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Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

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Five years after its first publication, with more than 150,000 copies in print, Final Gifts has become a classic. In this moving and compassionate book, hospice nurses Maggie Callanan and Patricia Kelley share their intimate experiences with patients at the end of life, drawn from more than twenty years experience tending the terminally ill.

Through their stories we come to appreciate the near-miraculous ways in which the dying communicate their needs, reveal their feelings, and even choreograph their own final moments; we also discover the gifts—of wisdom, faith, and love—that the dying leave for the living to share.

Filled with practical advice on responding to the requests of the dying and helping them prepare emotionally and spiritually for death, Final Gifts shows how we can help the dying person live fully to the very end.

239 pages, Paperback

First published January 1, 1992

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Maggie Callanan

6 books14 followers

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Displaying 1 - 30 of 569 reviews
Profile Image for C. Janelle.
1,438 reviews37 followers
March 8, 2013
Back when I was a doula, I had this thought that working with women through the birthing process must be similar to working in hospice with people who were dying. I didn't share this thought with many people. In general, I would try not to mention death to pregnant women, and I worried that anyone not involved in doula work might think I was just weird. But to me---next to being born, which for most of us is stored only in our implicit memory and therefore inaccessible with our conscious methods of "remembering"---giving birth was the closest one could get to the process of dying without actually dying. I kept this notion largely to myself and quietly kept my eyes out for people who'd worked with both laboring women and dying people to either confirm or disprove this idea, all the while wondering if I dared try doula-ing to the dying and finding out for myself.

And then I started this book and read in the third chapter:

"As nurses who care for the dying, we see ourselves as the counterparts of birthing coaches or midwives, who assist in bringing life from the womb into the world. At the other end of life, we help to ease the transition from life through death to whatever exists beyond."

The authors go on to draw parallels between the medicalization of birth and the medicalization of death, in which both natural processes were moved out of the sphere of home and family and into the closed-off corridors of medical facilities. Birth and death became events cloaked in secrecy and silence rather than transitions to be experienced surrounded by those who love us. Thankfully, this trend seems to be shifting.

Mostly the book is made up of brief accounts of the last moments of dozens of individuals. I read these with the emotion and enthusiasm with which I used to read birth stories in the days before I'd ever attended a birth or given birth myself. I read them hungrily, with the sense that there is a hidden truth in them and that I need only see these stories from the proper angle for this truth to be revealed.

The authors point out the similarities between different stories, and encourage the reader to find significance in these similarities. They give suggestions for maintaining the awareness and open-mindedness necessary to receive the often cryptic or confusing messages that dying people sometimes try to convey. They encourage the reader to remember that the dying person is still a person---an individual going through a momentous transition and experiencing a wide range of emotions and sensations that we can only guess at. The authors encourage compassion and connection, and they talk with reverence about the honor of being a part of these families' lives, if only for a short time.

This is all so very similar to how I feel about being with a woman in labor. Probably in part because it was so familiar, the insights from these stories helped ease some of my fears about my own inevitable death. They helped me to see the beauty in the transition and the many gifts that the dying have to offer us, and it reminded me that emotional pain isn't always bad, isn't always something to avoid. The message I got from this book is that there is tremendous power and grace in opening ourselves to the emotional pain that accompanies death. It is a beautiful, powerful book, and I would recommend it to everyone. (My only caveat: I would caution against reading it sitting in the back of the library story room while your children are in Story Time. People seem to feel a little uncomfortable when a woman is choking back sobs while children sing "Head, Shoulders, Knees, and Toes".)
Profile Image for Nikki ღ Navareus.
928 reviews426 followers
July 27, 2016
I've never read anything like this before. This is an amazing book, that would be a fantastic gift to give people who have a family member dying. It's very educational, from the hospice aspect, of what to expect and how to help your loved one through their fears and stress at they approach their end of life. This book also has important information to help the supporting family member reading this book, to help them through their fears and loss of words to say to their dying family member. This book is worth its weight in gold.
Profile Image for Roxanne.
21 reviews
July 27, 2007
This book is for everyone... We all know someone who is dying, has died or is related to someone with cancer or a terminal disease. It is written by a pair of Hospice nurses who documented cases of patients and families of those in the final stages of death.

The 'Final Gifts' of the dying are very often missed or refused by the living for fear of looking greedy or uncaring. I learned that the dying know they are dying and we need to respect their wishes. They may want to give you a precious item of theirs and the usual reaction is to refuse or tell them they'll be needing or wanting it later. What you should do is accept the gift. That gives the loved one pleasure and peace, knowing their wishes are being fullfilled.

