End-of-Life Books

Question: What is the difference between palliative care and hospice care?

Answer: Palliative care offers pain and symptom management for people at any time during an illness. Hospice care seeks to ease pain and suffering for terminally ill patients.

This explanation comes from the new book From the Start Consider the Finish: A Guide to Excellent End-of-Life Care. It's a collection of true stories and practical advice written by attorney Susan R. Dolan and her clinical psychologist mother, Audrey R. Vizzard. Both authors are also nurses and hospice volunteers. In 17 short easy-to-read chapters, they cover everything from Managing Pain and Funeral Plans to What It's Like to Die. One of my favorite chapters, the Pleasure Diet, advises that terminal patients be allowed to eat whatever they want. That's how one man who had stopped eating got his final wish: a tall, cold beer. Ten minutes later that man died with a smile on his face.

I found myself filled with admiration for Susan Dolan's extraordinary mentor, Divina, a smart, tough, funny, and compassionate hospice nurse. I also admired Mollie, the social worker who threw herself over the body of a dead hospice patient to prevent paramedics from performing CPR until the DNR--Do Not Resuscitate*--order was found under the kitchen table. (I recently learned that in some medical facilities, the term "DNR" is being replaced by "AND" -- Allow a Natural Death.)

"Doctors Are Human Too" was one of the saddest chapters for me. A usually decisive doctor stood at her father's hospital bed, agonizing over whether to remove his ventilator. When the author suggested hospice care, Dr. Lucie started to question all the times she had withheld hospice referrals from her patients, recommending instead one more aggressive treatment. Susan Dolan notes that many doctors "overestimate the length of time their patients have to live, thereby depriving them of the benefits of hospice" (79).

Dr. Lucie's father had neglected to complete an advanced directive or have a conversation about how he wanted to be treated if he was unable to make decisions for himself. Most people avoid talking about their own death or making any plans for it. The authors reiterate the importance not only of written documents but of ongoing conversations with loved ones about our final wishes. Even one family member left out of this conversation could prevent removing life-support machines and allowing a natural death.

This book is a many-faceted gem. For families who are considering hospice, it will show them what to expect. The explanation of what each member of a hospice team does, including volunteers, physicians, chaplains, music therapists, and grief counselors, is invaluable. So is Appendix II, a list of Questions to Ask When Choosing a Hospice. Highly recommended!

Nancy Manahan, Ph.D.
Author of Living Consciously, Dying Gracefully - A Journey with Cancer and Beyond(Beaver's Pond Press, 2007)

As a Christian, I know that I will be leaving this earth to live with my Heavenly Father forever. Before reading this book, I never gave a thought to any of the events that could lead up to that death. This book has changed my view on how I want my final days to be. It opened my eyes to the fact that I need to have conversations about this very subject with my family. Not only about my death, but their deaths also. I don't want anyone in my family making uniformed choices for me. As a family, we don't like to discuss death. It's usually done in whispers, as if just mentioning death will make something bad happen. This book is a breath of fresh air that takes away that looming dark cloud. It explains how Hospice can make death less painful, for everyone involved. It explains how we all need to have conversations about how we feel about life and death. It's all about talking to one another. Sharing our feelings. I loved the stories about real life people who experienced death through Hospice. I loved reading about the Hospice Staff. They are very special people. I believe that they are there because they feel a sense of fulfillment in what they do for others. They are definitely blessed people. I want them taking care of me when it's my time to go. How about you? This book is a must read.

As a former Hospice nurse, I simply could not put this book down. It so accurately portrayed the spirit and substance of Hospice as I experienced it. I couldn't wait for the next chapter to unfold. I especially enjoyed the descriptions of the roles of the varioous members of the team. Everyone thoughtfully contemplating end-of-life issues needs to read this. it will change your death!
Barbara FarrFrom the Start Consider the Finish: A Guide to Excellent End of Life Careell, R.N.

As an octogenarian with not his feet but his actuarial table on a slippery banana peel, "From the Start Consider the Finish" had ominous relevance. I don't know when I'll go, but the authors have convinced me that, for my sake and that of those who may be with me at the transition, a call to hospice will be in order. Half way through the book, the glowing anecdotes about hospice made me call my niece in California. She had enlisted the help of hospice on her mother's passing. She not only supported the authors, but added that they even coordinated the transport of my sister's remains to be interred in Pennsylvania.

