Practical wisdom and holistic planning to ease life's most difficult transition, from an acclaimed hospice nurse, death doula, and end-of-life educator
Many of us have to show up for someone we love at the end of life. Knowing how to do that changes everything. With over twenty years of experience as a hospice nurse, palliative care professional, and founder of the Doulagivers Institute, Suzanne B. O’Brien, RN has trained more than 350,000 people in what can be done to help the dying person, caregiver and other loved ones so they may move through each stage with as much comfort and ease as possible.
In The Good Death, O’Brien provides a comprehensive plan and the empowering knowledge to make a beautiful, sacred, and profound experience for everyone involved. Through practical advice, emotional support, and expert insights, O’Brien gently holds your hand through every aspect of the process, including:
· Learning how fear of death makes end of life harder, and how we can begin to quell it · Care instructions to ensure your loved one’s comfort · Support system strategies to avoid burnout as a caregiver
To further empower you in facilitating a good death, the second half of the book is presented workbook-style. The Peace of Mind Planner features prompts to initiate important conversations with your loved one about their physical, mental, emotional, financial, and spiritual preferences, and space to record this important information. The planner allows you to be fully present in these last precious moments, and come away with a thorough plan for your loved one’s end- of- life wishes. With empathy and a careful approach, The Good Death is not only a comprehensive, compassionate, and in-depth resource, it is a beacon of hope and support.
Okay, so, this is very practical and easy to digest. This is a book that literally everyone can and should read. Personally, I found the description of Christianity’s concept of the soul to have missed the mark, but the book is not about the spiritual side of death. It’s about dying in a way that serves others kindly.
This woman claims that she wants people to experience a good death but apparently not through MAID. MAID is medical assistance in dying which means a person is given help in dying by a doctor. The author says that this option is unnecessary since there are other options such as VSED and palliative sedation. VSED is the option where you choose to stop eating and drinking to hasten death. VSED is not a well known option to many and is only now starting to gain popularity as an option. I think that VSED is a good option especially for those who does not live in a state where MAID is available. The problem is that VSED is not a quick death and can take a week or more before you actually die. The author's second choice is palliative sedation in which your love one is sedated into a coma like state to help with suffering. MAID guarantees a quick death that allows you to spend your final moments with loved ones enjoying every last moment. Another issue is that the author says people choose MAID because of fear mainly the fear of pain or loss of control. There are many people who do choose MAID so they don't have to experience pain and suffering their disease will cause. As for control I do think many choose it to take control of when and how they will die so that they die on their terms People chose MAID for multiple reasons so claiming that people just choose it out of fear is just incorrect. Maybe if the section of MAID was longer and more in depth the author could have explained more about this option. After this little section she adds a little section that hints that there's a difference between choosing MAID and dying with dignity. The author says to die with dignity means to die comfortably without pain and and suffering That describes MAID perfectly and so should be an option available to everyone who is terminally ill.
I'm not currently in the situation of supporting a loved one's impending death but I like to be prepared. After my parents died, I started reading books about death to help me process my emotions and to clarify my thoughts around the end of life. I saw this was written by a death doula so I figured she would have some great advice. She does.
The biggest thing I got out of this book was learning about a POLST form. It also might be called a MOLST or POST form or a TPOPP form, depending on where you are in the USA. (While death happens everywhere obviously, since the author is located in the USA a lot of her medical advice is specific to the country). I had heard of living wills and actually have one but I had no idea that doctors and hospitals are not bound by law to follow them. Wha???? It's more about protecting doctors from malpractice. If they don't intubate you or whatever, they cannot be sued if you have a living will stating you don't want to be. Living wills also keep the story straight, in terms of your family recalling what your wishes are. The author mentions families arguing, each remembering a totally different conversation with the sick family member. So write down your wishes!
Living wills are still good to have since you cannot get a POLST until the person is actually gravely ill. POLST stands for physician orders for life-sustaining treatment and is legally binding. You can basically use the person's living will as a template to fill out the POLST. It's often printed out on brightly colored paper and hung near the patient's bed. Once a person is nearing the end, you want to keep one with you so you can give it to the ambulance if needed. Otherwise, EMTs are obligated by law to try to keep someone alive by any means necessary.
This form must be completed by a doctor and is a medical order that all medical professionals must follow by law. It sets forth that CPR will not be done, so it is a DNR. People can specify whether they want to go into a hospital if they are still breathing and have a pulse, as well as the treatments they want while there, including whether they want to go into the intensive care unit and be put on a breathing ma-chine, if necessary. They can also specify whether they want a feeding tube if they can no longer eat by mouth and whether they want to receive antibiotics.