I have a dear friend who's brother was dying of a very aggressive form of cancer. The dying man wanted to take his lady-friend, his brother and sister-in-law (my friends) to Disney World and pay for everything. My friend didn't want to go for a few reasons. He thought it was too much for his sick brother to travel and he wouldn't hear of him paying for the whole trip. He said he would pay for himself and his wife if they decided to go. I had recently read the book and told him he should let his brother pay for everything and go! I explained that it was his brothers Final Gift to him.

Eventually, he agreed to go. The trip was very difficult and the two brothers spent the entire trip in the hotel room while the women went to the parks. Within weeks after returning the brother passed away.

The other day we were talking with our friends and the topic came up. My friend once again thanked me for getting him to go on that trip. It was the last chance he got to spend real quality time with his brother before he passed away. And he now recognizes the value of HIS Final Gift to his late brother.
Profile Image for Laurie Zagurski.
11 reviews1 follower
January 10, 2012
I have purchased and given away SO many copies of this book! When my own mom was in Hospice House, the nurses recommended this book to all of us girls (me and my 3 sisters). When people have terminal illnesses they often share experiences and the people they see as they make their journey to the next life.

Unfortunately, many friends and family members will write-off these experiences to "the meds" or "their illness." This book helps you open your eyes and heart to these "FINAL GIFTS" that the dying give to you when they share these experiences.

After reading this book, we were very open-minded. My mom began to share beautiful things with us. I used to be afraid of death - not any more. I know one day my mom will come back to help me with my transition.

If you ever want to ask me, I will GLADLY share some stories with you. Thank God for this book. It's a great book for anyone who has a friend or family member dealing with a terminal illness. A must read for them BEFORE their loved one reaches those final days.
16 reviews6 followers
September 24, 2013
I am a volunteer in a program at MetroHealth System in Cleveland, OH, USA called No One Dies Alone. I read this book as part of the orientation and training we receive prior to caring for patients.

The authors, experienced hospice nurses, speak to the many ways that people can be present to the dying (and their loved ones), and in so doing help the dying find peace in their final days and hours. They discuss the many issues that dying people often want to resolve or communicate, and how the dying often do so in non-obvious ways. They also demonstrate, through their stories, how to communicate with the dying in a generous but direct way as they approach death.

The first several chapters are a brief exploration of the theory that forms the foundation of the practice they have developed over the years they have worked with the dying and their families. They speak to the Nearing Death Awareness that the dying develop, and how family and friends can spot the manifestations of that awareness and serve as guides and allies to the dying.

The rest of the book is mostly stories of patients they have cared for. The authors use stories both to illustrate dying as the conclusion to life and to reinforce the practices that anyone can use to accompany the dying through their final days, hours, and moments.

There is a deep beauty in this book. It caught me by surprise. I was expecting to be somewhat depressed by so many stories of death. And while it is true that I felt great sadness and shed many tears while reading the book, every time I finished a story, I was uplifted by the gift of kindness, compassion, and love that the people close to the dying person were able to find in themselves even as they experienced the sadness and stress of losing someone they love, and to see that kindness, compassion, and love reciprocated.

In the end, at least for me, the book is as much about living as it is about dying. (The authors make the point that many of the urgencies that the dying feel - achieving reconciliation, for example - can be addressed while we are still healthy and very much alive.) It is a soul touching and a soul stretching book, quite worthy of your time.

Profile Image for Carolyn Johnson.
6 reviews1 follower
May 13, 2007
I was given this book to read several years ago when my father-in-law was dying. I mean, right at the very moments of his dying. I sat in the living room of the house in which he died, and read several parts of the book, and became too overcome with emotion to finish it. And, of course I was not in a place or emotional space to take in the information. I later purchased a copy of this book and read it. Incredible. The last moments of any human life are indeed someone's Final Gifts's to us, and by being present, it is our way to return these gifts. Not everyone can or will want to do this, but even if you want to make the last of the time you spend with someone you know is very ill, this book is good preparation. I believe it helped me very much, and will continue to as I lose cherished loved ones, or if I find I need a way to prepare them if my time should come.
Profile Image for Leigh.
1,284 reviews22 followers
July 19, 2013
Basically, the goal of this book is to teach families and caregivers how to respond to the needs of the dying, so that everybody gets peace and closure. The book tells many stories of individuals and how they coped with the loss of loved ones. However, most of the families were upper middle class. There were numerous mentions of private round the clock nurses, and almost all the patients were well educated, and had supportive families to help them. Additionally, all the deaths were calm, peaceful and painless. I've heard that death usually is a benevolent angel, not a phantom full of dread (to quote Lousia May Alcott) but I would have liked a greater spectrum of experiences. Not every patient is an international diplomat, retired colonel or honor roll college student. And some deaths are painful and messy. Readers should be told of those as well. But I think the goal of the book was to help readers feel more at ease about dying and death and this book could be useful for those who need reassurance.
Profile Image for Andrea Uhde Shepherd.
52 reviews5 followers
October 7, 2011
I realize...this is weird.

