The only consolation, even for someone like him who had been a good man in bed, was sexual peace: the slow, merciful extinction of his venereal appetite. At eighty-one years of age he had enough lucidity to realize that he was attached to this world by a few slender threads that could break painlessly with a simple change in position while he slept, and if he did all he could to keep those threads intact, it was because of his terror of not finding God in the darkness of death.

I entered the picture in the eleventh hour as a guide to the exit of his life. I navigated as best I could the role of end-of-life shepherd—a journey that I had never taken before. I have to forgive myself for what I did not know. And I have to forgive him for the times that he felt unequipped to deal with the unknown.

It took until the end of her life for me to cherish each day with my mother the way I naturally did with my brother. At the end, I loved my mother simply, without request to do better in any way, or be more capable in any way. I simply loved that she was there, and she was my mother. I wish I did that more often in my life. I will do that more often in my life for those who are still here.

I told her that the pills will let her slip off and that when a person dies there comes a long clean sleep.” “That’s all,” Alexandria whispers, echoing after her, “a long clean sleep.

When I reflect on the stories of death supported by hospice care and contrast it with our story depicting an absence of support, I find myself dealing with envy and anger. I have channeled those emotions into this book with the hope that hearing our story might give someone else a chance to create a better ending to the life of a loved one.

A paradigm shift of viewing palliative care or hospice as a gift instead of seeing it as giving up has the potential to change the way we experience advanced age.

I believe it’s imperative to bring the light of support and knowledge to patients and families when death is approaching.

Gomers are human beings who have lost what goes into being human beings. They want to die, and we will not let them.

[We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

Our health care approaches squander billions on extravagant treatment regimes that end up accomplishing little, as a society we refuse to adopt the small, even tiny adjustments that could easily reduce the clawing uncertainties that now degrade millions.