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The Conversation: A Revolutionary Plan for End-of-Life Care
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The Conversation: A Revolutionary Plan for End-of-Life Care

4.18  ·  Rating Details ·  274 Ratings  ·  69 Reviews
There is an unspoken dark side of American medicine--keeping patients alive at any price. Two thirds of Americans die in healthcare institutions tethered to machines and tubes at bankrupting costs, even though research shows that most prefer to die at home in comfort, surrounded by loved ones.

Dr. Angelo E. Volandes believes that a life well lived deserves a good ending. Th
Hardcover, 240 pages
Published January 13th 2015 by Bloomsbury USA
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Jan 08, 2015 Jimmy rated it it was amazing
Shelves: non-fiction
I received this book as part of the Goodreads first reads program.

We all talk about living a good life, but what does it mean to have a good death? It's time we discussed this concept more than we do with those we love and with our political and religious leaders.

"Strive in regards to disease two things, to do good or not to do harm."--Hippocrates. A great quote, but does it sometimes promote more harm than good? Is not helping someone in pain to die doing them any good?

Fifty years ago people
Jessica Ye
Mar 11, 2016 Jessica Ye rated it really liked it
Whether you wish to pursue medicine in the future or prefer to remain on the other side of the stethoscope, Angelo Volandes provides very useful information on the reality of hospice care as the end of a patients life creeps near. Similarly to Atul Gawande in Being Mortal, Dr. Volandes' the main idea that was relayed was that quality precedes quantity in terms of creating an end-of-life plan for patients who can do so while they are still conscious and competent in making their own decisions.
David Quinn
Jul 21, 2016 David Quinn rated it really liked it  ·  review of another edition
This book, or something similar (perhaps Being Mortal by Atul Gawande), should be on everyone's must-read list. Better yet, everybody should actually read it and have a copy handy for future reference.

The author is a physician (a hospitalist) and he takes a very balanced and evenhanded approach in trying to convince the reader that everyone needs to think and clearly communicate about the type and level of medical care they wish to receive when they're not able to express their wishes on their o
Apr 15, 2015 Alona rated it it was amazing
I'm giving this book 5 stars because it's a really important idea that's beautifully presented. No one likes to think about dying but that's often at the cost of not contemplating how best to live before one dies. I cannot recommend that you read this book enough.

Full disclosure, I work at the publisher but if you've ever read anything by Atul Gawande, you should definitely read this book too.
Dec 19, 2014 Nancy rated it it was amazing
"The Conversation" is worthy of five stars. Written in an easy-to-digest format suitable for all, I finished it in three 1- to 2- hour sessions.

Few of us will avoid having to make end-of-life care decisions, either for ourselves or a loved one. Dr. Volandes uses rich anecdotes from his medical experience to personalize the options available to individuals and their loved ones. This humanization of the choices we have is invaluable. We are inundated by fictional media which overwhelmingly paints
Jun 10, 2015 Jane rated it it was amazing
I found this book fascinating. The idea centers around having a conversation with patients and family members regarding treatment and life sustaining interventions. According to the author many people have no idea what being critically ill or having a terminal disease looks like therefore they are unable to make informed decisions regarding their care. The author encourages education and discussion to help patients and families decide how the end of life will be. It is a conversation long ...more
Margie Dewind
Jan 01, 2016 Margie Dewind rated it liked it
Shelves: 2015
I think this book would be more useful for people who haven't read much about end-of-life planning. I have, so the book gave me little new knowledge, except for an interesting statistic about the number of people with terminal illnesses who, after being given graphic information about CPR, expressed that they did not want CPR for themselves.
Oct 21, 2016 Megan rated it liked it
3.5 stars

This book did a great job outlining the specifics of end-of-life care, including questions that should be asked and information about advanced directives/healthcare proxies. Everyone should start learning about these terms as well as common issues that come up at the end of life. While I already have knowledge of these topics, I was not aware of the videos being used to supplement the difficult conversations that physicians should be having with their patients. I think these videos are
Oct 18, 2016 Julie rated it it was amazing
Required reading!
Karen Germain
Feb 16, 2015 Karen Germain rated it really liked it
A few weeks ago, I read an article regarding Doctor Angelo Volandes's book, The Conversation: A Revolutionary Plan for End-of Life Care and I bumped it to the top of my TBR pile.