Most of the chapters are anecdotal and they record experiences during patients' last days. The stories vary as widely as people are individuals. For some, death comes at the end of a prayer; for others at the end of an epithet. All the stories are real and most witnessed by one of the authors and told with empathy and reverence. The dedication of the authors to the hospice function and their sensitivity as practitioners to the differing needs of each dying patient, physical, emotional and spiritual, is evident. Their support is extended as well to the loved ones involved who may have various issues to resolve. ARV, as a nurse, also provides some background of how death was treated pre hospice.

The stories are well told and I became involved in several as I identified the characters with friends and relatives and could almost hear the conversations, declarations of love and shrill complaints. I found nurse Divina, a hospice veteran, to be almost a divining angel, able to understand and bring peace to the dying and the living.

In all, the functions of the several hospice team members and the skills they bring to those present are described in some detail. They often act to diminish tensions that exist or arise between patient and grievers or among grievers. They are often able to provide a projection of what to expect as the end comes.

One thread of continuity throughout the book is the need for and the value of communication (conversations). What eventualities to discuss while still healthy, measures to be taken preceding death, the disposition of the remains and all the services post mortem. The value of the DNR (Do Not Resuscitate) directive, its effect and its display is discussed.

While the anecdotes are a good read, a few chapters are rich in useful information:
Chapter four is a listing of the services available from hospice, with possible variations. E.g., care may be provided in the home, a hospital, long term care or other facilities; there are visits from the team, appropriate medications, equipment and supplies approved by hospice; you may use your physician or a hospice physician skilled in palliative care, etc.

Chapter six lists the team members and the talent each brings to the scene along with an anecdote for each to describe the performance of their function.

Chapter seventeen introduces something with which I was unfamiliar; the Ethical Will. It is essentially a remembrance to be passed on to the survivors: expressions of love, family history, prescriptions for living and stories untold.

A prequel provides a glimpse of SRD's parents, her father a professor, her mother a registered nurse and a psychologist. It also relates how SRD, a single mother, came to hospice, first as a volunteer while an attorney and finally full time.

Appendix I provides Home Site Web addresses and telephone numbers to contact the agencies.

Appendix II is a list of questions to ask when enlisting hospice care.

If you expect to die, I recommend this book to plan for and to anticipate the events leading to the occasion whenever it may happen.

I bought this book when it first came out in 1996. I have now just gotten around tor reading it (1999). I am bad about putting off things I suspect are going to be very good (Delayed gratification).

One of the great pioneers of not just running, but healthy living via serious play, George Sheehan, wrote a book that is the final work of his life. Subtitled, One Man's Journey To The End Of His Life," Sheehan has his eyes wide open, avoiding clinging to pure emotionalism and the could-of-should-of-would-of mentality, looking deep into his own felings and observations.

This book is not for everyone. It is for those that choose to face life and death with their eyes open -- willing to face themselves and what makes them tick.

Just as you cannot put a bandaid on cancer, George Sheehan doesn't try to cover up his humaness. He fully embraces what he was, what he is now, and acknowledges the similarity between the very young and the very old.

Unfortunately, this book will hard to find if you have an interest . . . Long overdue for a reprint.

G.R. Ford

This was the first running book I ever read, I am trying to read all of his books. But some are hard to come across. A touching story of a man and such a stong devotion of the meaning "life," god bless him.

While George Sheehan is best known for his expertise in running, he may be more accurately described as a philosopher than a runner. Going the Distance is a wonderful journey through a dying man's thoughts and reflections on dealing with the end of his life. Diagnosed with prostate cancer, Sheehan embarks upon a journey to battle the disease, and then come to terms with his own mortality when the battle is lost. As per his usual work, there is the obvious emphasis on running, but even the non-runner will enjoy this book. Not merely a book for "jocks", Sheehan once again displays his artful writing style and philisophical nature. A must read for the runner, walker and couch potato alike!

