If you are looking for a deeper understanding of elder care at the end of life, this book, Amy Ziettlow and Naomi Cahn, Homeward Bound: Modern Families, Elder Care, and Loss (2017) will disappoint.  If you are looking for insight about the complexities of elder care in the U.S. in a culture of changing family structure, you are in luck.  What is clear about this book, and so many other recent books on the end of life, is the avoidance of discussion of the decision, circumstances, timing, and means for ending life consistent with the person’s values and management of a well-lived life.

What is important about this book is the clear elevation of the new and developing reality of family structure diversity that impacts management of end-of-life decisions.  Family structure norms now include divorces, blended families, multi-faith families, and gay families.  The impact of this family structure diversity on decisions and involvement at end of life is more complex than the current institutional arrangements for end of life can easily accommodate.

What is particularly unique and surprising about this book is the Appendix D:  “Funeral Seating Chart”.  You are correct.  We need guidance regarding the priorities in funeral seating when the families are melded and managing divorces. This appended offering shows incremental practicality and creativity as we move forward.

What is disappointing are the lack of comparable practical offerings for the improvement in the services of the religious community for end-of-life assistance.  The authors are a clergy and law professor team.  The book summarizes the current situation in both areas of religion and law, but does not move the discussion forward much in either realm. The book is silent on dementia, even though dementia will be the dominant future challenge and diagnosis for end of life in the next two generations.

The book is soft/weak on recommendations for public policy.  The authors limit their recommendations to nudges toward earlier and more comprehensive planning.

The title of this book is misleading, clever but only weakly descriptive of the content and thesis of the book. The index is comprehensive.  The endnotes are clear and useful in linking to other resources, while avoiding resources related to the difficult issues of the timing and means for a good end of life.  The appendices are useful and conventional for an academic publication.  

This book is a useful addition and will encourage more creative thinking about public policy and religious community improvements to assist families in decisions and services at end of life.  The most useful point is in thinking about the prospect of effects for public policy and cultural norms of considering the new family structure diversity in U.S. society in relation to end-of-life caregiving. 

This book is useful for all humans and, particularly, for the Quaker community.  

Quakers: The book makes no mention of Quakers or the Quaker tradition.  Quakers are following the same path toward facing the diversity and melding of families.  Quakers face the same challenges as other religious communities.

Questions:

• What can the Quaker tradition and reflection contribute to end-of-life services to seniors?  
• Is there a universal standard for how all religious communities serve seniors in the end of life?  
• Do we have universal human expectations, or only local cultural ones, for end of life?  
• Should we expect any leadership from Friends United Meeting or Friends General Conference to support yearly meetings and local meetings and churches, beyond the current cultural expectations for religious communities, in the face of end of life?

Resources:

Amy Ziettlow and Naomi Cahn, Homeward Bound: Modern Families, Elder Care, and Loss (2017)