I read a book about dying.

I'd been trying to avoid it - my mom loaned it to me a year ago, after my dad died. I was scared of it. BUT MAN, this book was actually really uplifting. It's amazing the things I saw my dad do in his final weeks - talking about "going home" and grabbing his luggage bag, and talking about seeing St. Peter and his parents, who have died - how this is something many, many dying people do - no matter their age, culture, disease, medications, etc. It gave me an enormous piece to hear that no matter the religion, many people see a "Supreme being" and angels or people who have passed away when they're nearing death, and they have peace. It isn't a Christian book, but my word did this strengthen my faith.

I highly recommend this book. And yes, I realize most won't read it, but it's darn good.
Profile Image for Lori.
294 reviews62 followers
October 5, 2013
This book is, quite simply, the most helpful thing I have read this year as I continue to cope with my parents' declining health. It is just uplifting enough to make me fear the entire concept of death less. It is just reality based enough for me to buy into the content. The authors are hospice nurses who have witnessed more death than the average person. Throughout their years working in close proximity with dying patients, Callahan and Kelley began to take notice of certain patterns of behaviour and need. Final Gifts is the result of their direct observation of hundreds of people experiencing the end of life.

I am not religious in any organized sense and derive little comfort in the standard methods used to console the grieving. However I am open minded enough to believe that there is more than what we experience in the here and now. Perhaps this is why Final Gifts touched me and gave me such hope. Individuals from all walks of life...religious and non religious...are all described as finding comfort and peace as they died. Most reached out to others whom the survivors and the medical team could not 'see'. The patients appeared to be reconciled with loved ones who had died before them. They were described as being happy and ready to go.

We have no idea if these visions and peaceful feelings are based in our neurology or based in something more. But, personally, I don't think it matters. If the experience feels intensely real to the dying individual and it is their final experience...then it becomes 'real'.

Final Gifts made me believe that I have the power to help my loved ones achieve a more gentle and peaceful death. I cannot prevent them from leaving me. But I can respond in ways that will help ease and comfort them. And stories like the ones presented in this book give me hope that my own passing can also be natural and free of fear.

It makes me even more angry and distraught to contemplate our violent society. It appears that death can be a beautiful transition if the individual is being nurtured...if pain is being managed...if family and friends are at the bedside...and if there has been sufficient time for the dying person to put affairs in order. Although these stories offered me much solace, they also made me feel anger on behalf of all the people who die alone and in pain. Or whose lives are taken suddenly and violently.

Apparently there is really such a thing as a 'good death'. Just like a 'good life', half of it is based on circumstance. For those of us who will have time to say goodbye to our loved ones and who will be cared for at the end by compassionate people such as the authors of this book, a 'good death' is within our reach.

Profile Image for Beverly Diehl.
Author 5 books69 followers
May 16, 2023
One of the most frustrating things about being with a person who's dying is a sense of helplessness combined with ignorance. What is the person feeling, what does he WANT, are some of the things he says delusional or do they have a greater meaning?

This book helps answer many of those questions, and gives clear examples of these things. If you will be spending time with a person who is nearing death, I highly recommend this book. And for all that many people find death depressing, I have to say I found this book both comforting and extremely uplifting.
Profile Image for Ashley.
26 reviews
July 30, 2017
My husband recently passed away from Melanoma. Before he passed, one of my family friends gave me this book explaining it would help me better understand what my husband was experiencing and what he was trying to communicate. As his primary caregiver, this book was a God send (this is not an understatement). When he would exhibit some of the Near Death Awareness types of communication such as picking at the sheets, reaching for no one, talking about needing to leave or go, I would know what questions to ask him or know how to respond. Not only do I think this book helped me but I think it helped my husband too. Since I had a better understanding of what he was asking for, some of the frustration he may have felt had I not read the book were eliminated. I highly recommend this book to anyone caring for a terminally ill loved one.
Profile Image for Rebecca.
2,569 reviews125 followers
May 3, 2019
Since I’m approaching the one year anniversary of my mom’s death, I’m finally feeling ready to read this book, which was recommended by a close friend who also lost her mother. Am I really ready? We shall see ...