I would give this book 10 stars if I could. First, I should mention this is *not* a book about running any more than Moby-Dick is a book about whales. Rather, it is a discourse on how best to live one's life, written by someone near the end of his. I read this every year, and every year I'm amazed at how wise Dr. Sheehan was. Like Shakespeare or the Bible, it opens up to me the more I read it, and every time I learn something new, if only because I've changed and understand it better through experience. It helps me measure my own growth. I can't express what an influence it has been.

The Good Death provided me with information that everyone should know! If you have a loved one facing a trminal illness this is the book that you should read. I was especially grateful for the information about pain management, about what to expect, and to learn why we fail so often in this country to make people comfortable in their final days, how our "war on drugs" has tied the hands of doctors and resulted in dying patients being under medicated, often times grossly under medicated even hospices, and what you can do to insure that your loved on will not suffer.

You cannot walk away from this book without a new persepective on how modern issues have affected the death experience. Marilyn Webb not not only brings insight to the reader on how death affects the family and friends, but also the dying. She presents a breadth of knowledge on so many point of views without pushing one or the other, because she knows death is a personal experience.

"The Good Death" has been selected for listing in "Religion and Psychoactive Sacraments: An Entheogen Chrestomathy." http://www.csp.org/chrestomathy

Offering no soft, simple answers, this book gives a troubling look at many different views of dying in America. A necessary read for anyone interested in not just the spiritual side of dying, but the practical, political, difficult aspects of dying.

When I started reading books on dying (Final Gifts by Maggie Callanan, Patricia Kelley; The Grace in Dying by Kathleen Singh), I read books that gave me hope and comfort in dealing with my own mortality. This book made the hair on my neck rise up.

It begins by shattering illusions (the ones I'd built up) about having a pain-free, easy death. There are insurance companies, personal opinions, differing agendas of a variety of institutions that come into play.

In short, some people have an easier death than others. Webb writes in an easy to read, article style. She begins with a chapter called "Dying Easy", about the nearly beautiful, fairly comfortable death of Judith Hardin, who at 36 dies at home with her husband and children.

"Dying Hard," is based on Webb's personal interviews and experiences with the death of Peter Cicione. Cicione died a death more painful than it needed to be, largely due to medical staff's fears that this dying man was misusing morphine, might overdose or use so much medication that the drugs would no longer be effective (not true).

In "The Sorcerer's Apprenctice" and "When Death Becomes a Blessing," Webb focuses on the history of medical control of pain, the prolonging of life with new medical techniques and modern pain control through the works of Dr. Kathleen Foley, director of neurology pain service at Memorial Sloan-Kettering Cancer Center. Foley estimated that 5% of the patients she was seeing were "in unassuageable pain." Webb's conservative estimate offers that "109,500 people a year die with unrelieved suffering." Much of this is due to outdated information, old rules, and misunderstandings about how much medication a dying person in severe pain can and should get. She offers the possibility that terminally ill patients who want to commit suicide or look for assistance in dying might not do this, if their pain could be properly handled.

She has chapters about the legal conflicts for families who want comatose relatives off of life-support systems, with detailed information about Karen Quinlan and Nancy Cruzan's cases and the affects on their families long after these women died.

"Bearing the Burden" focuses on what happens to the lives of families with a terminally ill member - "The sad secret that many don't want to admit is that care at home, wonderful as it can be in helping a patient to a good death, is hard on families. Home care may allow for those close, intimate, late-night times with the dying family member...but there are also the difficult times: changing diapers, losing sleep or feeling intense anxiety because the patient is in pain or can't breath..."

This first half of the book is tough reading, but necessary - for there is still a lot of work to be done to make dying easier. The second half of the book deals with hospice; assisted dying (suicides); spirituality in dying.

She closes with 10 common factors 'good deaths' have - 1) open, ongoing communication with doctors, patients, families 2) preservation of the patient's decision-making powers for as long as possible 3) sophisticated pain control 4) limits on excessive treatment (medical interventions, per the patient) 5) focus on preserving the patient's quality of life 6) emotional support 7) financial support 8) family support 9) spiritual support 10) patient isn't abandoned by the medical staff even when curative treatment is no longer required.

She also has 10 changes, which she believes need to be made to change the culture of dying from a cold, hospital-set detachment to a family affair. These encompass everything from expanding health insurance to cover needs currently not met, to legalization of assisted suicide.

