The Conversation: A Revolutionary Plan for End-of-Life Care

By: Angelo Volandes

Narrated by: Angelo E. Volandes

Despite billions of dollars invested in medical research and technological breakthroughs in American healthcare made to prolong and improve the lives of patients, a devastating statistic remains. Two thirds of Americans die in healthcare institutions tethered to machines and tubes at bankrupting costs, despite research that shows 80 percent of Americans would prefer to spend their last days in their homes surrounded by loved ones.

Dr. Angelo E. Volandes, a physician at Harvard Medical School and Massachusetts General Hospital, has witnessed far too often the unnecessary suffering patients and their families face when confronted with difficult end-of-life decisions. The solution, he knows, is not the latest technology. The most effective, powerful, and empathetic tool a doctor can offer is perhaps the simplest: The Conversation.

In his groundbreaking new book, Volandes illustrates how initiating an honest discussion among doctors, patients, and their families will empower patients to establish the treatment goals they want while avoiding procedures that cause more harm than good, thus closing the enormous gap between the care people want at the end of life and the care they actually receive.

With wisdom and compassion, Volandes not only recounts the compelling stories of seven patients confronting different end-of-life experiences, but also provides invaluable information-from helpful language to address family members and physicians to instructions for navigating advance directives. He delivers important lessons and indispensable resources-including an online video.

As a physician and patients' rights advocate, Volandes has dedicated his life to establishing a new standard of care. The Conversation is the essential guide that has long been missing from American medicine. It will embolden patients and inspire doctors to advocate for the choices that promote peace of mind and improve quality of life, because a life well lived deserves a good ending.

©2015 Angelo E. Volandes (P)2015 Angelo E. Volandes

Every physician should read this

As a chaplain I both appreciated and was irritated by this book. It's important for physicians to be able to have this conversation with their patients, but chaplains tend to be a helpful part of this conversations. Chaplains are the only member of the interdisciplinary team the author seems to completely ignore. All in all, I'm really glad this book exists to educate and encourage physicians to have the conversation.

This should be required reading

Just because we can, doesn't mean we should. I am overjoyed that this subject has been so well presented with honesty and compassion. After watching my first code blue as a new nurse, and then learning about the subsequent statistics related to outcomes for patients who are coded, I have advocated for this type of information for the public.
After working 42 years as a nurse, I learned that it's not just the elderly that should be having these discussions. Sadly, every day decisions have to be made by family members for young accident victims, end stage cancer patients who are facing their early mortality.
Thank you, Dr. Angelo Volandes. You have my utmost respect and gratitude. RC, RN

The conversation we need to have.

This was compelling and very interesting to listen to. I easily became invested in the stories of other families having to make end of life care choices for their loved ones. I appreciated the differences in perspectives. I would have really appreciated an accompanying PDF with some of the website and video locations. Having to listen to the narrator read them off was painful. A resource that will go unused sadly.

Essential for end of life planning

Any additional comments?

Excellent book to consider and understand options for end of life care. The author is a doctor and gives many examples about choices his patients made for prolonging life, limited medical care and comfort care. He supports conversation between an ill person and his doctor and family. A must read for educating yourself or a loved one to be more informed and empowered.

Important topic, well presented

I enjoyed listening to this book and found the information to be well presented. It has helped me to consider my end of life care decisions and work towards creating a living will.

The Conversation

As a healthcare provider, this is a difficult discussion to have with any family let alone your own family. Dr Volandes puts the decision into the hands of the patients. His book was very well written and informative and I had the pleasure to hear him during a case management convention in Florida. I thoroughly enjoyed hearing him speak and discuss this difficult subject. I plan to reference his book to our patients and their families and encourage them to have the discussion before it's too late.
Thank You for putting into words what everyone "tip-toes" around.

Hilda Crystal, RN
Oreana, IL

Excellent for all mortals

This is an excellent book for understanding the medical points of view and how to navigate a holistic approach to your own or a loved one’s choices at the end of life.

Not a plan. Just a rant and some general advice

This book doesn't provide detailed information or advice. It provides stories about patients' and families' suffering, a lot of ranting about the medical system, and the most general of advice. In a nutshell: you should consider preferences for end of life care, communicate and document those clearly for the people who will deal with it when the patient can't make competent decisions. That's about it.

As for the performance, the book is self-narrated, and that seems a good decision. Volandes delivers the message with frankness and earnest emotion.