One day, the sun will set for all of us for the last time. Life invariably comes to an end. The timing is the great unknown. The conduct of your last days can however be largely controlled. With some thought about what makes your life worth while, you can specify the care you would like to receive in those days at the end when you may not have the ability to comprehend what is happening to you. Through a series of cases illustrating the choices that you need to consider you will learn that there is more to these plans than DNR or "full code." Through encounters with many patients the author poses questions and alternatives to contemplate. With this information you should be able to formulate a plan acceptable to you to be shared with your family or friends and your medical providers.Death in America has become a medicalized event conducted in the hospital, often the intensive care unit. This is true despite the overwhelming preference of most people to die at home, in familiar surroundings with those close to them at their bedside. Examples of the benefits of palliative care and hospice care are presented. The differences between these services, which share a common philosophy are explored.The end of your days can be peaceful, dignified and largely free of pain, anxiety and fear with the support of these professionals and your loved ones.
About the Author: Dr. Buckhout completed medical school at the Medical College of Ohio at Toledo in 1979. CT scans were not in common use, death was the most obvious sign of medical failure. Instruction in caring for the dying or palliative care was not part of the curriculum. He then completed a family medicine residency in Toledo and moved his family to begin a twenty year career as a family practitioner in Phoenix, AZ in 1982. His practice included office care of newborns to centenarians as well as caring for his patients in the hospital and assisting in surgical cases as well. In 2002 he closed his practice and began his next career in the skilled nursing facility of the Phoenix Veteran's Affairs Medical Center. Care of our nation's veterans has been, for him, a distinct honor. The complexity of this mostly geriatric population provided daily challenges. Many of these veterans had accumulated a lethal combination of chronic medical conditions that could be palliated but not cured and the focus of his career began to change again to end of life care. In 2012 he received his certificate of added qualification in Hospice and Palliative Care and focused his efforts on making the final transition of those veterans whose days were coming to end as peaceful and pleasant as possible. He continues in this capacity and also has served as the program director for the Hospice and Palliative Care fellowship training new physicians in the techniques of this specialized care.