THE FINAL JOURNEY--Complete Hospice Care for Departing Vaisnavas written by Susan Pattinson, RN (Sangita devi dasi) is an invaluable tool for anyone who will be caring for a dying relative or friend. This book is a Krishna-ized look at the compassionate art of hospice care and is expertly written for the layperson in easy to understand language. As the title suggests this is a complete guide which includes all aspects of care that one needs to confidently care for their patient. Sangita devi dasi is herself a hospice nurse with years of experience which she brings to her writing.
~Judy Harris RN BSN
Jusaniya devi dasi
Vaisnavas C.A.R.E. Inc. web site developer

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Chapter Outline

Chapter 1. What is Hospice?

This chapter includes a brief history of the Hospice movement; explanation of palliative care vs. aggressive treatment; spirituality and the devotee’s decision to accept hospice care; quotes from Srila Prabhupada concerning preparing for death; and the “Bill of Rights” for the dying Vaisnava.
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Chapter 2. Practical Matters

This is an excellent chapter for getting down to the basics of who, what, where, and when, of hospice care. The author considers the practicalities of caring for a dying devotee depending upon his or her own personal needs, temperament, prognosis, and location. Also included in this chapter is information on toll-free referral services in the U.S. and U.K, financial concerns, Living Will, and Medical Power of Attorney.
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Chapter 3. What is Holistic Care?

This chapter addresses the essential aspect of holistic care which includes the mental, physical, emotional, and spiritual needs of the Vaisnava. The author explains ‘spiritual pain’ and how to talk to a person who is dying, as well as how to create for this person a peaceful, Krsna conscious environment.
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Chapter 4. Terminal Illnesses

This chapter is just what the title implies; some of the most common hospice-appropriate terminal diseases are briefly and informatively explained in easy-to-understand layman’s terms.
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Chapter 5. The Grief Process

The author does a great job of explaining the stages that the dying person, as well as the caregivers and loved ones, go through in order to finally accept the inevitable truth of the impending death. Although Vaisnavas in general have spent time thinking about and preparing for death, it is still a shocking reality when it hits home. This chapter gives one an understanding of the emotions and behaviors that can be expected of all concerned.
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Chapter 6. Pain Management

This chapter reviews types and character of pain, as well as what questions to ask to understand the pain your patient is experiencing. The author also defines medications commonly used in the hospice setting and goes over their uses, precautions, and possible side effects. An easy-to-read medication chart is included as a reference.
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Chapter 7. Symptom Management

There are many conditions and symptoms caused by the immobility, and/or disease process of the terminally ill patient. It is important to understand these and how to manage them for the comfort of your patient. To that end this chapter is an invaluable tool.
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Chapter 8. Personal Care

Practical and comfort care is explained step by step including:

giving a bed bath
washing your patient's hair
changing linens when your patient is bed-ridden
skin care
repositioning an immobile patient

Chapter 9. Complementary Therapies for Comfort Care

In this chapter the author explains some of the more common complementary therapies that can be used as adjuncts to pharmacological agents to control pain. Included are breathing and relaxation exercises, visualization, heat and cold applications, aromatherapy; herbal, massage, and music therapy. The author also includes some of Srila Prabhupada's remedies for symptom management.
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Chapter 10. Care of the Caregiver

In this chapter the author helps the reader to recognize and avoid caregiver burnout. This is an important concept to understand and prevent in order to continue providing quality care to your patient.
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Chapter 11. Signs and Symptoms of Approaching Death.

This chapter explains how to help the patient with "closure", recognizing "Nearing Death Awareness" in the patient, and giving permission to "let go".
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Chapter 12. Post-mortem Care, Cremation Ceremony, and Memorial Service

This chapter explains what to do when a devotee passes away. Included are quotes from His Divine Grace A.C. Bhaktivedanta Swami Prabhupada. There is also an interview between Padma Nabh Goswami (Radha Raman Temple; Vrndavana, India), and a disciple of Srila Prabhupada, Her Grace Kusa devi dasi, concerning subject matter included in this chapter.
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Chapter 13. Grieving, Healing, and Rejoicing for the Vaisnava

This chapter focuses on the loved ones left behind. The differences between grief, mourning, and bereavement and common experiences of the three are explained. Reasons to rejoice for the departed Vaisnava are given through quotes from Srila Prabhupada.