PLOT - In his non-fiction book, Volandes explains how years of working with terminally ill patients, plus personal experience with his own father, have made him realize the need for patients to create an end-of-life plan for themselves, while they are still healthy and competent to make their wishes known. Volandes noti
Richard Jespers
Apr 07, 2016 Richard Jespers rated it really liked it
Medical Doctor Volandes offers a plan for terminal patients to share with their family members and loved ones concerning how and when their lives should end. He informs the reader that “only 24 percent of Americans older than sixty-five die at home; 63 percent die in hospitals or nursing homes, sometimes tethered to machines, and often in pain” (3). He blames the medical profession—doctors like him— for their failure “to have discussions with patients about how to live life’s final chapter” (3). ...more
Dec 16, 2014 Jen rated it it was amazing
Shelves: first-reads
I received an ARC of The Conversation via a GoodReads giveaway.

I didn't know what to expect from this book, but it was a great read. I had halfway expected a dry, clinical book that I'd put down halfway through. As it turned out, I read the entire thing in just a few sittings. Dr. Volandes' writing is extremely accessible; there's minimal jargon and what jargon is there is fully explained (or used for effect).

Overall, the book reads like a memoir, with chapters that highlight the importance of
Jess Dollar
Sep 15, 2016 Jess Dollar rated it liked it
This is the only book my library has on managing the health care system at the end of life. It's a good starting point for family members and patients to begin understanding the options and how to talk about these difficult issues.
I would recommend this book but also suggest Being Mortal, which is both informative about end of life issues and beautifully written .
William Nist
Mar 27, 2015 William Nist rated it really liked it
Shelves: medical
This book is a simple plea from a physician for everyone to have THE CONVERSATION before it is necessary to decide if you are going to have interventional care (CPR, Breathing tubes and/or feeding tubes). Through his own case studies, including his own family, the doctor makes a powerful case that this should be done in every hospital, nursing home, and doctors office in America. The options are full code intervention, Palliative Care, or something in between.

He has even made a video outlining
Apr 06, 2015 K. rated it it was amazing
Volandes is a physician and researcher (who did an undergrad degree in philosophy). Based on his clinical experience, Volandes observes that people don't have serious conversations with their family members or their physicians about end-of-life care. Often people lose the ability to communicate their wishes when they become terminally ill.

Each chapter of his book centers on a case study--a narrative about a person with a serious illness who is facing death. Do the ill want to have invasive proc
Jun 20, 2015 David rated it really liked it
very good, convincing description of why and how to make known to family and care providers how you'd like to be treated near end of life, on continuum from "full code" [do whatever it takes; don't let me die a second sooner than I otherwise might] to "comfort care".

He pretty clearly favors comfort care in wide range of situations but empathizes with those who have thought it over, considered their options, and choose differently, in part based on his own experience of being kind of taken aback
Jan 13, 2016 Karen rated it really liked it
Good advice in this book, along with some useful information - for example, about what it is realistic to expect from things like CPR performed by the medical team on a frail, elderly ICU patient.

I do admit to some disappointment when I opened the video he linked to and it was just a video of him talking. One of his key recommendations is that medical professionals should show people videos of the life-extending but quality-of-life-degrading medical procedures about which they have a choice (lik
Andrea Larson
Feb 24, 2015 Andrea Larson rated it really liked it
Shelves: non-fiction
This is a thought-provoking book on a topic none of us wants to think about: how to manage end-of-life care. “The Conversation” refers to that tough talk we should all have with our loved ones about how we want to spend our last days or weeks. Through a series of vignettes from his own experience with patients, Dr. Volandes illuminates just how invasive and brutal life-prolonging treatments can be, sometimes without much benefit to the patients or their families. Yes, it’s possible to extend ...more
Kel Munger
Dec 08, 2015 Kel Munger rated it it was amazing  ·  review of another edition
Prepared to go

The Conversation: A Revolutionary Plan for End-of-Life Care by Angelo Volandes (Bloomsbury USA, $26).

Angelo Volandes, a Harvard University medical researcher and the founder of Advance Care Planning Decisions, offers a rational and compassionate antidote to fear mongering about “death panels” and the almost-universal reluctance to discuss end-of-life issues. In The Conversation: A Revolutionary Plan for End-of-Life Care, Volandes busts myths and offers sound advice about how to dec
Georgia Herod
Apr 03, 2015 Georgia Herod rated it really liked it

