The Conversation: A Revolutionary Plan For End-of-Life Care Download Free (EPUB, PDF)
There is an unspoken dark side of American medicine--keeping patients alive at any price. Two thirds of Americans die in healthcare institutions tethered to machines and tubes at bankrupting costs, even though research shows that most prefer to die at home in comfort, surrounded by loved ones.Dr. Angelo E. Volandes believes that a life well lived deserves a good ending. Through the stories of seven patients and seven very different end-of-life experiences, he demonstrates that what people with a serious illness, who are approaching the end of their lives, need most is not new technologies but one simple thing: The Conversation. He argues for a radical re-envisioning of the patient-doctor relationship and offers ways for patients and their families to talk about this difficult issue to ensure that patients will be at the center and in charge of their medical care. It might be the most important conversation you ever have.
Hardcover: 240 pages
Publisher: Bloomsbury USA; 1 edition (January 13, 2015)
Language: English
ISBN-10: 1620408546
ISBN-13: 978-1620408544
Product Dimensions: 5.8 x 0.9 x 8.6 inches
Shipping Weight: 10.4 ounces (View shipping rates and policies)
Average Customer Review: 4.7 out of 5 stars See all reviews (94 customer reviews)
Best Sellers Rank: #102,292 in Books (See Top 100 in Books) #8 in Books > Medical Books > Pharmacology > Clinical #8 in Books > Textbooks > Medicine & Health Sciences > Medicine > Clinical > Hospice & Palliative Care #22 in Books > Medical Books > Medicine > Hospice Care
Underway in this country is a monumental effort to transform healthcare, driven by the need to reduce waste, redundancy, and danger . What Dr. Volandes brings to the table is visibility into the lives of those who struggle to find their way through this complicated, confusing, and intimidating medical industrial complex and reveals the simple yet profound notion that we can take back control of what happens to us. What is astounding is that to take control we must start with the simple act of conversation. When we, as healthcare providers, caregivers, family members and loved ones can lovingly and courageously discuss what is most important to a person at the end of life, we can support and honor that person. We can ensure that he or she is treated in a manner consistent with what defines them; in short, we can change the world. This book puts us on that path.
The Conversation serves as fascinating introduction to the life and work of Harvard Medical School physician researcher Angelo Volandes. As other reviewers have noted, the book is equal parts physician-patient narrative and how-to book in what it means to navigate life's final chapter. There are additional themes in the book of importance: the full circle of a father-son relationship, the complex interface between technology and human values, and how an aging population will touch us all in some way.The writing is a superb combination of storytelling and practical advice. The stories- the professor and his wife, the poetry teacher, the young woman with breast cancer, the coal miner- conclude with Volandes' challenges in navigating The Conversation with his own father. You read about these lives spellbound and wanting more. Maybe it is because these characters are so real, we naturally start to think about what we would want in similar circumstances. Volandes walks with us on this journey with the final sections of the book offering real world advice for individuals and families. It is an incredible reading experience to start with these stories and end up at our own lives. I heard Volandes interviewed on public radio recently and he distilled his message into what matters most: The Conversation is not about dying but living. It's about knowing what we want (and what our loved ones want) so we can live a better life in the face of whatever might happen in the future. At the heart of the book is an optimistic message, one that Volandes clearly believes in enough to dedicate his career to advancing. I cannot recommend The Conversation enough as a compelling novel and a start in clarifying some of the most important decisions we will ever make.
I received my copy of The Conversation yesterday, and read the whole thing, cover-to-cover. Angelo's book is so important; everyone must read it. We will all face end-of-life issues sometime in our lifetime, and it could be sooner than we think. As someone who has been dealing with terminal lung cancer for over 6 years, I should have already had The Conversation, but I have put it off. No longer! Angelo has given me the courage and the information I need to talk to my sons - and doctors - about this very difficult topic.I waited too long to have The Conversation with my mother; she's still alive at 94, but has severe dementia. As her health care proxy, I only hope I will make the right decisions for her in the end, which will be soon. She has only said she wants DNR. Angelo makes it clear that we need much more specific, personal information.I'm so glad Angelo has written this book. I am going to gift it to many of my friends and family.
In The Conversation, Dr. Volandes accomplishes a rare feat. It is a unusual for an accomplished, academic physician-researcher to be able to place their research in the human context, in narrative form, to bring to life what the questions and struggles faced by patients and their families, as well as the doctors caring for them, actually feel like. The stories Dr. Volandes tells are compelling, and alone make The Conversation worth reading, but the stories alone are not what makes the book novel. Into these stories, Dr. Volandes has beautifully woven the insights of his clinical practice, and even his personal life, that have inspired him to pursue an unusual research path to address a timeless problem for all doctors: how to talk with patients about the medical choices they face when living with, and dying from, serious illness.What he learns and shares in The Conversation is revelation for us all. Dr. Volandes certainly does emphasize that we all desperately need to take the time to understand what is possible from healthcare when living with serious illness and what we then want, what doctors have now been calling the Conversation, but what we learn is that explanations based on talking alone are often just not good enough. As portrayed by Dr. Volandesâ stories themselves, we all make decisions in the light of our human experiences, but frequently, patients simply do not have the experience to be able to understand what doctors are saying in the Conversation, unless these words are augmented with images. Dr. Volandesâ research has shown how patients and families make better end-of-life decisions for themselves when they really understand their choices as informed by video decision aids. These video aids help them understand visually what is often only understood to doctors with years of actual clinical experience. Dr. Volandes poignantly is redefining what it means to have the Conversation by ironically reminding us what we often know in life, that sometimes words are not enough. We are all better for it.Elmer Abbo, MD
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