at home by his dedicated single father, and an equally dedicated hospice team. Michael's story is also featured in the HBO documentary Letting Go: A Hospice Journey. (Dr. Byock is also in this film.) You can watch this 90 minute film for free on You Tube, and I highly recommend it as a companion to this book.
I highly recommend this book to anyone facing a terminal illness, and those who may have to deal with the terminal illness of a family member or friend.
February 11, 2012
My sister has a terminal illness and I needed some help to understand what she's going through and how I can help her. This book written by a hospice physician uses case studies to illustrate that no matter what the disease, personality, age, or spiritual orientation, all human beings need to die with dignity and love. How that is accomplished is unique to each person, but there are common principles that should help anyone who is trying to assist their loved one travel from this life to the next.
November 28, 2020
This non-fiction book about hospice care took me eight months to read because of its heavy subject matter but I'm glad I did read it. Each chapter was a patient case study recounted from the perspective of their hospice doctor (the author.) In my ongoing efforts to face my own fear of death, this book taught me a lot and was easy to understand. Even though it was written in 1998, I bookmarked almost all of the Q&A responses at the end, to return to again and again.
Quotes:
Modern medical technology and advanced pharmaceuticals have given doctors the ability to reliably ease the physical discomfort of terminal illness. The fact that many doctors and medical centers do not treat pain aggressively does not mean that physical pain is uncontrollable. Physical pain among the terminally ill exists because doctors lack the will, not the way.
***
In talking with family members about the decisions they can make and opportunities they can provide for a dying loved one, I occasionally ask them to imagine a time months after the person has died when, perhaps in the intimate quiet of early morning, they might ask themselves Did we do the right thing? Did we make the right decisions? Did we give up too soon or hang on too long? Was there anything else we should have done? Did we seize every opportunity, take every action, for a loving, peaceful end? I want them to be able to review what happened and confidently conclude: Yes, we did it right.
***
In deciding that a loved one will not be allowed to die of malnourishment, a family is making a tacit decision to let the person die of something else. Thus, the declaration by the daughter of an eighty-seven-year-old comatose patient, "I would never let Mom die of starvation," is a decision that Mom must, therefore, succumb to infection or stroke or seizure or blood clot or gastrointestinal hemorrhage. Each complication that is treated merely shifts the physiology of the person's dying, it does not halt it.
***
When they can be expressed honestly, feelings of forgiveness should be shared with your mom. Similarly, if she would be worried about you in the future, tell her that you can make it without her - you can. If there is a sense that she has been hanging on for some reason, at some point it may be helpful to tell her that it is OK to let go.
***
As important as family is, there are other aspects of our personhood that are equally important. In what ways might it be important for you to change or grow, as a person, during the life that lies ahead?
***
Malnutrition and infection are two of the most natural ways for people with dementia and general debilitation to die. By "letting nature take its course" you can remain loving and pampering in the your care of your grandfather without feeling that you have caused his demise.
Quotes:
Modern medical technology and advanced pharmaceuticals have given doctors the ability to reliably ease the physical discomfort of terminal illness. The fact that many doctors and medical centers do not treat pain aggressively does not mean that physical pain is uncontrollable. Physical pain among the terminally ill exists because doctors lack the will, not the way.
***
In talking with family members about the decisions they can make and opportunities they can provide for a dying loved one, I occasionally ask them to imagine a time months after the person has died when, perhaps in the intimate quiet of early morning, they might ask themselves Did we do the right thing? Did we make the right decisions? Did we give up too soon or hang on too long? Was there anything else we should have done? Did we seize every opportunity, take every action, for a loving, peaceful end? I want them to be able to review what happened and confidently conclude: Yes, we did it right.
***
In deciding that a loved one will not be allowed to die of malnourishment, a family is making a tacit decision to let the person die of something else. Thus, the declaration by the daughter of an eighty-seven-year-old comatose patient, "I would never let Mom die of starvation," is a decision that Mom must, therefore, succumb to infection or stroke or seizure or blood clot or gastrointestinal hemorrhage. Each complication that is treated merely shifts the physiology of the person's dying, it does not halt it.
