Overview

What do you say that is helpful to those at the end of life? Are you an end of life caregiver and want to be more certain your interactions are helpful and relevent to those you care for? This book overs a science based method of understanding what people and their families at the end of life are experiencing. It offers an approach to caregiving that individualizes care so those at the end of life know they are not alone and that the caregiver understands what is being felt and thought. Those who work with the dying have informal understandings of the ideational worlds in which their patients and families live. We know those who have a fervent belief in a life to come and rely upon that for comfort and sustenance in their transition and we know those who are more matter of fact about death being a part of life. Formalizing these understandings can give us a more exact picture of the ideational and emotional landscapes our patients are traveling through. This assists caregivers in more precisely targeting their interactions and interventions in ways that help the patient know they are not alone and their journey is understood. Caregivers are then equipped to use the patient's own resources and ideations to assist them in their journey and transition. This book uses a psychological assessment tool, Death Attitude Profile-Revised, to understand these distinctive landscapes and offers resources to creatively individualize care in each of the five specific death domains. Robert Kastenbaum in, The Psychology of Death, has noted that post mortem case studies have indicated that knowing the patient a little better would have resulted in better care. This book offers a way to know the patient and this/her worldview and self-concepts vis a vis death and dying better so that they will know we are accompanying them on their journey and they are not alone. The five death domains, Approach Acceptance, Escape Acceptance, Neutral Acceptance, Fear of Death and Death Avoidance are explained and explored. A heuristic is offered, based on how closely the statements that comprise each domain are related, that makes this easy to use in clinical practice. Prayers, hymns, scriptures, readings and songs are suggested for each landscape aka domain. With quality indicators being increasingly used by the Center for Medicaid and Medicare Services, this book offers a way to marry narrative with data. Each patient's landscape can be assessed at admission and, through interviews with family and loved ones, after death, a post mortem assessment can be devised which uses both numerical and narrative information. Keith A. Rasey, M.Div., LNHA, is a graduate of Eastern Michigan University, Yale Divinity School and Kent State University. He has over 25 years of experience in working with patients and their loved ones at the end of life. The very first patient to die at home while receiving hospice care in the United States on May 25, 1977 was a member of the parish he served as minister in New Haven, Connecticut. Some have called him a pioneer in the hospice movement as he was one of the thousands of nameless volunteers who provided care, education and lobbying of the government to pay for hospice care.

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Keith A. Rasey is a graduate of Eastern Michigan University, Yale Divinity School and Kent State University. He has Bachelor of Science degrees in History and Economics and Gerontology and Long Term Health Care Management. He has a Master of Divinity. Keith has done postgraduate work in organizational leadership and advancement at Perkins School of Theology at Southern Methodist University. He is also a Licensed Nursing Home Administrator. Keith has over twenty-five years of experience in working with patients and families at the end of life. The very first patient to die at home in the United States, while receiving care from hospice, was a member of the parish he served as minister on May 25, 1977. Keith was working with hospice as a volunteer before hospice care was approved for payment by the Federal government. He is particularly skilled and experienced at Judeochristian and Buddhist approaches and practices for end of life care. He is currently exploring the ways in which traditional healers, aka shamans, practices can inform, enrich and deepen spiritual care at the end of life. He also understands that, from a family systems' viewpoint, humor, wit and whimsy are ways of being in the world that can create a way for change in organizations and groups that are stuck in a rut. Some of the crazy things that traditional healers do may offer us postmodern people a way to live more authentic, centered and whole lives in the sociocultural contexts of our present lives. The Landscapes of Our Patients' Journeys grew out of his interest in both science based or evidence based approaches and spirituality. The Center for Medicare and Medicaid Services is increasingly requiring hospices to measure the quality of care and the patient/family experience. The Landscapes of Our Patients' Journeys offers a method to marry narrative and data that provides a means to assess the patient/family experience of end of life and measure the quality of caregivers' responses. He is currently formating his newest book, Polar Bear Angels: Humorous, Insightful and Irreverent Stories from a Reverend, to make it conform to epublishing platforms. It is based on real interactions. Keith lives with Diane, his wife of twenty years, and two dogs, Benny and Sunshine. He enjoys theater, cinema, travel, reading and jogging his two canine housemates through a five mile route in a local cemetery.

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