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Communicating Care at the End of Life

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Carey Candrian

While health care at the end of life is changing, the language for talking about treatment options and patient preferences around the end of life is taking longer to change. This book carefully details the way language shapes decisions around end-of-life care. Using ethnographic research from two sites that offer emergency care and end-of-life care – a hospice and an emergency department – the author illustrates common themes around language use that serve as microcosms of the larger healthcare system in the United States. The sites have different purposes for providing care, yet the themes from both serve as guidance and reflection for other areas of caregiving.
The language used to talk about death holds consequences and opportunities for understanding and making decisions about care practices. This book uses personal stories and perspectives from patients, family members, and medical workers to paint a picture of some of the issues and tensions individuals and caregivers face. With an aging population – one that represents a major public health challenge in the twenty-first century – Carey Candrian argues that examining the care we provide for individuals, especially aging individuals, is fundamental to creating a developed, ethical, and engaged society.
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Acknowledgments

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This project would not be without the help, guidance, and support of many. First, thank you to Stan Deetz. I could not have done any of this without you, your ideas and your support. Next, thank you to Mary Savigar, Sophie Appel, and Gary Kreps for your insightful and thoughtful review, and for being so delightful to work with. Thank you to Susan and Gerry for your incredible wisdom and help over the years, and for inviting me into the emergency department and hospice. And thank you to Jean Kutner for sharing your belief in palliative care and the relationship between communication and care with me a long time ago.

Thanks especially to the patients, families and health care workers I have shared moments, hours and days with who are not listed on this page but infuse every single one of the following pages. I have been humbled in many ways having met you all. And many of you have shown me—and some have made me feel—the difference between life and living, a lesson far more important than I could have learned on my own. Finally, thank you to my incredible family—Bev, Scott, Jeff, Jody and Ibby—for understanding, supporting and caring for me beyond words. And thank you to Leo, the love of my life, for being the way you are. ← xi | xii →← xi | 1 →

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