If you have given little thought to some of the darker sides of dying, focusing as I have on the spiritual and more uplifting side, this book offers a lot of food for thought. Well-written, easy to read, disturbing.

Even if you have different opinions than Webb has (about assisted suicide, for example), this book is a good read to investigate the other side's information and arguments.

The rapture has happened. Judd, Vicky, Lionel & Ryan are left behind. These 4 CDs are based on the 1st 4 books of the series as Judd, Vicky, Lionel & Ryan band together dealing with: being left behind; becoming Christians; getting used to each other; & the consequences of the rapture that start happening in the world.
The CDs are dramatised and really make the stories come to life. Highly recommend, particularly if you are a fan of the left behind series. You'll want to listen to them over and over again!

I am really enjoying the Left Behind: The Kids Live-Action audio series. Well-acted and every episode has captured my attention. As an adult, one of the reasons which drew me to the audio series is because LaHaye and Jenkins intertwines the Left Behind universe and its characters together, so if you are reading or listening to the audio series of Left Behind, I highly recommend listening to the Left Behind: The Kids for a little bit more in-depth coverage of recurring characters.

In this first volume is the introduction of the four individuals. Judd, who was on the plane which Rayford was piloting when the disappearances occured. Vicki, a goth teen who makes fun of people of religion (her parents are religous), Lionel, who's mother works with Buck and Ryan, who was best friends of Rayford's son.

Their families are gone because they didn't believe and now they are left behind. The focus of this first volume is how the four getting to know each other, learning to live with each other and get along with each other as well as help one another with the help of Pastor Bruce Barnes.

The first volume focus on how the four came to be believers of Christ.

As an adult and fan of the "Left Behind" series, I find it awesome how much this series is intwined with the LB series and you get to know more about the supporting characters of LB through "LB:The Kids". Highly recommended for children and adults!

Each collection is excellent. The sound effecs and acting really bring the books to life. We have listened to all 3 editions (12 cd's in all) and can not wait to hear the fourth.
The adults in our family have read adn listened to the adult series and even we are enjoying the childrens. Age appropriate for any child in the family. A wonderful tool for opeing up discussions about God, Christ, love, Death, life, characeter and much more.

What a great gift for teens. The actors are great, sound effects are well done and the music is absolutely terrific! What a great evangelism tool.

I recently purchased this wonderful book. It was so touching and meaningful, that I ordered one for each of my friends. It speaks to all women and all girlfriends about relationship, friendship, and loss. Each of my girlfriends so enjoyed the book, that they are sending one copy to each of their friends. The presentation of the book is simple, clever, and unpretentious. It is a keeper book that needs to be read more than once.Life Begins and Ends with Girlfriends

As a certified social worker, I am always interested in new books on relationships. This book hits the mark! Very insightful thoughts on the dynamics of friendhips and and how these relationships can have a lasting impact, on all aspects of one's life. The way the author's weave their own experiences into the book gives the book a personal touch that makes it interesting and enjoyable to read. Good friends are someting to be treasured and after reading this book one has a clearer understanding of why it is so imporatnt to celebrate the gift of girlfreinds whether you are 6 or 66 or older!!

A very interesting and informative treatise on friendships of all kinds.

A definite must read!

Charles W. Cheek, MD

Judy Van Ginkel and Betsy Newman have put into words what every girlfriend has thought or experienced at sometime. Thank you, ladies, for reminding us how special and needed women friends are in our lives.

For those protesters out there, this is a series of NOVELS. Sure, like many NOVELS, they're based on something else, in this case the last book of the Bible. Read them as novels and stop whining.

The story is riveting. I had seen the two movies first, so found the first book, LEFT BEHIND - the adult version, long and drawn out. Thus, the 4 rating. I probably won't buy any more of the books. I did, however, send the first copy of the Kids' version, TAKEN, to my grandtwins for their birthday. [Don't know how they got away with using the name, TAKEN, as there's already a TV mini-series with that name, available here on Amazon.]

IDIOT YOU WERE NOT FORCED TO READ THE BOOKS, THESE BOOKS DO NOT FORCE THESE BELIEFS ON ANYONE, YOU HAD A CHOICE TO BUY IT OR NOT, CHECK IT OUT OF THE LIBRARY OR NOT,YOU GOT IT SOMEWHERE, I DONT CARE WHERE ALL I KNOW IS YOU MADE THE CHOICE TO READ IT. SO DON'T TRY TO SAY IT WAS FORCED ON ANYONE. DONT FORCE YOUR BELIEFS ON ME!!