***
When they can be expressed honestly, feelings of forgiveness should be shared with your mom. Similarly, if she would be worried about you in the future, tell her that you can make it without her - you can. If there is a sense that she has been hanging on for some reason, at some point it may be helpful to tell her that it is OK to let go.
***
As important as family is, there are other aspects of our personhood that are equally important. In what ways might it be important for you to change or grow, as a person, during the life that lies ahead?
***
Malnutrition and infection are two of the most natural ways for people with dementia and general debilitation to die. By "letting nature take its course" you can remain loving and pampering in the your care of your grandfather without feeling that you have caused his demise.
August 1, 2017
Trust me, I'm not being depressing when I read hospice books. What started out as a way to research & find meaning in my mother's death has turned into a sincere interest in hospice care. If this whole art thing doesn't work out, I've been toying with the idea of going back to school to be involved in hospice in some sort of way. (None of my siblings went into the medical field after doctor dad and nurse mom, so maybe I'd be the one, haha.)
As for the book though, this was an excellent read. I would have benefited from this if I had been presented it before mom died. Maybe the stories would have freaked me out then, maybe. It would've taken a bit to get used to, but the end of the book contains an excellent question-answer section as well as resources for palliative care.
Either way, I would have been INFORMED. Which would have been lovely and would've helped so much with my grief afterwards. If I had known the signs of my mother wanting to talk about her death with me, maybe I would have been a better help.
Hospice was involved in our case, but our family was so dysfunctional that so many things went wrong. It would've been nice to not have been thrust into it like I had been and had been presented with more information.
This is a good book and a necessary one to read.
As for the book though, this was an excellent read. I would have benefited from this if I had been presented it before mom died. Maybe the stories would have freaked me out then, maybe. It would've taken a bit to get used to, but the end of the book contains an excellent question-answer section as well as resources for palliative care.
Either way, I would have been INFORMED. Which would have been lovely and would've helped so much with my grief afterwards. If I had known the signs of my mother wanting to talk about her death with me, maybe I would have been a better help.
Hospice was involved in our case, but our family was so dysfunctional that so many things went wrong. It would've been nice to not have been thrust into it like I had been and had been presented with more information.
This is a good book and a necessary one to read.
August 29, 2022
Read this as part of my palliative care psych training and I highly recommend! The author poses death as a process to be embraced rather than avoided. He highlights how modern medicine, family and relationships, and focusing on ones’ personal values and wants can lead to a meaningful death. All my medical friends should put this on their want to read list (I know u see this 👀)
August 6, 2016
An incredibly beautiful and moving book. Ira Byock narrates the end-of-life stories of several patients in his hospice-program. His goal is to document the human capacity to experience meaning, value, transformation, even joy within the process of illness and dying. The life of an individual facing terminal illness and imminent termination of life can play a profound part in both the life of the person and their community. Byock is a wonderfully gifted writer who interweaves not only the medical challenges patients have faced, but also the interpersonal and intrapersonal struggles through which patients have battled. Many of these stories left me challenged, moved, teary-eyed, and deeply reflecting on the way our culture and society views those who are about to die, especially the elderly. Personally, having never seen someone dying or die in my presence, I appreciated the way Byock places his readers face to face with the patients in these deeply personal narratives. This book should be read by anyone who is facing terminal illness, or whose loved one is shaken by this kind of diagnosis. It opened my eyes to a world of palliative care and hospice-programs that I really didn't know existed. It made me reflect on the certainty of own mortality and inspired me to ask the question again: what is my only comfort both in life and in death? What a joy to know I am not my own, but belong in life and in death to a resurrected and reigning Jesus.
Read
March 2, 2015Recommended by Tom Mahan and Susan Peterson, this is a wonderful book! I have a phrase that I've always used to admonish myself in making decisions: "Live your life in such a way..." That thought helps me for the short run and the long run. The message of this book reinforces that way of thinking.
