The book begins with Dr. Atul Gawande criticizing medical schools for focussing more on the survival rates and looking at patients as numbers rather than looking at them holistically.
He begins to describe how his grandfather Sitaram was cared for by family in his old age. In comparison, his grandmother-in-law, Alice, has lived independently since her husband’s death decades ago.
Gawande then focuses on a couple he knew, Felix and Bella Silverstone, who moved to a nursing home unit but did not like the fact that their autonomy was taken away. As such, they move back to their own home, and Bella dies peacefully there.
The book then covers the difficulties of caring for the elderly, as seen by the father-daughter relationship in Lou Sanders and his daughter Shelley. However, after he is moved to the Leonard Florence Centre, she copes much better. A key message in the book is the importance of prioritizing hospice care and asking about the patients wants before referring to hospital guidelines and practices.