Christian books are not my usual genre, but one day i picked up the first book in the Left Behind series and i was hooked. The authors are brilliant, the characters are realistic. Honestly these books don't read like the typical Christian book. They don't 'push' religion on you at all. Of course they talk about religion and the christian characters try to help the non-christians to try to save themselves, but everything is presented as action books. There's danger, guns, heros, mysteries being solved, love, and 'thank god', none of those sex scenes that are constantly taking too much space in most of the books I enjoy reading. I'm pretty open-minded on religion, I believe that all things are possible. These books are entertaining, well written and engaging, with enough excitement and drama that even Non-Christians would get a lot of enjoyment out of reading them.

I have always enjoyed the adult series of Left Behind books. The kids books are just as good. The kids interact with the characters from the adult series, experience the same events, etc. However, since the main characters are teens, these books can appeal to younger readers. So far, the stories haven't had the ups and downs that the adult series has had. The adult series has books that are a lot more boring than others. The kids series seems to be good in every book. These are not for really young kids, but would be appropriate for young teens. I enjoy them and I am an adult.

For all the information packed into this book, it reads like a rich and compelling narrative rather than a stuffy textbook. Care plans for three critically ill patients are debated by a diverse panel of experts from around the globe. The debate is lively and energetic, engaging and candid. Geared for anyone with an interest in healthcare, it goes beyond clinical medicine to consider ethics, the law, and the three individuals behind the Three Patients.

An interesting book, probably unique in its kind. Dr Crippen is an intensive care specialist from Pittsburgh, Pennsylvania who in 1996 started an international internet discussion group (CCM-L) to deal with many issues involving critically ill patients. More than 1,000 members have enrolled. This is exceptional in the sense that for the first time health care professionals and providers from all over the world were able to interact and exchange information and opinions in such a direct, facile, almost immediate way.

A fundamental problem - As the population ages and life may be "artificially" extended with the use of sophisticated and often expensive technical support, ICU availability and costs have become an issue of growing public importance and concern. Dr Crippen created three hypothetical patients and asked critical care providers from all over the globe to offer their comments on their management. The result is this remarkable book which is surprisingly easy to read despite the use of specialized terminology. Different perspectives based on different cultures and socioeconomic backgrounds emerge as the reader proceeds. A physician from South Africa describes the huge demand for ICU beds and the limited availability. Physicians from India and Russia underline the importance of the patient's social and financial status and what impact this may have on future decisions related to hers/his critical care. A physician from the Netherlands describes the universal coverage health system available in his country and how the decision for further care rests primarily on the physician's medical judgment. A physician from Israel tries to achieve a balance between religious constraints and futile care. And at the end of the book, non-physician critical care providers contribute with vivid descriptions of pertinent cases and with their perception of futility. Among them, a hospital chaplain describes how she helps her patients deal with the fear of the incoming inevitable death by bringing them closer to a picture of a God who is love, mercy and compassion instead of fear, punishment and revenge.

It is evident throughout the book that one of the major issues shaping critical care costs and distribution in the USA is unlimited patient autonomy and overzealous litigation. Increased physician mistrust on behalf of the patients is stated as a major cause of this phenomenon. Whereas many physicians outside USA would assume a role conceived as paternalistic for the USA standards, patients in the USA are often offered a menu of available option regarding their future critical care treatment ("Mr. Jones, in case your breathing worsens do you want us to proceed with mechanical ventilation? In the event your heart stops, do you want us to start chest compressions?" and so on... )

Under the editing of Dr's Crippen, Kilcullen and Kelly a balance and an answer is sought. It is not an easy task but the team involved is one of the best international teams available. I highly recommend this book. It underlines once again the concept that a good question is often more important than the answer.

From Dr. Hoyt's chapter "Globalization of Critical Care"
"There is only one way to explain the birth of this book. That is CCM-L..., an electronic bulletin board that is devoted to critical care medicine), and Dr. David Crippen, one of the book's editors. An avowed nonconformist and refugee from the 1960's, Dr. Crippen has connected intensive care unit (ICU) physicians from around the world by means of the Internet. He has singlehandedly, without commercial sponsorship, woven a network of international intensivists. Nothing like this has ever occurred before. All readers of this book are being treated to a unique experience."