Dr. Byock details so many ways of dying, and I was so pleased when he recommended Final Gifts since it's been a very important book for Jim and me. The important point is to live one's life in such a way that there are no lingering angers or resentments or unspoken love or thanks. Keep it all clear and simple and then ***pray*** that hospice will be available for each of us! What a terrific idea! True inspiration and great help.
Dr. Byock details so many ways of dying, and I was so pleased when he recommended Final Gifts since it's been a very important book for Jim and me. The important point is to live one's life in such a way that there are no lingering angers or resentments or unspoken love or thanks. Keep it all clear and simple and then ***pray*** that hospice will be available for each of us! What a terrific idea! True inspiration and great help.
May 24, 2013
Since death and dying is a professional (and not being immortal, I guess personal too) interest of mine, I've read a fair amount about it. This is one of the most moving and thoughtful books about this subject I''ve come across. The humanity of Dr. Byock (a hospice and palliative care specialist) and his patients vividly comes across in the stories he's written. Whole heartedly recommended for those planning to die someday...as well for those who are not.
June 26, 2023
I had to read this in my Death, Dying, and Grief class and I throughly enjoyed it. This book helped me get a better picture of hospice and the goods and bads to the service. This book definitely made me cry multiple times so be prepared for that, but I love to feel something so strongly when I’m reading because it is quite rare for me. I love books about mortality and I think this should be on everyone’s list, when your in the mood for something moving and intense.
March 31, 2024
At first, I was apprehensive about reading this book. Since I had to read it for school, I thought it was going to be boring and hard to get through. I was very wrong, Ira has a way of hitting me right in the gut with emotion. I was immersed in each patient's story, understanding and empathizing with their loved ones as their family members took their last breath. Dying doesn't seem so scary now, and I appreciate this book for opening my eyes to the possibility of dying well and peacefully.
September 1, 2017
Not what I expected, and not what I thought I wanted, but in the end exactly the book I needed to read. There are no specific health issues in my family now, but my mother died of lung cancer several years ago, and I have thought long and hard about her death, mostly in terms of my own and my families eventual deaths. The greatest gift for me from,this book was less about the five things the author suggests families think about and more about the reality of advocating for your own needs fervently and until the end. Thoughtfully written, well supported and very frank read well worth a read by every person who wishes to face their own death and the death of loved ones with dignity and love.
May 28, 2021
In this classic, Byock works hard to convince us that hospice is a good thing, which I think the US has come to accept over the last 20+ years since he wrote the book. He tells the stories of the dying processes of maybe a dozen different people, each of which illustrates a different point. Byock encourages people to "complete" tasks and relationships while they still can. He believes firmly that dying is an importnat part of living that should generate growth. He also believes firmly that with careful attention, end-stage pain can always be controlled. I found the appendix more helpful than some chapters of the book.
September 21, 2015
Dr Byock spoke to my heart in this well-written on the importance of facing death with honesty and dying with dignity. It was a difficult book to finish because it tugged on my emotions, especially as I've begun hospice patient volunteer work. 'Work'. That is completely the wrong word for the privilege of spending time with someone at arguably the most meaningful point of their life. I am grateful to Dr Byock for bringing hospice to the forefront over the past twenty years so that now, Dying Well is a very real option.
October 26, 2016
This book made me cry. It made me cry for my dad and all the people like me, who are poor and therefore don't"qualify" for a good end-of-life experience.
The author is a pioneer in the field of community-wide hospice. The cases he inscribes here, where he assisted, or was a consultant, had meaningful death.
Here in our society, especially if you are poor, or of color, have mental illness, you are at-risk. "You need to just die and make way for younger people who can contribute to society." That is pretty much what our country's attitude to you will be when your time comes.
The author is a pioneer in the field of community-wide hospice. The cases he inscribes here, where he assisted, or was a consultant, had meaningful death.
