Last Comforts: Notes from the Forefront of Late Life Care

by Ellen Rand

As the baby boomer generation lurches--sometimes kicking and screaming--into old age, ten thousand of us become eligible for Medicare each day. By 2030, one-fifth of the
population will be 65 and older, compared to 13 percent in 2015. The fastest-growing population--the "oldest old," 85 and older--will number nine million by 2030, more than
double their number in 2015. By 2050, the number of Americans requiring long-term care is expected to more than double from 13 million in 2000 to 27 million.

This book chronicles Ellen Rand's journey through this unwelcome territory, beginning with the illnesses and loss of her parents and continuing through more than five years as a hospice volunteer. Though she had initially aimed to write solely about hospice, it soon became clear that there were so many broader, interwoven issues in end-of-life care.

She broadened her reporting to cover such issues as medical and nursing education, dementia care, long-term care alternatives, challenges faced by minority, gay, and transgender populations, and public policy.

The book grew out of one basic question that kept nagging at her not long after she became a hospice volunteer: Why do people enter into hospice care so late in the course of their illness?

So late that they don't have the chance take full advantage of all that hospice offers. So late that there isn't sufficient time to develop the trust, ease and, yes, friendship that can provide great comfort for the ill and their families experiencing what is likely the biggest challenge of their lives.

Call it curiosity, call it frustration, call it exercising a reporter's muscles, this question drove her to begin researching the current realities of end-of-life care. She wanted to learn: how can we do this better?

An optimist by nature, her goal was to look to the pathfinders and innovations in caring for people with advanced and life-limiting illness to learn how the future might be dramatically different for the coming wave of aging baby boomers.

The seeds for better end-of-life care have been planted. It is up to all of us to nurture the seeds and insist on the kinds of changes we'll need.

Genres: Grief, Health

350 pages, Paperback

Published March 23, 2016

About the author

Ellen Rand has been a journalist for more than 40 years, including five years as a housing columnist for The New York Times. She is a hospice volunteer with Holy Name Medical Center in Bergen County, New Jersey, a member of the Hospice Volunteer Association and the Association of Health Care Journalists. Her essays have appeared in several medical humanities publications, including Pulse—Voices from the Heart of Medicine; KevinMD; and Life Matters Media. She blogs at http://lastcomforts.com and tweets: @EllenRandNJ.

Midwest Book Review has praised this book: "Impressively well written, extraordinarily well organized and presented, as informed and informative as it is thoughtful and thought-provoking, "Last Comforts: Notes from the Forefront of Late-Life Care" is a critically important and highly recommended addition to community, college, and university library Health/Medicine collections. Simply stated, "Last Comforts" is directly recommended for the personal reading lists of all health care givers and hospice staff members, as well as non-specialist general readers with an interest in end-of-life care issues."

Reviews

[Susan Walker · Rating 4 out of 5]

The Author not only takes the viewpoint of the patient but of all the caregivers involved. This is an excellent book on end of life care.

[Patricia Ann · Rating 3 out of 5]

Ellen Rand states that this is a" mosaic of the lessons I've learned ... " She presents case studies , then some insightful answers to more culturally oriented end of life care, and then talks about places that have implemented some of these solutions. I would have edited a great deal of the information given as to credentials, wishes, dreams of the experts she cites and places; it's cumbersome in attempting to get a real focus on some genuinely good ideas and practices. Applause is to be given for her presentation of adding to quality of life, decreasing suffering in that last chapter in the book we've written called "My Journey"... She addresses the horrid issue of palliative VERSUS hospice care ; something that needs to be integrated and funded, not at odds with each other; physicians' attitudes towards death and the dying process; the cultural aspects of end of life issues re Baby Boomers, with LGBTQ (friends as family, having those you love around, staff remaining nonjudgemental) ..She addresses patient "getting to know me", the lack of training for physicians re: listening and talking with the patient , caring for the whole person, having an interdisciplinary approach to the patient, and lastly places that have implemented some solutions to a better quality of life at the end of days.