I might add a historical irony. One of Dr. Crippen's ancestors was Dr. Hawley Harvey Crippen. This man was the first criminal to be arrested in 1910 via the use of wireless technology. The earlier Dr. Crippen had murdered and disposed of his wife, then sought escape by going on an ocean liner with his mistress (disguised as his 12 yr. old son). The Captain grew suspicious (he saw the "father and son" holding hands and appearing amorous) and wired back to shore. This then led to a spectacular arrest as a member of Scotland Yard traveled on a faster ship and arrived in time to board and arrest Dr. Hawley Crippen. The papers at the time had a field day and this case was part of the "inspiration" for the Alfred Hitchcock film "Rear Window" starring James Stewart, Gene Kelly, and Raymond Burr. Now at the turn of another century we have yet another Dr. Crippen again making history via the use of a new "wireless" technology-- the internet. And the issue of death is involved. But instead of the sensational and criminal death of one person, we have the issue of death and dying in ICU's all over the world.
The four issues interwoven and discussed throughout the book are 1) patient autonomy, 2) beneficence (providing benefit), 3) nonmaleficence (doing no harm), and 4) distributive justice. Does patient autonomy imply not only the right to refuse treatment, but also to insist upon whatever aggressive therapies they may desire (and may have looked up on the internet)? Could we provide more benefit by trying to ease suffering during the end of life as opposed to prolonging life by a matter of days to weeks? To what extent do patients, on the surface appearing calm and sedated, actually suffer as we apply futile resuscitation efforts in their last days? If we are to formally apply some legal formula for the just distribution of critical care resources, is this a decision best left for medical professionals? Or is it a political and ethical decision for the public at large? Those looking for easy and short answers to these questions will be disappointed with this book. Many of the chapter's authors take divergent viewpoints.
What I found interesting was how several authors pointed to a historical trend in the USA. In the old fee-for-service era, when all provided technology and service was very lucractively billed, it was the families whom were going to court to have futile life support terminated. Now, in the new era DRG's, capitation & shrinking reimbursement, it is the hospitals and MD's whom are seeking to legally no longer provide futile care. This seems to imply that there has always been an economic foundation as to the determination of what constitutes "futile care". If we are discussing the compassionate and just application of medical technology and service then "futile care" may be seen as one thing. If we are talking about the provision of billable medical services then "futile care" may be seen as quite something else.
If this book has any one failing in my opinion it is that the issue of Palliative Care isn't addressed adequately. I feel this issue warranted a full chapter at least. While "palliative care" was mentioned in passing by several contributors, a more in depth look at the international differences would have been quite revealing. In many countries Palliative Care is it's own specialty. "Doing everything" is usually meant to do everything in regards to prolonging life, not doing everything to ensure a good death-per many of our default biases. Indeed a recent SCCM pamphlet I received in the mail, titled "ICU, Issues and Answers" and meant for family members of ICU patients, answers the question ""What is meant by `doing everything' with the following.
"'Doing everything' implies tht any and all appropriate therapies will be utilized in order to preserve life." The pamphlet goes on to describe how MD's aren't required to offer therapies that would be medically ineffective. But what if we expanded our definition of "doing everything" to include effective and compassionate end of life care. That care may not be "critical" in the technological sense, but certainly it is "intensive" from the standpoint of patient need and clinician time, energy, and professionalism.

One chapter is by an RT and is titled "Advanced Medical Technology and End of Life, A Respiratory Care Practitioner's Perspective by David Walker, MA RRT. Mr. Walker eloquently describes a "day in the life" of a Respiratory Therapist.
Another chapter is titled "End of Life Care in the Intensive Care Unit" by Gabriele Ford CCRN. Ms Ford paints a rather disturbing picture of what it is like to oversee the provision of futile care.

This is one of the most interesting and riveting books I've read in a while. It is a book which deserves to be both read over again as well as passed around. No ready-made solutions pop out of the book, but I assure you that your cerebral matter will be quite stimulated.