Here in our society, especially if you are poor, or of color, have mental illness, you are at-risk. "You need to just die and make way for younger people who can contribute to society." That is pretty much what our country's attitude to you will be when your time comes.
October 14, 2024
I read this book as I watched my brother care for his dying wife. She passed away from cancer at the age of 42, leaving behind her husband, their three teenage children, and a ton of emotional wreckage. There's a lot of stuff to think about here, and if I had a time machine I would have gone back and given the entire family copies of this book to read ... by the time I discovered Dying Well it was too late to make a difference, and it might have helped.
March 31, 2021
A good selection of representative examples
Reviewed in the United States on May 30, 2020
This was a good book.
I recommended it be read in conjunction with 2 others:
1. Atul Gawande. "Being mortal."
2. Derek Humphry. "Final Exit."
What those two books offer that this one doesn't:
1. The Gawande book is more current (Byock was written in 1997), and he brings a lot more statistics to bear about average life expectancies and questions that you might ask if you were doing a cost-benefit analysis of whether or not to hang on.
2. The Humphry book actually talks about the nuts and bolts of assisted suicide (and neither of the other two books address this directly).
I can say the reading this book is not a waste, and that is because: if someone is himself watching a loved one die, it is not possible to do a dispassionate analysis of the situation.
The book has 12 chapters, each of which averaged about 20 pages. But, the chapters don't specify well what they talk about in the event that you wanted to read the book out of order (and you can do that).
**Introductory sections
1. Author's own personal story with his father's passing.
2. Author's starting to specialize in hospice care.
**Specific case examples
3. An example of repairing broken relationships prior to death.
4. An example of someone becoming so consumed with anger that psychiatric treatment becomes a problem in and of itself.
5. Three examples of the psychological cost of loss of dignity as a result of being a terminal patient.
6. An example of a patient that hung on just long enough to see a big lifetime event.
7. An example of a person getting in touch with his own emotions during this process of accepting his death. Also, an example of a person who leaves hospice due to new treatment.
8. An example of adjustment to a new role as a dependent.
9. An example of a parent having to let a very young child go, as well as the bonds of a family forming around the care of a young terminal patient.
10. An example of a patient suffering indescribably as a result of fighting too hard against inevitable death.
11. An example of a patient who took the death in the most natural and smooth way possible.
**Conclusion
12. Synopsis and final thoughts.
13. Frequently asked questions section.
The book is fairly well written and easy to read.
It also has some extremely memorable quotes, which are worth reproducing in full:
(p. 31). "To those who know, no explanation is necessary; to those who don't know, no explanation is sufficient.
(p. 83). The true root of suffering is loss of meaning and purpose in life...... He who has a why to live, can bear almost any how."
Verdict: This book is worth the second hand price, and it can be read over two afternoons. Recommended.
Reviewed in the United States on May 30, 2020
This was a good book.
I recommended it be read in conjunction with 2 others:
1. Atul Gawande. "Being mortal."
2. Derek Humphry. "Final Exit."
What those two books offer that this one doesn't:
1. The Gawande book is more current (Byock was written in 1997), and he brings a lot more statistics to bear about average life expectancies and questions that you might ask if you were doing a cost-benefit analysis of whether or not to hang on.
2. The Humphry book actually talks about the nuts and bolts of assisted suicide (and neither of the other two books address this directly).
I can say the reading this book is not a waste, and that is because: if someone is himself watching a loved one die, it is not possible to do a dispassionate analysis of the situation.
The book has 12 chapters, each of which averaged about 20 pages. But, the chapters don't specify well what they talk about in the event that you wanted to read the book out of order (and you can do that).
**Introductory sections
1. Author's own personal story with his father's passing.
2. Author's starting to specialize in hospice care.
**Specific case examples
3. An example of repairing broken relationships prior to death.
4. An example of someone becoming so consumed with anger that psychiatric treatment becomes a problem in and of itself.
5. Three examples of the psychological cost of loss of dignity as a result of being a terminal patient.
6. An example of a patient that hung on just long enough to see a big lifetime event.
7. An example of a person getting in touch with his own emotions during this process of accepting his death. Also, an example of a person who leaves hospice due to new treatment.
