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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.

When she started working with the aged more than forty years ago, Ann Burack-Weiss began storing the knowledge and skills she thought would help when she got old herself. It was not until she hit her mid-seventies that she realized she had packed sneakers to climb Mount Everest, not anticipating the crevices and chasms that constitute the rocky terrain of old age. The professional gerontological and social work literature offered little help, so she turned to the late-life works of beloved women authors who had bravely climbed the mountain and sent back news from the summit. Maya Angelou, Colette, Simone de Beauvoir, Joan Didion, Marguerite Duras, M. F. K. Fisher, Doris Lessing, Mary Oliver, Adrienne Rich, May Sarton, and Florida Scott-Maxwell were among the many guides she turned to for inspiration. In The Lioness in Winter, Burack-Weiss blends an analysis of key writings from these and other famed women authors with her own wisdom to create an essential companion for older women and those who care for them. She fearlessly examines issues such as living with loss, finding comfort and joy in unexpected places, and facing disability and death. This book is filled with powerful passages from women who turned their experiences of aging into art, and Burack-Weiss ties their words to her own struggles and epiphanies, framing their collective observations with key insights from social work practice.