For all the information packed into this book, it reads like a rich and compelling narrative rather than a stuffy textbook. Care plans for three critically ill patients are debated by a diverse panel of experts from around the globe. The debate is lively and energetic, engaging and candid. Geared for anyone with an interest in healthcare, it goes beyond clinical medicine to consider ethics, the law, and the three individuals behind the Three Patients.

If you love horses & want to help save them from slaughter this is the manual. Bill Heller tells the truth.
Along with the stories & information about the horrible practice of horse slaughter there are websites listed for every state where you can find horse shelters if you want to adopt a horse or need to find a permanent home for one you love.
I found a shelter in Michigan that I send a little gift to monthly. My first foster horse there was a blind palamino named Billy. His owner put him there before she passed away of a terminal illness. Billy passed away too so now I foster one of his companions. For a city person it's fun to help lovely creature.
There are two reasons to stop horse slaughter besides being kind. One, horse theft has risen because someone can make a profit selling a stolen horse to a slaughter auction. Children wake up to find their beloved pet horse has been stolen. It's too heartbreaking! Two, personally, I believe that horses are being more frequently injured on racetracks because there are not enough of them running. I think they are fatigued by running too often.
HR 503 passed in Congress. If you love horses please contact your senators about saving them from slaughter.
I am editing this review because the horse slaughters have been shut down. Now we need laws where horses cannot be transported in double decker trucks to go to slaughter in Canada and Mexico. Fifty nine Belgium Draft horses tipped over in Wadsworth IL in '07. It took all the local fire departments five hours to cut the truck open. Some of the horse had been so horribly maimed I cannot say how bad it was in a review. The horses that had to be put down as soon as the truck was opened suffered agony for the entire five hours not to mention riding in a truck where it was too short to hold up their lovely heads for G-d knows how many hours. Where is our humanity?

I needed this book to help me write an essay for college. It was a great tool to have along side my work. It is against slaughtering horses on US soil and it is filled with insightfull information and helped me tie all my lose ends up. A graphic read but good.

There are many, many nice people in the Thoroughbred industry. But if it solely comes to judging those in influential positions who can make positive change, the handling of the beautiful equine athletes after the finish line has been nothing short of criminal.

Bill Heller exposes the ties that the horse slaughter industry has to racing in this brutally honest and very important book for fans of the sport at any interest level.

And don't think for a second that the slaughterhouses who "process" the meat for foreign consumption become the final vestiges for the runners who are just not good enough, too old or battered to race anymore, or too old or just don't have the pedigree to stay in the breeding shed.

There are runners that have regal bloodlines and/or major stakes victories who plummet through into the sales ring to be sold for pennies on the dollar or sold privately for shipment to the plants; crammed together in double-decker semis, without adequate food and water and oftentimes even more brutally treated during the final hours before a bolt is fired into their heads, hopefully putting the Thoroughbreds quickly out of a misery that may have built up for years.

After the Finish Line is not an easy read. But there is some hope captured in several chapters, with Heller discussing the horse sanctuary and adoption movements, with a listing of organizations throughout North America.

You may not look at the regal days of the Triple Crown or Breeders' Cup Championships the same way after reading the book. It hopefully will get you involved in some way to assist those who have the resources to make a difference before that last race is run.

End of life issues and talking about them openly is one of the least common topics most Americans are willing to talk about, even beginning the conversation is tough enough. As a grief counselor and traumatic stress management consultant, I found this book very well written, topics plainly spoken about and in terms anyone would be comfortable with.

Before anyone begins the arduous task of estate planning, whether it's for themselves of a loved one, this book is a must read BEFORE that task ought to begin. I would recommend to any funeral director to offer this book as part of their services to be able to put their customers immediately at ease.

Dick and Sue Coffin have done all of us a favor and put together a great resource to use and has given all of us that well needed 'nudge' to begin speaking and acting on this difficult topic.

Retirement planning encompasses many facets, some that we enjoy exploring such as potential vacation spots and new adventures, and others that are a necessity yet many avoid altogether often leaving their loved ones in a panic. Most dread estate and the ultimate End-of-Life planning that can only make it easier for those left behind.

My retirement planning site at http://federaljobs.net/retire deals with most pre and post retirement issues with one exception, the ultimate end-of-life planning. That is the one hole left uncovered so to speak.