8. An example of adjustment to a new role as a dependent.
9. An example of a parent having to let a very young child go, as well as the bonds of a family forming around the care of a young terminal patient.
10. An example of a patient suffering indescribably as a result of fighting too hard against inevitable death.
11. An example of a patient who took the death in the most natural and smooth way possible.
**Conclusion
12. Synopsis and final thoughts.
13. Frequently asked questions section.
The book is fairly well written and easy to read.
It also has some extremely memorable quotes, which are worth reproducing in full:
(p. 31). "To those who know, no explanation is necessary; to those who don't know, no explanation is sufficient.
(p. 83). The true root of suffering is loss of meaning and purpose in life...... He who has a why to live, can bear almost any how."
Verdict: This book is worth the second hand price, and it can be read over two afternoons. Recommended.
June 4, 2017
I picked this book up at the library by happenstance, and I'm so glad I did. To tell you all a little about my personal life, I had two family members on hospice care, and now I only have one. This is the first time in my life I've had a major death in my family, and in all honesty I think I would have been a little lost without this book.
Byock explains how different people die. While the overt disease is the "leading" cause of death, death usually comes from malnutrition, choking, or lack of oxygen. And none of these are painful if we focus on the loved one's comfort. After all, it is called comfort care. He explains things like "how much morphine is too much morphine?" Answer: whatever amount stops the pain. It's knowing things like these that put me at ease--well, more at ease--with mortality.
He also explains how to have conversations with our dying loved ones, whether they're angry, sad, or accepting of their declining condition. What would you regret not saying? Can you forgive the dying loved one, or somebody else in your family? Are you okay with letting go? Have you said your good-byes? All of these are important questions for you to consider, he argues. And I think he's right.
Each story he details is uplifting, and ends on a positive note. The question he wants us all to consider is: "Can any good come out of this bad situation?" If so, try to make it happen. Another thing that I found was very important was that in terms of hospice, hospice nurses, and palliative care doctors: "Do not settle for less." This is so so so true.
Byock recognizes that every person and every death is different. However, the title of his book stems from the dislike of the term "a good death." Because, what is a good death? It's impossible to say. But the term "dying well" indicates no suffering, comfort, and complying with the dying person's wishes.
Ultimately, this book was incredibly healing for me as a person going through these types of experiences. It helped assuage my fears and discomforts, and provided me more information than a Google search could have provided me with. I don't know how often I can say this for other books, but this book truly came into my life at just the right time.
Get the full review here!
Byock explains how different people die. While the overt disease is the "leading" cause of death, death usually comes from malnutrition, choking, or lack of oxygen. And none of these are painful if we focus on the loved one's comfort. After all, it is called comfort care. He explains things like "how much morphine is too much morphine?" Answer: whatever amount stops the pain. It's knowing things like these that put me at ease--well, more at ease--with mortality.
He also explains how to have conversations with our dying loved ones, whether they're angry, sad, or accepting of their declining condition. What would you regret not saying? Can you forgive the dying loved one, or somebody else in your family? Are you okay with letting go? Have you said your good-byes? All of these are important questions for you to consider, he argues. And I think he's right.
Each story he details is uplifting, and ends on a positive note. The question he wants us all to consider is: "Can any good come out of this bad situation?" If so, try to make it happen. Another thing that I found was very important was that in terms of hospice, hospice nurses, and palliative care doctors: "Do not settle for less." This is so so so true.
Byock recognizes that every person and every death is different. However, the title of his book stems from the dislike of the term "a good death." Because, what is a good death? It's impossible to say. But the term "dying well" indicates no suffering, comfort, and complying with the dying person's wishes.
Ultimately, this book was incredibly healing for me as a person going through these types of experiences. It helped assuage my fears and discomforts, and provided me more information than a Google search could have provided me with. I don't know how often I can say this for other books, but this book truly came into my life at just the right time.