O'Brien also discusses more general end of life issues that are not dependent on location. Her stories are ones I have heard about in other books, like how dying people have a short burst of energy shortly before death (twelve hours to a few days before). Families will think their loved one is getting better. They aren't. This turns out to be an ideal time to have any final conversations, before the dying person slips back into mainly sleeping.
Another common behavior is that quite often the dying person is visited by dead family and friends. I love this! I find that so incredibly comforting. Some people explain it as a brain glitch, a hallucination. Hmmmph. Or maybe all these dead people are experiencing something we can't quite fathom yet.
O'Brien gives a brief summary of what are some common death experiences for illnesses that people die of. I had no idea that when you are dying of liver disease, you feel like you are suffocating due to severe fluid retention in the abdomen, pressing on the diaphragm and lungs. I would have assumed that would happen with lung cancer. Nope. When dying from lung cancer you get incredibly weak and O'Brien states lung cancer deaths are some of the gentlest she has seen. Who knew?! Ok, medical professionals know, but I didn't.
The final part of the book is structured like a workbook, with lots of questions that need to be answered in order to have a good death. I tend to only get books from the library these days, but this seems like a book worth buying if you are actually living this situation. Some of the questions seemed obvious but others got me thinking. It never crossed my mind, what sort of smells I would want to have around me while dying. Music, yes. People, yes. Smells - ok, yeah, that would be nice.
Here are a few of the many many questions:
How do you want your environment to feel? Do you want it to be quiet and spiritual, or would you prefer people be talkative and jovial?
Do you have a preference for personal grooming? Would you like your hair and nails done, and if so, who should do this task for you? Would you like to wear particular clothing?
Animals are often very important to people, so please specify if you want pets to be a part of your end-of-life care family.
Do you want any holistic therapies? These might include Reiki healing, massage, therapeutic touch, and aromatherapy, among others. Please specify.
How do you want people to physically interact with you? What do you need in terms of the way others interact physically with you in order to feel that you have your dignity and that you are respected?
All in all, a very helpful and supportive book worth reading. Don't we all want a good death? This book will help that happen.
Suzanne B. O’Brien’s The Good Death is a caregiving guide with a clear emotional center: death is frightening partly because most people are left unprepared for it. O’Brien writes from her experience as a nurse, hospice worker, oncology nurse, and founder of Doulagivers, and the book’s main promise is practical comfort.
What makes the book work is that it treats end-of-life care as both deeply human and very logistical. The first half explains why families often end up overwhelmed, how medical systems can keep people on what O’Brien calls the “medical treadmill,” and why planning ahead matters. She covers aging plans, advance directives, disease-specific expectations, the three phases of dying, caregiver burnout, home funerals, green burial, and other choices that families often don’t know they have.
The second half becomes more like a workbook, organized around what O’Brien calls the Peace of Mind Planner. It asks readers to think through a “good death” physically, mentally, emotionally, financially, and spiritually. That structure is one of the book’s strengths because it doesn’t reduce dying to medical symptoms. It understands that a family may need medication instructions, legal documents, permission to rest, guidance for grief, and language for spiritual mystery all at once.
O’Brien’s tone is warm and direct, which helps the book stay readable even when the subject is heavy. She’s at her best when she turns clinical experience into plainspoken guidance, especially for family caregivers who may suddenly be expected to do intimate, round-the-clock care with very little training. Her invitation near the beginning, “As you walk this path, allow me to hold your hand,” fits the book’s voice: calm, personal, and determined to make a difficult experience less lonely.
The Good Death is a compassionate, practical book about reclaiming death from panic, silence, and rushed decisions. It’s not just about dying peacefully, but about helping families feel steadier while they care for someone they love. The book’s real value is its combination of tenderness and preparedness. It gives readers permission to talk about death sooner, plan for it more honestly, and see caregiving at the end of life as an act of love rather than a crisis they have to stumble through alone.
Won a finished hardback copy of this book in a Goodreads giveaway—thank you so much to Little, Brown and Company for this generous and deeply appreciated gift. 💛
💬 A few highlights from my reading experience:
Offers practical, compassionate ways to support someone through death—emotionally and physically.
Includes a Peace of Mind Planner that’s a priceless gift for anyone facing end-of-life care decisions.
