When the Time Comes

Dr Magnolia Cardona is a former GP, public health practitioner and current associate professor of health services research. She is a passionate advocate for the rights of older people dying of natural causes to not be over-treated with low-value care and instead have a dignifying end of life through aligning treatments with patients values and planning in advance. She arranged her own first advance care directive before the birth of her child by elective caesarean, as she envisaged the possibility of things going wrong and had the urgency for planning what clinicians and her family should do if she couldn't decide. She now conducts research with patients, families and clinicians on ways to improve the end-of-life experience for all. Nurse Ebony Lewis is experienced in emergency medicine and geriatrics, a skills combination that made her highly aware of the needs of older people to be treated compassionate at a place of their choice including their own home rather than in the emergency department environment or the intensive care unit. She loves talking to older patients, visiting them at home for their health assessments, and helping them express their values and preferences before they become critically ill. She was awarded an international prize for her research into advance care documentation and is now undertaking her PhD studies on frailty. With contributions from 15 relatives, informal caregivers and health professionals.

Foreword by Dr John Kellett (Ireland); Foreword by Dr Aoife Lowney (Oxford, UK); Introduction; Preparing for death but living life to the full; What time is the right time; An unexpected friendship; Where is the manual for the family of the dying person? The belated conversation and the imprecise directive; Not coming home; Letting go of love and life; The daughter from California syndrome; My 'new normal'; 'Ready to go' Bob; What Dad learnt from Mum's death; too late to change her mind; Knowing when to do nothing; Not for resuscitation; A celebration of life on his own terms; The advocate and translator; The right to not know; I think it was the right choice; Dying and grieving during the pandemic lockdown; Dad, sorry we can't honour your wishes; The future me; The 'other' end of end-of-life; Afterword by Norman Swan