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Dying declarations: notes from a hospice volunteer (book review)

Posted: March 28 2023

Social Work student & staff projects, Social Work
Social Work student & staff projects, Social Work

Interested in Social Work and want to learn more about the subject? The book reviews written by our Social Work students and staff help you identify the best literature to advance your learning.

This week:

  • Title: Dying declarations: notes from a hospice volunteer
  • Publisher: The Haworth Press
  • ISBN 13: 978-0-7890-2545-6
  • Author/s: David B Resnik
  • Originally published in 2005
  • Reviewer/s: Faye Dandy, MSc Social Work student
  • Originally published in the Journal of Social Work Education
book cover of dying declarations

Dying Declarations gives an insightful look at what it is like to provide care for patients that have reached the end of life. The author reflects on his own experience as a hospice volunteer

and how spending time with the dying can help us appreciate the important things in life that our busy lives often make us forget. The author, David B Resnik has volunteered in hospices and nursing homes since 1995 and is a professor of philosophy and Religion at North Carolina University. The author previously served in the Department of Medical Humanities at East Carolina University and has published over a hundred articles on ethics and philosophy. David B Resnik also has an interest in the ethics in Biomedical research and his strong sense of morality is apparent throughout the book.

The book begins with the author sharing the personal loss of a family member as the reason that motivated him to become a hospice volunteer. The author explains the interesting title of the book and how in criminal and civil law trials, the only exception on hearsay testimonies is the rule of ‘dying declarations’ which allows the statement of a dying person to be admitted as testimony after they are not available to testify. The author explains the reason for this exception in the court of law is that dying people have many reasons to tell the truth and very few reasons to lie. The prominent theme throughout the book is that people who are in the process of dying have a great deal to teach the living if we would only take a moment to listen.

The author tells the individual stories of the people he encountered during his time as a hospice volunteer and the unique relationships he formed with the people who were dying. The author sheds light on the difficulties that the families who are taking care of a loved one, who has reached the end of life, experience. As often the carers of these individuals who are likely to be their spouses have little to no respite. The author goes into detail in one chapter about how this continuation of care can become stressful for the family member, as well as the person who is dying. The reason being is that often dying patients suffer from dementia and are in the habit of repeating themselves and therefore can cause irritation to their regular caregivers. The beauty of hospice volunteers is that they are a fresh pair of ears for the dying patient as well as providing relief for the caregivers. This is an important detailed part of the book that relates to any health care professional reading it such as nurses or social workers as it outlines what works in health care to provide the best support for hospice patients.

There are many insightful and philosophical gems throughout the book and the author’s style invites the reader to empathise with each of the individuals he encounters. One particularly insightful moment the author describes stands out: he visits a hospice patient who is dying of lung cancer that has spread to his liver. The patient is living at home with his wife and the author visits on this particular day with his four-year-old son. There is an encounter at the dining table where the hospice patient is pleasantly watching the author’s son eat his favourite candy M&M’s. The author notes how his son is taking his time and enjoying one piece of candy at a time and how the hospice patient is getting as much joy by watching this moment as his son. The next day the author received a call from the nurse stating the patient had died and he takes this moment to reflect that he learnt a vital lesson from this hospice patient. In a humble passage of the book, the author states how he learnt from the patient that as children we truly know how to live in the moment and we eat one M&M at a time. Yet as we reach adulthood we devour life by the handful and lose the essence of appreciating the true beauty of the only moments that we have. In this passage, the author reflects that he has noticed through working with dying patients how time stands still and how it has allowed him to slow down in his own life and eat one M&M at a time. The author further states that he feels that he has benefitted more from being a hospice volunteer than patients have received his help. This is particularly relevant to anyone reading this book who is a health care professional as at the core of good practice is collaboration and empowerment.

However, the book does go into more challenging themes as not all hospice patients accept their fate gracefully. The author touches on the theme of denial of hospice patients who are reluctant to acknowledge that they are dying. The difficulty that family members and health care professionals experience with a hospice patient that refuses to acknowledge they are dying is the inability to provide the right end of life care for the patient. Health care professionals need to draw upon these challenging circumstances and reflect on how they would provide care for such a patient as well as ensure that they are meeting their best interests. The book does touch on a variety of different themes such as class, race and gender. The author does a great job of including the multi-cultural perspective and does not exclude marginalised patients’ perspectives on dying.

Overall, the clear and insightful writing style of the book turned a heavy subject such as dying into one that was uplifting and gave a philosophical viewpoint. However, the major critic of this book from the perspective of a social work student is that there is a lack of substantial scientific evidence, and the subject was presented from the author’s personal perspective. Yet this book gives vital insight into supporting hospice patients and should be a recommended read for any individual who desires to develop a deeper understanding of the topic.