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Living with Dying: Finding care and compassion at the end of life

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Title: Living with Dying: Finding care and compassion at the end of life              

Author: Margaret McCartney        

Publisher: Pinter & Martin Ltd

Reviewer: Jane Brocksom, urology & continence nurse specialist, Leeds Teaching Hospitals NHS Trust

 What was it like?

This book has been a refreshing read, like a collection of interconnected essays or having a discussion with colleagues. I like her style of writing. It is questioning, humorous, personable and curiously makes you keep reading. I have not previously read the “Patient Paradox” Dr McCartney’s first book; she is a GP in Glasgow who is a well published author including BMJ plus her own blog and a speaker on Radio 4’s Inside Health. The 8 chapters are subdivided and make for compelling reading, in a sensible and thoughtful way. Dr McCartney’s argument is we need to start valuing a good death, as we live longer we have a desire to fight death at all costs and medicine may harm and non-medical interventions maybe more effective. (Vice versa?)The author also argues for more conversations around “Deathcare” particularly in term of hands on, human, holistic care. Death is an unpleasant part of an HCP’s role (and our personal life) but done well it can provide us/carers with a cathartic experience.

What were the highlights? 

The book is a revelation and a highlight throughout. Where is the balance of medicine between caring and curing? Has medicine got in the way of good care? Do we rely on technology rather than essential care? “When professionals go bad” (is a sub heading), which highlights the importance of caring for the carers, emphasis on a positive working environment and supportive network, often hard to provide in a healthcare culture of quantity over quality.

Strengths & weaknesses:

The interesting titles of the chapters include; - The modern death: Too many tablets: Caring not curing: The politics of death: War, Truth and Lies at the end of life. It’s difficult to halt curiosity and stop reading chapters with such titles and you are rewarded with balanced and thoughtful dialogue. The final chapter is “Things to think about” - if I’m honest I started doing this on page 1. I did send a tweet to Dr McCartney asking why the chapter was at the end of the book and not the beginning - she tweeted back “I think because the book is an argument for doing so, and thought a bit much at first” Thank you for tweeting back Dr McCartney.

Who should read it?

Any HCP who wants an articulate, challenging, uncomfortable yet exhilarating read, yes its in-depth but it packs a lot in for 212pages, I suspect the most likely to pick the book up will be HCP’s involved in death and dying - but it is for anyone involved in caring. Deathcare is the focus, but Margaret McCartney is arguing for a compassionate and humane approach - some may agree this is back to the essentials of care.

”To die a good death, we need unglamorous, humane, hands on care. This can never be replaced by computers or machines”

Finding the middle ground is as challenging and rewarding as this book…….

Living with Dying

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