Get the full review here!
October 15, 2025
Terminally Ill Reader
I really needed to read this book, even though I believe it is targeting the caregivers and families, it helps me to know what I can do for myself when I enter my final stage of living and begin my transitional stage towards death.
Am I frightened, that is a very complicated question, but the overall answer is yes. My biggest fear is dying in extreme pain, left unattended within an undignified state, and dying alone within an institutional surroundings.
This book helped me realize that I can define my transition, to some degree, but overall the book gave me a sense of hope and instilled thought about how I want my life to transition into my final passing.
I am in stage IV of Renal Cell Carcinoma metastasized to my lumbar spine and right hip areas, the pain before I was diagnosed and treated was terrible and frightening. I don’t want my final moments to be overwhelmed within that terrible suffering.
This book gave me hope and helps guide my thoughts as I approach my final days. I hope anyone who reads this book can digest and apply the thoughts and methods prescribed.
I had the privilege of tending to my mother’s final months of her life, from living with me through being admitted to hospice and peacefully passing away from her life.
Given how this country regards her aging community, I am not so convinced that I will have the same opportunity afforded to my wonderful mother, I am just thankful she passed so peacefully and quite quickly.
It is hard to convey the peace of mind Dying Well has afforded me and my thoughts as I approach my last moments in this world. Currently I am mobile and can take care of myself, not sure how long this will be a reality.
I really needed to read this book, even though I believe it is targeting the caregivers and families, it helps me to know what I can do for myself when I enter my final stage of living and begin my transitional stage towards death.
Am I frightened, that is a very complicated question, but the overall answer is yes. My biggest fear is dying in extreme pain, left unattended within an undignified state, and dying alone within an institutional surroundings.
This book helped me realize that I can define my transition, to some degree, but overall the book gave me a sense of hope and instilled thought about how I want my life to transition into my final passing.
I am in stage IV of Renal Cell Carcinoma metastasized to my lumbar spine and right hip areas, the pain before I was diagnosed and treated was terrible and frightening. I don’t want my final moments to be overwhelmed within that terrible suffering.
This book gave me hope and helps guide my thoughts as I approach my final days. I hope anyone who reads this book can digest and apply the thoughts and methods prescribed.
I had the privilege of tending to my mother’s final months of her life, from living with me through being admitted to hospice and peacefully passing away from her life.
Given how this country regards her aging community, I am not so convinced that I will have the same opportunity afforded to my wonderful mother, I am just thankful she passed so peacefully and quite quickly.
It is hard to convey the peace of mind Dying Well has afforded me and my thoughts as I approach my last moments in this world. Currently I am mobile and can take care of myself, not sure how long this will be a reality.
June 13, 2018
I've recently been looking up a lot of books on death and dying. I took a Death and Dying class in university and I found it interesting. We will all die, and I wanted to learn more on the process and how our last days on Earth will look like, especially when faced with illness. This book had great reviews so was at the top of my list of books to read. Conclusion, everyone should read it!
Dr. Byock is an expert and has been working in hospice car for like 30 years. In this book, he describes multiple different cases he's been involved with of people dying and how they spent their last days. He shows the importance of family and social support. He shows how some families handled it well, while others handled it negatively, why, and how. Everyone will handle it differently, but he explains what are the best ways to ensure your last days are good ones, and an opportunity to get the family together and bonding, and how you can die with dignity. It was very moving.
It's very interesting and I am extremely thankful for reading these different family situations, for I had no idea about.... any of it really. Def recommended by me as it opened by eyes.
Dr. Byock is an expert and has been working in hospice car for like 30 years. In this book, he describes multiple different cases he's been involved with of people dying and how they spent their last days. He shows the importance of family and social support. He shows how some families handled it well, while others handled it negatively, why, and how. Everyone will handle it differently, but he explains what are the best ways to ensure your last days are good ones, and an opportunity to get the family together and bonding, and how you can die with dignity. It was very moving.
