Book Review: Geriatric Palliative Care

Despite the fact that more than twothirds of those who die in the United States are age sixty-five and older, aging and dying has long been neglected. Many of the pioneers in the discipline of gerontology wanted to emphasize that older persons were vital and active—living beings. Many of the groundbreakers in thanatology became interested in the field because of their personal experiences with untimely, “out-of-order” deaths. Even today, there are far more books and journal articles on children and death than there are on older persons and death. This is one reason why Geriatric Palliative Care is so welcome. Happily, there is also a second reason. It is an exceptional work. Geriatric Palliative Care is a contributed book covering a broad spectrum of issues characterizing care of older adults near the end of life. Beginning with the social and cultural context of old age and frailty, this volume details specific aspects of palliative care relevant to particular disorders (e.g., cancer, strokes, and dementia) as well as individual symptoms (pain, fatigue, anxiety, etc.). Communication between caregivers and patients, in a variety of settings, is also discussed. Although any edited book has some variance in quality and content, it is a significant mark of the knowledge and dedication of the authors and editors that each chapter is of high quality. That fact makes it hard to highlight only some chapters. In a book of this caliber, what is pointed out is far more an indication of the reviewer’s interest than anything else. While each chapter makes a significant and specific contribution to the literature on geriatric end-of-life care, what makes the book extraordinary is the integration of key themes throughout the chapters. The book’s approach is highly holistic—a clear reflection of the philosophy of palliative care but one that is often not as well integrated in fact as in theory. These chapters demonstrate that philosophy in exemplary style. Moreover, a deep respect for the personhood of older people permeates the pages. Finally, there is an abiding interest in ethical issues that arise in the care of older persons. Again, these themes reflect my interests. Those who look for more specific medical interventions for various diseases, syndromes, or symptom management also will find them well discussed here. In short, this book is destined to be a classic. It not only deserves a place on the shelf of every hospice and geriatric facility and practitioner; it needs to be read—and practiced.