📚 What I Loved:
• Compassionate tone without being overly sentimental
• Deep respect for the emotional and spiritual aspects of death
• Encouragement to talk now about difficult topics, before it’s urgent
• Workbook format that makes intimidating conversations doable
🌀 Considerations / Room for More: There’s a brief mention of MAID (Medical Assistance in Dying), which the author doesn’t support, instead suggesting VSED and palliative sedation. While I understand her perspective, I found the treatment of this topic a little too brief and perhaps dismissive of the broader reasons people may choose MAID—not just fear, but autonomy, control, and peace. That said, the overall message of minimizing suffering and maximizing comfort remains strong and consistent.
Thank you to Little, Brown Spark, and Netgalley for the digital arc. This wasn't the book I wanted it to be. The technical details and emphasis on the correct paperwork is the theme of the first half of the book and although it is essential, these things would be best completed way before the patient is sick or dying. After that, the stages of grief are described, and then finally Chapter 10 speaks to an emotional good death. In my opinion, this is the most important step in the process of death, but even this chapter focused on resolving negativity in one's life but there is a very nice list of questions to prompt the patient in remembering their life. The next chapter reverted to a discussion of finances. So if you have everything planned, skip this book, but if you don't, it will be invaluable. If all is planned, then I recommend the series or podcast “Dying for Sex”, which is excellent in describing the end of life process, but it does have some intense sexual themes. It really spoke to me on how to interact with someone who is terminal, which is what I really wanted to know.
Suzanne B. O'Brien's "The Good Death" absolutely captivated me. I could not put it down. In addition to describing and providing information to help a loved one through this last stage of their life, she also provided much needed information concerning Advance Directives, Living Wills and more to ensure that the terminal patient truly makes all decisions about their care even when they've lost the ability to communicate. As an oncology and hospice nurse, she has the experience to guides us with what to expect - some of which can be beautiful. I'm a former hospice volunteer and after reading her book I explored her "Doulagivers" teaching institute, attended a free introduction and then signed up for a 3 month course. I'm in the midst of it and it has wildly surpassed my expectations.
The Good Death is for everyone since we all will face the death of loved ones throughout our lives. It will make you more comfortable with death and the dying, more helpful in their times of need, and more secure in knowing what to do, even know, to ensure you have as good a death as possible.
Won a finished hardback copy of this book in a Goodreads giveaway. 4.5 stars rounded up to 5! Really, really well written and deeply moving. Reading it felt like having a supportive, informed friend help me through difficult times, and I so appreciated that! The book likewise provides lots of practical info and outlines steps we can all take to regain some of our agency, which I’ve found to be one of the biggest challenges when dealing with a love one’s death: Feeling like we can do something, anything, that makes a difference. Love how it addressed, head-on, the feelings swirling inside folks who are in these situations. I feel less alone and more equipped because of this book!
This book has some wonderful thoughts around death and truly does a good job of preparing the reader for understanding the process of death and what to expect along the way. It also does a good job of helping navigate the complexities of the “death enterprise” and the legality around death.
They do make a strong push for a more environmentally conscious death, but they don’t beat you over the head about it. They also take a multi-faith general approach to questions around the soul and what happens at death.
Overall, I’d recommend this book to anyone as a helpful primer for them to think about either the death of a loved one or their own death in a different light.
I almost didn’t read this book because the chapter on “dealing with disease states” does not have Parkinson’s disease!!! I guess maybe it really is not all that common, but as my dad’s legs are locked into a position as he dies slowly inch by inch, I would love to read about others going through the same thing.
I did skim through the chapters and I will say that I do think this is a very good book and I ended up reading a lot of it. Overall, it is very good. I actually would recommend this book over some of the others I have read.
I know some will say this topic is way too depressing. O'Brien's approach is therapeutic and helpful to the point that most people can use this book as a guide to handle terminal illnesses involving their own lives and their loved ones. The book covers hospital care, hospice care and how to manage wills, trusts and all legal matters with regard to end of life. How do you want to live your final days? Ask your loved ones what they want and then have it documented.
If you do one thing, you HAVE to listen to the 1000 Hours Outside podcast featuring this author. And then if you have a few more hours, read the full book. There is SO much we don't talk about when it comes to death/funerals/last wishes/etc. and this book lays it all out. Also, talking about death is great for making you appreciate life more!