It's very interesting and I am extremely thankful for reading these different family situations, for I had no idea about.... any of it really. Def recommended by me as it opened by eyes.
July 26, 2021
This book does have some amazing information and insight into the process of dying and going through all the difficult emotions and hard choices. It is told through multiple stories of people’s experiences and I find that helpful in gaining a feeling of empathy towards the characters and their struggles in a way that allows the reader to relate it to their own experiences. However, it just drags on and on with useless information and is padded with so much fluff I could hardly bring my self to push through and read the entire book. I found myself skimming through pages and pages of unnecessary build up that seemingly has nothing to do with the actual subject of the book.
I wish I could rate this higher for what it does offer and excel in giving new perspectives and breaking the taboos of growing ill and preparing to die. But it was just so boring and desperately needed to get to the damn point sometimes.
I wish I could rate this higher for what it does offer and excel in giving new perspectives and breaking the taboos of growing ill and preparing to die. But it was just so boring and desperately needed to get to the damn point sometimes.
December 20, 2024
Even in dying, maybe especially, our compassion, honesty, and perseverance reveal our humanity.
25 years later, and this book is still just as relevant and truth-seeking as ever. What is a good death? Is it cruel to let my loved one die? Is it cruel to not let them die? Needless to say, I cried more than once. It made me think about how after hundreds of thousands of years we're still the same, relying on our little communities as we try and gracefully exit this mortal plane. Gentle caresses, fresh flowers near the bed, a quiet and respectful burial with a few items for good luck and safe-keeping.
25 years later, and this book is still just as relevant and truth-seeking as ever. What is a good death? Is it cruel to let my loved one die? Is it cruel to not let them die? Needless to say, I cried more than once. It made me think about how after hundreds of thousands of years we're still the same, relying on our little communities as we try and gracefully exit this mortal plane. Gentle caresses, fresh flowers near the bed, a quiet and respectful burial with a few items for good luck and safe-keeping.
March 3, 2019
The subtitle of the book "The Prospect for Growth at the End of Life" is what each chapter showed the reader. Dr. Byock was compassionate with each story even when one of the deaths was not what one might consider dying well. The book was published in 1997 and I assume some of the protocols and medications and treatments have evolved since then. I have read some of his more recent books and liked them a bit more. However, this book was well written and is still worth reading if you have interest in this subject matter.
August 18, 2022
Excellent book on the complex issues - medical, emotional, familial - that arise around dying, especially dying from lingering, terminal conditions. People are often unwilling to consider how to handle the passing of loved ones, even though it is something we all have to face. The roles of the palliative care physician and hospice (Byrock is a palliative care physician) are the centerpiece of the book, and using case studies to examine end-of-life issues is a good way to tackle some of the larger problems and possibilities relating to terminal care.
October 5, 2017
I recently read three books on dying. This one was hands down the best! Dr. Byock illustrates his points about the dying process through poignant stories about dealing with patients and their families through the end stage process. I started this reading because my own mother is terminal and this really helped me to understand not only what she might face, but some of the ways I could work to help her through it. Excellent book!
February 20, 2023
I read this in case my Mom ends up in hospice eventually. Very informative. I learned that hospice care isn't just about giving the patient medication to keep them comfortable. It's an entire team of people who help with the mental, emotional and spiritual needs of people whose medical treatment is no longer stopping or slowing terminal illness. And it's not just for the patient, but also for their family. Lots of case studies featuring different patients and how hospice helped them.
July 16, 2019
Every aging adult should read this. Every adult child of an aging adult should read this. For that matter, every adult should read this. Ira Byock is compassionate, knowledgeable, supportive...everything one wants in a physician when faced with a life limiting illness and more.
This is a must read.
This is a must read.
July 24, 2020
This book is not an easy read, exactly, but it is compelling and goes by quickly. I found it very useful in terms of getting ideas for my role at work in ocassionally supporting with people who are dying. Although there were many tears shed, I found a great deal of comfort in these narratives and the possibility for personal growth and development for the entire lifespan. Highly recommended.
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