REVIEWED BY JAMES P. RUDDEN, M.S.W., L.C.S.W. AND BONNIE M. RUDDEN, M.A., L.P.C.
LAST ACTS OF KINDNESS: LESSONS FOR THE LIVING FROM THE BEDSIDES OF THE DYING
BY JUDITH REDWING KEYSSAR, RN
Transformations-in-Care, 2010
216 pages, $15.95
lastactsofkindness.com
Just as we celebrate the birth of a new child, we should also celebrate the death of a person, Judith Redwing Keyssar writes in Last Acts of Kindness. The author, a leader and innovator in the field of palliative care, has gathered many stories during her career as a "midwife to the dying." By sharing some of these experiences, she hopes to change the emotions surrounding dying in our culture from one of fear and anxiety to one of acceptance and compassion. Her nursing expertise, along with her efforts to provide emotional and spiritual guidance to patients, has helped many people to accept and celebrate the end of life.
Hoping for a day when death will be widely understood to be a more natural part of life in Western culture, as opposed to something to be kept hidden from view, she offers readers examples from other cultures. These include non-traditional celebrations intended to assist the spirit's return home from her own Native American background and from Buddhist traditions.
Our family received a copy of Last Acts of Kindness from a caring relative when our daughter, Dana, was at home with hospice care due to inoperable lung cancer that metastasized to her brain. Many parts of the book were quite validating and educational for us as practicing clinical counselors and, most importantly, as grieving parents. The touching end-of-life stories documented in the book all share beautiful endings.
Despite the tensions that often go hand-in-hand with serious illnesses and decisions around end-of-life care, Keyssar believes the end of life is not the time for family feuds. "When a loved one is dying the past is truly the past and the present is all that counts. The tangle of family dynamics needs to be put aside," she writes. She encourages people to examine their personal relationships with an eye to healing.
For instance, we had mixed feelings about Dana's end-of-life challenges. Our daughter had been an enlisted military staff person for the past 26 years. Because of her military assignments, she lived away from the family home, both out of state and many times out of the country. We had minimal contact with her in recent years, leaving much to be desired. Then her illness and imminent death brought intimacy back into our relationship with her. We are saddened that it took such a drastic event to bring the family together. We learned and witnessed, even at the time of approaching death, that Dana was an extremely strong-willed and generous person. She said she wished she could take all of the family's illnesses with her, so no one else had to go through the suffering she experienced.
Adding to all we have learned from this book, we have come away with a deeper understanding of palliative care. When palliative care was mentioned to us as an option for Dana's health care, we really were not sure what it meant. From Keyssar we learned that palliative care is about relieving suffering, whether a person is in hospice care or not.
Keyssar's recommendations validated for us that we were taking the right approach to Dana's last days. We visited Dana at her home in Oklahoma at least once a month. Encouraged and inspired by Last Acts of Kindness, we strove to go where our hearts led us during this sacred time for our family.
JAMES P. RUDDEN is a licensed clinical social worker specializing in anger management. He sees residents at The Elder Haus, a residential care facility, and counsels children at Catholic Family Services, both in Troy, Mo.
BONNIE M. RUDDEN is a licensed professional counselor in private practice in St. Louis. She specializes in family and marriage counseling, blended families and remarriage .