(Note: The pdf for the issue in which this article appears is available for download: Bifocal, Vol. 36, Issue 1.)
The way “Without Regrets: A Nurse’s Advice about Aging and Dying” is organized speaks volumes about the philosophy of the author on the issues of aging and dying. Author and registered nurse (RN) Helen Emmott starts with how families, relationships, family dynamics, and individual values and beliefs should shape care in later life and end-of-life decisions. The book uses a very modern person-centered approach that looks to the individual first, and then at how medicine and law can support the wishes and needs of the person.
Person-centered care focuses on the individual, or their surrogate—informing them of multiple care and treatment options so that they may make choices based on their beliefs and values in consultation with health care professionals. The real shift is in offering more treatment options, including options of not treating and empowering the individual to make their own health choices. The essence of this book is to explore person-centered care from the point of view of the individual and family.
It all starts with a person’s values, Emmott asserts, and throughout the book the author urges her readers to have meaningful discussions about values, hopes, and goals as people age and approach the end of life. The book provides an intimate view of the complex personal and family dynamics that shape decision-making about care in later life and about dying. The issues are richly illustrated by narrative drawn from the author’s decades of personal and professional experience as an RN, medical ethicist, and family caregiver. The book explores selecting a surrogate and empowering intra-family communication.
This is not a book about the medicine or the legal issues of aging and dying. It is about how beliefs, values, and goals should guide the life of an older person. The author explores the tension between honoring the values and wishes of a frail adult and the caregiving capacity and needs of family members and other caregivers.
The book is a worthwhile read for aging professionals seeking a deeper understanding of person-centered care and the interpersonal dynamics of aging and dying. The text is clear and easy to read. The subject is not always easy; there is a lot of discussion of end-of-life issues and dying. The book helps readers to develop understanding and skills that will make us better advocates for our clients, their families, and ourselves. ■