Hard Choices For - CPR, Artificial Feeding, Comfort Measures Only and the Elderly Patient - Third Edition

Oct 13, 2026

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Hard Choices for Loving People: CPR, Artificial Feeding, Comfort Measures Only and the Elderly Patient presents guidance for end-of-life decisions, focusing on five clinical areas—cardiopulmonary resuscitation, artificial hydration and nutrition, hospice comfort measures, hospitalization choices, and the emotional and spiritual journey of letting go. Organized into chapters with practical questions and care frameworks, it explains survival context, potential burdens, patient eligibility, and how to shift from cure to comfort while supporting families and caregivers.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages56

Reading Time2 h 21 min

AccessFree to download

Table of Contents

Chapter One—Cardiopulmonary Resuscitation

Chapter Two—Artificial Hydration and Nutrition

Chapter Three—Cure Sometimes-Comfort Always: Hospice and the "Comfort Measures Only" Order

Chapter Four—Making End-of-Life Decisions

Chapter Five—The Journey to Letting Go

Acknowledgments

About the Author

RA 997 D865 1994 The Libraryof ClaremontSchool ofTheology 1325 North College AvenueClaremont,CA 91711-3199(909)447-2589 Hard ChoicesFOr LovingPeopleCPR,Artificial Feeding,Comfort Measures Onlyand the Elderly PatientBy Hank Dunn # The Libraryof ClaremontSchool ofTheology 1325 North College AvenueClaremont,CA 91711-3199(909)447-2589 一 35194Hard ChoicesFor # LovingPeople Third Edition ## CPR,Artificial Feeding,Comfort Measures Onlyand the Elderly Patient By Hank Dunn Chaplain Hospice of Northern VirginiaLeesburg,Virginia Copyright ◎1994 by Hank DunnPrinting History Published by Fairfax Nursing Center,Inc. First Edition September,1990-1,000 December,1990-2,000 March,1991-4,000 May,1991-30,300 September,1991-8,200 November,1991-27,900 January,1992-20,579 Revised Edition April,1992-30,850 August,1992-31,600 January,1993-37,750 Published by A&A Publishers,Inc.July,1993-12,500October,1993-21,000April,1994-5,000June,1995-5,000January,1996-5,000Third EditionJuly,1994-29,000October,1994-30,100December,1994-30,450June,1995-37,245January,1996-37,250June,1996-30,000December,1996-27,400 We gratefully acknowledge the use of quotations from the following books: Excerpts from Further Along The Road Less Traveled COPYRIGHT C1993 by M.Scott Peck,and The Troubled Dream of Life COPYRIGHT◎1993 by Daniel Callahan areboth reprinted by permission of Simon &Schuster,Inc. EXCERPTS from The Tibetan Book of Living and Dying by SOGYAL RINPOCHE.Copyright ◎1993 by Rigpa Fellowship.Reprinted by permission of HarperCollinsPublishers,Inc. This booklet is published by:A&A Publishers,Inc.P.O.Box 1098Herndon,VA 20172-1098 Write for information on purchasing bulk copies. # Table of Contents Introduction ## Chapter One—Cardiopulmonary Resuscitation Survival Rates With CPR..Burdens of CPR…CPRand theFrail Elderly Patient...CPR Is the Standard Order ## Chapter Two—Artificial Hydration and Nutrition Intravenous(IV)Artificial Hydration...The Burdens ofArtificial Feeding...Words Can Be Loaded...The Cases Forand Against Artificial Feeding...Would Withholding orWithdrawing Artificial Feeding Cause a Painful Death?...TheDifference Between Withholdingand Withdrawing…ArtificialFeedingand the Dementia Patient…Consider SeveralTreatmentOptions ## Chapter Three—Cure Sometimes-Comfort Always:Hospice and the "Comfort Measures Only"Order Three Possible Goals of Medical Treatment…Hospice….WhatAre Comfort Measures?...Which Medical Treatments AreOptional?...Which Patients Are Candidates for Hospice orComfort Measures Only?When Is the Right Time?...End-Stage Dementia and Comfort Measures Only...Turning FromCure to Comfort Care Only ## Chapter Four—Making End-of-Life Decisions What To Do...Hospitalization and the Do Not HospitalizeOrder….Consider an Advance Directive…Questions To HelpMake a Decision...Getting Help With End-of-Life Decisions ## Chapter Five—The Journey to Letting Go The Four Treatment Decisions-CPR,Artificial Feeding,Hospitalization and Hospice/Comfort Measures Only.·.Changing the Treatment Plan...The Emotional Nature of theStruggle…CanILet Go?….ALifetime of Letting Go….SomeReligious Questions...The Spiritual Nature of the Struggle...Giving Upand Letting Go..Fatal Isn't the Worst Outcome 5 7 12 25 31 # Acknowledgments lamgreatly indebted to those who took the time to review my manuscriptand make valuable comments.Their suggestions came in by mail,fax,e-mailon the Internet and through personal discussions.At times i felt like we werehaving a coast-to-coast dialogue on how best to say what we wanted tocommunicate.In addition to those listed here,I must acknowledge the staffresidents and families of Fairfax Nursing Center,who,for twelve and one-halfyears,taught me more thanlever could have gathered from books.From themIhave learned it is possible to live a life of grace even as one faces the end oflife. Those who read and commented on Hard Choices:Kathryn Baugus,LMSW

FAQs

What decision areas does the book address for elderly patients near the end of life?

It addresses CPR, artificial feeding, hospitalization choices, and hospice/comfort measures only, then frames how to change the treatment plan as needs evolve.

How does the book explain the difference between withholding and withdrawing artificial feeding?

It includes a dedicated discussion on the case for and against artificial feeding and asks whether withholding or withdrawing artificial feeding would cause a painful death.

What guidance is offered for choosing hospice or comfort measures only?

The text outlines possible goals of medical treatment, explains what comfort measures are, lists which treatments are optional, and helps identify candidates and the right time for hospice or comfort measures only.

Oct 13, 2026

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