Reviewed by: Alysa Cummings
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: September 26, 2011
Series Editor:Judith Redwing Keyssar, RN
Publisher: CreateSpace, 2010
The book's subtitle eloquently captures the essence of this very special book: Lessons for the living from the bedsides of the dying.
Throughout Last Acts of Kindness, the author, "a self-defined death midwife" who refers to herself as Redwing, shares stories and lessons learned from over twenty-five years of nursing experience in oncology, critical care and hospice. She is currently the Director of the Palliative Care Program of Jewish Family and Children's Services of the San Francisco Bay Area. Redwing's artistic sensibilities – she is also an artist, poet and songwriter – are reflected throughout the text, effectively balancing and softening the clinical aspects of the book.
Last Acts of Kindness is truly patient-centered, driven by twenty-seven stories of Redwing's former patients - individuals dying either in hospitals, assisted living facilities or in their own homes. The author invites the reader – whether you are a hospice volunteer, nursing student or healthcare professional - to analyze each case study. Here's a sampling of the questions the author poses:
Redwing presents dying as a sacred series of moments that we are honored to witness. "each one unique in its form," she writes, "enriching in its lessons, poignant in its depth."
She goes on to explain:
Death is not a medical event. It is indeed a spiritual experience. So often in hospitals, there are loud noises, machines, and constantly ringing alarms. Visitors feel separated from loved ones by bedrails and IV lines and often feel too intimidated by the aura of authority to unlatch the rail and simply sit on the bed or touch the person who is lying there.
The reader can't help but be deeply moved as Redwing shares her patients' stories of leaving this world. Clearly, the author's purpose is to educate and enlighten us all, professional and caregiver alike. Despite our culture's overall discomfort with the topic, death is a subject that is an integral part of being human. She wishes that our society could become as comfortable with the rituals associated with the end of life as we are with the birth of new life.
Every human is unique, and the stories of our deaths are as individual and poignant as the stories of our births and of our lives.
Scattered among the case studies are comments from the author; lessons learned, insights, tips, issues that she has confronted in her years of assisting dying patients and their families. One such comment speaks to the challenge of assisting a 94 year old patient with heart disease:
Western medicine has a myriad of protocols for blocked hearts, but they don't always work, especially in the frail elderly. When there is nothing more we can do to heal the heart, the greatest healing we can offer is our compassion and honesty. As healthcare professionals, we must let go of our fears of failing and our inability to fix everything, in order to be present for a patient's last conscious moments. Perhaps in this way, we do actually return the flow of energy to a blocked heart so that it can stop in peace.
Instructive. Poetic. Inspirational. Last Acts of Kindness belongs on the bookshelves of nurses, social workers and volunteers working in palliative, hospice and end of life care situations.