Knocking on Heaven's Door. Butler, K. (2013). New York, NY: Scribner. 322 pages.

Baby Boomers are the first generation to find themselves dealing with aging parents as they themselves reach their 50s and 60s. Advances in medicine and technology have created a generation of "super elderly," a term used to describe those older than 80 years of age. Some remain cognitively intact and active well into their ninth decade. For others, a longer life is not necessarily a better life. Author Katy Butler is one of those baby boomers. She tells the story of her aging parents following her father's stroke in this part memoir, part tutorial, on end-of-life decision making. She explores the historical, legal, and ethical influences that contribute to end-of-life decision making and the contribution of medical device companies that incentivized physicians to use their products. She describes a broken Medicare system willing to pay for high-tech, life-prolonging gadgets and care in expensive intensive care units while limiting the speech therapy that greatly enhanced her father's quality of life. This is a must-read for all home healthcare and hospice clinicians.

-Contributed by Maureen Anthony, PhD, RN

The author declares no conflicts of interest.