Final Gifts was written by experienced hospice nurses in 1992 so it is a bit dated but, in my opinion, the majority of the information remains timeless, extremely relevant, and helpful. The stories shared by these caring nurses were so interesting and focused on Nearing Death Awareness, which is "a special knowledge about--and sometimes a control over--the process of dying. [It] reveals what dying is like, and what is needed in order to die peacefully; it develops in those who are dying slowly."

Reading this book strengthened my own beliefs about my mom's death. First of all, she told me that "someone" told her she only had 3 more days to live (and that "someone" was eerily correct). Secondly, she asked for my permission to stop fighting and to let go. Saying yes was the hardest thing I've ever done in my life, but I knew it was best for her and that she deserved peace after being in pain for so long. Lastly, I believe she chose when to die. When all of this was happening, I felt confused and wanted to know who the heck would have told her she only had 3 days to live. After reading this book, however, I've come to understand that what I had guessed to be true probably was. Many dying people can predict their own death and even choose when to die. After being admitted to hospice, my mom died within just 32 hours, which didn't give my brother and I enough time to visit from out of state. We had, however, visited just a couple weeks earlier, exchanging meaningful conversation both in person and on the phone during the time in between. I now believe she did indeed choose to die alone to spare us the pain of being there. Lastly, by not lingering, she died more than a week before my birthday and more than 2 weeks before her grandsons' birthday. After reading this book, I am more convinced than ever that she chose to die alone and on a particular date as far from our birthdays as possible.

Although this book was very sad (I read most of it with tears streaming down my face), it was also reassuring, comforting, and even hopeful. So, while I can't say that I was totally "ready" to read it, I'm glad I finally did as it provided me with some peace knowing my mom did all she could to shield us from her death (proving her immense strength yet again). Love and miss you forever, mom.

For more information on this topic, the authors recommended On Death and Dying by Dr. Elisabeth Kubler-Ross and Life After Life by Dr. Raymond Moody.
Profile Image for Liz.
3 reviews
January 2, 2020
My father passed away in 2002 he said some things during the last moments of his life that I didn’t understand. I learned later about what the dying go through and understood what my father was saying at the end of life.
My mother passed away recently, her passing was different from my fathers. My mother died slowly. The verbal and non verbal signs she gave at the end were a bit confusing but I had some experience from watching my father pass. I wanted to understand from the hospice perspective and this book helped me learn what she was going through and what she was communicating.
This book is a good book for those who know someone in hospice and want to understand deeply what their love one is trying to say. I also recommend this to someone who may be tortured by not understanding some of the last verbal and non verbal communication of someone who has passed on. If you need some closure or want to learn more about the communication of the dying, you will feel peace reading this book.
Profile Image for Jennifer.
475 reviews4 followers
April 22, 2021
A close friend loaned me this book as I was helping to care for a friend with cancer. It was well done and thought provoking. I liked the examples these two hospice nurses gave of how those near death often communicate. I recommend it to anyone caring for someone with a long term illness.
Profile Image for Sherry.
633 reviews63 followers
November 1, 2021
This walks through the process of dying for the terminally ill, each chapter dealing with a different aspect that will be faced and what support may be needed. This was Immensely helpful while coping with the recent death of my mother. I found it helped shift the fear I felt for my mother as well as the fear about death. Highly recommend this beautiful, enormously helpful book.
Profile Image for Peg.
299 reviews
December 10, 2022
Superb explanation, with examples, of the Nearing Death Awareness -- what the dying experience and what they need for a peaceful death and how they may communicate that. I really liked the stories that exemplified the points being made. I wish I had known this information when I was present with my Mom at her death, and with my husband at his.
Profile Image for Josie.
423 reviews4 followers
May 28, 2011
If you're looking for a book with pat page-and-a-half stories of people making their peace and then joyfully passing on, this is the book for you. "I hadn't talked to my daughter in 20 years, but those last two weeks we grew closer than we ever had before. Fin."
Any story in this book that presented a modicum of complexity is glossed over or truncated. There is nothing in here that speaks to people who die angry, or without resolving their issues. There's nothing in here that deals with the complex emotions of the survivors (guilt, anger, betrayal, depression). Two or three stories was enough for me to understand how "beautiful death can be". I didn't need a whole book making death sound like a great gift for all...
29 reviews
September 14, 2016
What an amazing book! I was speechless and had to stop to intellectually and emotionally process the material presented several times during the book. This book is a compassionate and clear rendition of a difficult topic, a serious challenge to the heart and mind, and a must read for anyone with ill or aging family or friends -- at any time during life.

Actually, the book is for everyone.....as we will *ALL" be a "final gift" one day.