This is where Dick & Sue Coffin come in, yes their real name. Their new book, Ahead of Your Time; A Complete Guide for End-of-Life Planning provides the information you need to effectively plan for the inevitable. If you have a small estate, this one book alone, with a simple will and the use of In-Trust-For or Pay-on-Death (POD) account designations to avoid probate, is all that you need to set up a basic estate plan. This easy to read 8" by 8.5" 101 page book covers everything from preplanning your final arrangements, writing the obituary, keeping records, arranging services, legal aspects, to financial matters and commemorating the loss. All this in one compact easy to read reference guide plus 30 pages of helpful data collection forms for all aspects of your plan. Yes, it takes a commitment on you and your loved ones part to sit down and talk about this sensitive issue. However, you and your loved ones will be far better off taking care of business before its too late.

Dick & Sue explain the process and thus reduce the fear. They spent 28 years in the monument business and have seen too many families torn apart by difficult decisions that must be made at the hardest of times. They've seen too many people spend lots of money trying to do "the best" for a loved one, who might have opted for simplicity.

Don't leave your loved ones in a lurch. This excellent book will help to ease the pain at an unbearable time and insure that your loved ones wishes are honored. I added this book to my reference shelf and will mention it on my retirement planning site.

Memorial service professionals Dick & Sue Coffin present Ahead of Your Time: A Complete Guide for End-of-Life Planning, a straightforward guide to making simple basic decisions that will protect loved ones from extra costs and unneeded confusion in the wake of one's passing. Chapters discuss arranging services, the legal aspects of final arrangements including living wills and end-of-life care, financial matters such as providing for minor children, establishing a trust, covering funeral expenses, and estate taxes, and much more. A number of reproducible sample forms round out this useful and highly practical guide.

Ahead of Your Time: A Complete Guide for End-of-Life Planning


Ahead of Your Time-A Complete Guide for End-of-Life Planning is a must have for anyone who wishes to set things in order for themselves and their loved ones. A tender strategy for you and your loved ones to bring your final wishes to reality, simply and generously taking away the stress of double guessing your desires.

Not only do people avoid this topic, they don't know where to begin in this crucial task that we must all face. Dick and Sue Coffin give compassionate, critical and expert advice which will take you through the pre-planning process step-by-step. The authors recognize the gift of pre-planning not only reduces stress for your loved ones at such a difficult juncture; pre-planning often settles any arguments or disputes which sadly arise during this emotionally charged grieving time. What a wonderful book!
The authors include nearly twenty forms to fill out including everything from hospice care and living wills to floral arrangements and lists of people to notify, just to name a few. They include things I could never have thought of even with my best attempt.I very highly recommend this book.
Ahead of Your Time is a great way to put all your little ducks in a row.

I have always enjoyed the adult series of Left Behind books. The kids books are just as good. The kids interact with the characters from the adult series, experience the same events, etc. However, since the main characters are teens, these books can appeal to younger readers. So far, the stories haven't had the ups and downs that the adult series has had. The adult series has books that are a lot more boring than others. The kids series seems to be good in every book. These are not for really young kids, but would be appropriate for young teens. I enjoy them and I am an adult.

I'm actually reading book #11, second time around, and just ordered 19, 20, 21, & 22. By the time I get 19 & 20 I'll be finished with 18 again. Incidentally, I also just ordered the adult book #10 having read all the predecessors. I just can't stop reading these books once I start. Whoever said the "kids" books were up to age 12 forgot that they speak truth to all ages. I'm 62 years old with graduate degrees and they sure do hit my hot button. I hope they just keep coming! I love them.

The book Left Behind #18- "Darkening Skies" is a great book. It's about four kids who were originally Left Behind of the rapture of god's people. This is book number eighteen out of thirty-six. The 17th book was a thriller as they were on their trip to Israel. The 17th ends in suspense as nobody can find Tyson Ben-Judah. The 18th book tells about Judd in Israel and where Melissa can be found. In Israel, Judd finds a new friend, Samuel. Judd is betrayed by Samuel and runs into the Global Community. Will he escape the G.C., why did Samuel betray Judd, and two more of the Young Trib Force's friends die. Who? Find out by reading "Darkening Skies," the 18th Left Behind book.