This should be brought to every school and social community It is so refreshing to have validation and knowing that what I have been a witness to for decades is actually finally coming back full circle. We as humans started this process generations ago, and some where we got lost It has been a long journey to come back completing the circle of life Thank you
I wanted to like this more. There are parts of it that remind me of another book I read just over a year ago written by a hospice nurse. I thought the parts where she discussed specific terminal diseases was a filler. It just didn't seem to have anything to do with dying for most people and of it needed to be included then doing it at the end would've been more appropriate.
Wonderful book not only for someone like myself who’s preparing to be an end of life Doula, but really for anyone to understand the sacredness of the dying process and to have a better experience both as a dying person and for the family and friends around them, no matter their faith, religion, or spiritual practices it’s just humanity and the circle of life. An easy quick and powerful read!
The author is a Hospice nurse and Death Doula. She gives the reader the supplies needed to prepare for end of life with grace, dignity and compassion for all involved. She explains how all of us can prepare for end of life now while living so that the end isn't a stressful time but instead one surrounded by calm, peace and a loving atmosphere.
The Good Death is an incredibly moving, compassionate, and essential guide that approaches one of life’s most difficult realities with grace, clarity, and deep humanity. Suzanne B. O’Brien writes not only as an expert, but as someone who genuinely understands the emotional weight of end-of-life carem, and that authenticity shines through on every page.
Absolutely EVERYONE should read this book. Well thought out, laid out, informative and empowering. No one really wants to think about or talk about death, but it’s inevitable and at times comes earlier than we expect.
if your parents are aging and you're concerned about their death, this is a great book to read. it will guide you through so many aspects of dying and maybe you'll learn and do some of the things for yourself.
This read was purely for hypothetical knowledge…figured the time to think about this is when I don’t need it. Definitely some really good tips and explanations. I found a lot of it pretty common sense, and some was definitely too woo woo for me. But overall glad I read it.
This book is so helpful for planning ahead for the death of a loved one and for ourselves. It's also inspiring and full of compassion! I picked this book up for a couple of reasons. One is that I want to be prepared for what's ahead- both of my elderly parents are slowly on their "way out." (Mom has Alzheimers, and Dad has degenerative disc disease and is getting up there in age.) My sister has Parkinson's disease. At the same time, I discovered that I have a calling to be a death doula. This book is the perfect start to my studies and to be prepared for the passing of my loved ones (which hopefully won't be for years to come).
I highly recommend that everyone read this book, even if you have to skim through chapter four, which talks about common diseases at the end of life. Some people (such as my daughter) are sensitive even at the mention of the word c*ncer or anything that has to do with body malfunctions, so this could be a difficult chapter for some. I'm sensitive, too, and usually avoid this sort of topic, but I made myself read through it anyway, as I'm trying not to be afraid of it. We're all going to die of something, afterall. After you get through this chapter it gets much easier! There will be beautiful stories of end of life experiences that will uplift your spirit and bring you comfort. You might even kinda look forward to it...(?)! The book also includes a "peace of mind planner" that is also very helpful, and you can currently take a free caregiving class if you go to her website.
I'm now reading this a second time so I can slow down and annotate the book while I study to be a death doula. I want to get certified through Suzanne O'brien's Doulagivers Institute, but unfortunately I can't afford it at the moment. For now I am studying on my own and listening to podcasts, ect.
Overall this is a wonderful read. It will change the way you think of life and of death. I am also very happy to see a movement towards talking about death and taking the fear away from it. We need to talk about it! Death is not to be feared, as it a sacred part LIFE. If you are afraid of death, this book might help you. What helped me not be afraid of the terminal illness/dying part is learning that the body knows how to die, and that there are beautiful human beings out there called nurses that will help you feel comfortable and loved as you transition, minimizing pain and suffering. We are all in this together and everything's going to be OK.
Disclaimer: This book felt important for me to read because a family member I love has dementia. The book made me feel more empowered and determined that I could help facilitate a good death for her when that time comes. This is a gentle, reassuring book that offers practical ways to deal with caregiver guilt, sadness, and anxiety. What a gift and resource for someone who is struggling. I am grateful I found and read this, and will be giving to other caregivers who need it. Thanks to NetGalley for the ARC. Pub Date: March 18, 2025.
I didn’t want to review this book because at the time my friend was on a path to dying. I will say this book helped me immensely in the process of helping care for a friend going through the stages of dying. It really did help prepare me as best I could with information that did help me in the last month of his life. I am forever grateful this book came into my life at the right time. I hope no one else needs it, but if you do I highly recommend this book.