At Peace: Choosing a Good Death After a Long Life

When it comes to quality of end-of-life for people who are lucky enough to surpass the average lifespan, a good death is not guaranteed or easily obtained. By a good death, I mean one NOT in a hospital  as a result of heavy life saving interventions. But, rather, one in one’s home, with family and without excessive pain or unnecessary medical supports. Samuel Harrington spent the bulk of his medical career trying to steer people toward a better way to die. A way that avoids the hospitalized death with its array of tubes and wires and, many times, unnecessary life prolonging supports, like feeding tubes, mechanical ventilation and IV fluids. In this book, Harrington describes the horrors of a hospitalized death and maintains that one must plan carefully to have a chance of avoiding such a fate. The book, with its great advice is woven through with the stories of the deaths of the author’s own parents. He is frank about the things he feels his parents did right and what he thinks they did wrong. Though, it seems that both his parents had reasonably good deaths with minimal prolonged suffering. This was largely a result of fairly careful planning and some luck. The author explains why the medical system in the United States is not geared toward a good death at home, without a lot of life preserving interventions. He frequently points hospice out as a great program that has people trained to help folks die with as little medicalization as possible. He also does a good job of explaining what the statistics like median mean when these are used in demographic death statistics and in clinical outcome numbers. Harrington repeatedly explains that older people, especially those who are past the average societal death age, should be skeptical of invasive medical treatments and be “aggressively passive” in their approach to medical care. He often takes the medical system to task for promoting, and in some cases selling, large, invasive medical treatments to elderly people who are in a much higher risk category. He also showed you how to do your own research using valid tools on the internet to figure out whether a procedure makes sense or whether the risk of a prolonged, uncomfortable existence is more likely. There is a section that explains DNRs, living wills, and other legal instruments that can help a person to establish how they want to be treated in various medical situations and, ultimately, how they want to die. I recommend this book to all people who are concerned with how they will die. It is geared toward one goal: to teach you how to approach death and medicalization in a way that gives the reader a better chance of dining peacefully. A good death in old age is not guaranteed and one has to be proactive to ensure at least a chance.