Like Dr. Atul Gawande in Being Mortal, “Dr. Angelo E. Volandes believes that a life well lived deserves a good ending.” As a result, The Conversation extends and complements Gawande. Both are proponents of having conversations about end-of-life issues before decisions must be made, thus eliminating great anguish, frustration, and guilt for those who are caregivers. Volandes and Gawande agree that the medical community is all about prolonging life at any cost, and generally speaking medical pers
Apr 11, 2015 Jules rated it really liked it
Must read book, including for new doctors. Here is one excerpt I found fascinating. As much as we like to think the probability of success using CPR is high (in TV shows, it is around 75% successful), studies have shown a vastly different result. "In one study published in 2009 in the journal Supportive Care in Cancer, sixty-one patients with terminal advanced cancer and who had cardiac arrest underwent resuscitation. Of the sixty-one patients who had CPR, only ten patients (11%) were ...more
Joanne Mcleod
Jan 30, 2015 Joanne Mcleod rated it it was amazing
An important read for all of us who face our mortality, medical professional and layperson. I feel much more prepared to sit down with patients and family and have "The Conversation"! This quote by Dr. Volandes summarizes what the knowledge provided in this book is hoping to avoid: "Yet when it comes to talking with patients about end-of-life care, doctors rarely acknowledge the skill and practice needed to perform one of the hardest 'procedures' of all: having The Conversation with patients and ...more
Jan 15, 2016 Laura rated it it was amazing  ·  review of another edition
Excellent book. All healthcare workers who work with aging patients, chronically ill patients and especially patients approaching end of life should read this to prepare them to advocate for their patients and their family to have the conversation that clarifies what the patients consider a good end of life process. Too many people are having uncomfortable procedures done to prolong their life when they might be happier with a better quality of life even if it is somewhat shorter.

I am very inter
May 24, 2015 Nell rated it really liked it
Recommends it for: anyone who expects to die
I read this while in the library hold queue for Being Mortal, which both of my discussion groups plan to read, so I don't know how the two books will compare. Volandes lays out what really can happen, as opposed to what one sees on TV, when patients opt for all available measures at the end of life. For example, I didn't know that broken ribs are a common consequence of what the medical profession calls a "code." Yet he is not judgmental about anyone's choice, just persuasive that everyone shoul ...more
Aug 07, 2015 Cindy rated it it was amazing
I don't usually post my goodreads reviews on facebook but I think this book is really important and I want as many of my friends as possible to see this.

Dr. Volandes started working on this book as he realized that too many doctors weren't having important conversations about end of life decisions with their patients (even patients in end stage cancer) and that the medical default included procedures that were potentially traumatic, expensive, and generally didn't offer more quality time.

The bo
Apr 03, 2015 Janit rated it it was amazing
This is a must read by everyone over 50. And I think it is wise for younger people to read it as well. Volandes shows how important it is for us to communicate with our families and our medical team about how we wish to be treated as patients when we can no longer speak for ourselves. He uses terrific real life examples of patients with whom he has worked and pulls no punches as to how we need to take charge of our end of life care. This is a terrific book for families to read and start the ...more
Mar 04, 2015 Randy rated it it was amazing
This is an important, well written book concerning end-of-life care. Dr. Volandes presents a plan to implement so that you and your relatives can receive the kind of care you desire, at the end of your life. It is a difficult subject, but one that we must all deal with. You will feel more comfortable with it, and be more informed, if you read this book. It is very interesting and does not take long to read. Do this for yourself and your family!

And thank you Dr. Volandes for getting this book out
Apr 28, 2015 Alice rated it really liked it
Everyone, young or old, should read this book. I am on a kick recently of reading about end-of-life issues, partly because my father recently died and my mother is 91 in assisted living. I started with Nuland's HOW WE DIE, then read BEING MORTAL by Atul Gawande, then this book, then Dr. Byock's THE BEST CARE POSSIBLE. It's important to think about these issues and have a health care directive for yourself and loved ones in places B E F O R E you need it. I may sound preachy, but read any of ...more
I dont really want to say that I 'enjoyed' reading this book, but I believe that this is a book that EVERYONE should read. With the advent of, and continual improvement of medical technologies, people are living longer with more instances of chronic illnesses, which increases the urgency to start The Conversation with the help of the guidelines that Dr. Volante describes in this book. Although this book is a bit repetitive, I believe that this book is definitely a great way to get The ...more
Jul 13, 2016 Lynn rated it really liked it
This is a very helpful guide to help people face up to one of my main concerns as a pastor, which is that modern medicine has the power to do things to you that won't help you and that you may not want to have done. Dr. Volandes leas us through his own evolution of thoughts regarding such care and provides several good guidelines to help people have conversations about their end-of-life wishes with themselves, their doctors and their families. i recommend the book, but also that you have "the ...more
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“We see cancer patients battling death as valiant, and we think that if they try hard enough, they’ll beat it. In truth, cancer is an equal-opportunity killer and is impervious to moral virtues and emotional strength. No amount of courage increases a patient’s likelihood of survival. For every courageous patient who survives, there is another courageous patient who does not. Of course you’d never know that from popular media, where patients wage battle against cancer and win, and where almost everyone survives CPR and looks remarkably good hooked up to a breathing machine.” 0 likes
“Disease may invade the bodies of patients, but the experience of illness devastates all those around them. Suffering demands that others bear witness, and family members are assigned front-row seats.” 0 likes
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