Dying : a transition / Monika Renz ; translated by Mark Kyburz with John Peck.

Enhanced descriptions from Syndetics:

This book introduces a process-based, patient-centered approach to palliative care that substantiates an indication-oriented treatment and radical reconsideration of our transition to death. Drawing on decades of work with terminally ill cancer patients and a trove of research on near-death experiences, Monika Renz encourages practitioners to not only safeguard patients' dignity as they die but also take stock of their verbal, nonverbal, and metaphorical cues as they progress, helping to personalize treatment and realize a more peaceful death.

Renz divides dying into three parts: pre-transition, transition, and post-transition. As we die, all egoism and ego-centered perception fall away, bringing us to another state of consciousness, a different register of sensitivity, and an alternative dimension of spiritual connectedness. As patients pass through these stages, they offer nonverbal signals that indicate their gradual withdrawal from everyday consciousness. This transformation explains why emotional and spiritual issues become enhanced during the dying process. Relatives and practitioners are often deeply impressed and feel a sense of awe. Fear and struggle shift to trust and peace; denial melts into acceptance. At first, family problems and the need for reconciliation are urgent, but gradually these concerns fade. By delineating these processes, Renz helps practitioners grow more cognizant of the changing emotions and symptoms of the patients under their care, enabling them to respond with the utmost respect for their patients' dignity.

Reviews provided by Syndetics

CHOICE Review

In the hope of influencing how health professionals and caregivers attend to dying people, Renz (head of the psycho-oncology unit at St. Gallen Cantonal Hospital, Switzerland) explicates the mental states that people transition through as they die. Transitions in dying, unlike the phases of birth, are not sequential or continuous but instead oscillate back and forth into and out of perceptions. Using her discovery work with and analysis of data from nearly 700 people dying from cancer, the author describes the phases of pre-transition, transition, and post-transition as human perception changes in this threshold experience. For health professionals and caregivers this knowledge means being able to understand what patients need in order pass over the threshold to death. It involves being sensitive to both verbal and nonverbal behaviors, maintaining a patient's dignity within suffering, and, most important, supporting patients in their self-determination. Renz's findings from patients approaching death are similar to findings from people who have had near-death experiences, who describe a sense of peace, freedom, and dignity. Beyond encouraging professional and lay caregivers in delivering more sensitive care, this work also points out the complexity of dying and the need for psychotherapists, as members of palliative care teams, to educate themselves about the subtleties of the dying process. Summing Up: Recommended. Upper-division undergraduates through faculty and professionals; general readers. --Linda K. Strodtman, University of Michigan