Profile Image for Katrine Austin.
387 reviews14 followers
February 24, 2018
Powerful and poignant

If you struggle with how a loved one passed away or if you simply want more insight into the sometimes strange and beautiful conversations had with the moribund, you will get a lot out of this book. This read was recommended to me by my partner's therapist after he died. Have tissues with you at all times.
Profile Image for Cindi.
86 reviews3 followers
May 4, 2015
Accurate and excellent information on understanding those who are in the dying process. It is a process and one that if we are educated on, can turn the experience into a more rewarding & beneficial journey for those who are at end of life and those who care for them.
Profile Image for Swanbender2001.
1,391 reviews10 followers
May 19, 2018
This was an insightful, sad, educational and heartwarming book as I begin my journey as a hospice volunteer.
Profile Image for Reagan Crook .
22 reviews
February 16, 2023
This isn’t just a book on death. It’s a book on empathy and communication. How to listen to others and respect them, no matter what stage of life they���re in. How to be open and honest with people, instead of trying to shield or lie to protect them.

I have learned so much from this book, especially all the different ways people who are dying can convey different messages to us. I cried a lot from the dozens of heart-felt stories. And I’ve been forced to ask myself many introspective questions I had never asked before, the simplest of them being “am I afraid of death?”

Death isn’t something I had contemplated on a regular basis until the last year when several people I knew have died. None had the experience of a slow death (like this book talks about), but were taken suddenly and unexpectedly. However, I have learned priceless lessons from this book that have given me more confidence towards the seemingly unknown of death.

It was a wake up call when this book explained how as a society we have dehumanized the dying and treat many like they’re already dead. It’s heartbreaking to know many of them experience sub-par treatment as a result of that general bias. However, I am happy to know there are many amazing hospice programs out there that are beginning to change that. And I learned so much about all there is to be learned from those who are dying.

“We hope…we’ve helped you to see dying people as we do - not as mute unfortunates, but as teachers; not as shadowy figures, but beacons; not objects of pity and scorn, but individual people with the capacity to illuminate whatever exists beyond this life”
Profile Image for Connie.
111 reviews4 followers
January 26, 2023
The authors have the credibility of many years experience as palliative care nurses.

I found their explanation and description of the cryptic language of dying people that sometimes appears as death approaches important to know about. It’s something I’ve personally witnessed without understanding. The authors make a compelling case that family and medical staff need to pay close attention to important messages contained in the language of metaphor, rather than dismiss these attempts to communicate as incomprehensible, drug-induced raving.The nurses also cover the phenomena of visions of the dying that may too often be dismissed as meaningless hallucinations. There is such deep respect and compassion for people approaching death which I’ve seen in the best palliative care nurses. They have a lot to teach us.

The essential lesson I took away from this book is the need to be attentive, open-minded, and fully present to people nearing death and their experiences, hard as this can be.
Profile Image for Caroline.
Author 6 books43 followers
September 1, 2017
I found this fascinating. The stories of the ways the dying can communicate are kind of amazing (occasionally to the point that I doubted the authors a bit...but then again, they've had years of experience and have clearly heard it all). I also appreciated the stories about situations when they couldn't satisfactorily interpret the dying person's wishes, and how everyone coped with that. It has me inspired to listen all the more attentively as my mom declines.
Profile Image for Tiffany Walters.
39 reviews
April 19, 2020
Wish I had been able to read this a month earlier. A good & helpful read for anyone who has someone close to them near their end of days. I stood up to a Dr. and called his BS when he tried to say my dad needed to back off pain meds because he was seeing things that weren't there. Oh believe me, they WERE there.
Profile Image for Erica Wichtowski.
96 reviews1 follower
August 16, 2022
Very good book, written by a Hospice nurse, about her experiences with people dying. It’s shed a lot of light on listening to and paying attention to what the terminally ill are saying and doing and how to interpret that. It’s a book about helping the dying come to peace with their situation and how to “let go”. I recommend to any caretaker of a hospice patient.
11 reviews
May 9, 2023
My boss gave me this book to read as I'm now entering in the hospice portion of caring for my mom. I don't think everything related, and I still have a lot of questions about how my mom's passing is going to go but it does give me a way to think about things differently.
5 reviews
June 26, 2020
Excellent book to read to when you are dealing with a terminal loved one. Included are true stories written about patients that are dying of different illnesses. Helps so much with understanding how they may be feeling and how you can help them through with love and compassion.
Profile Image for Steven Hepp.
4 reviews
October 4, 2020
Overall a good message about Nearing Death Awareness, quite repetitive at some points, but all of the stories tug at your heartstrings.
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