Dr. James Hallenbeck

HOME2025-05-17T21:47:39+00:00

Physician

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About Dr. James Hallenbeck

James is a physician and associate professor emeritus at Stanford University in Palo Alto California. Prior to becoming a physician, he obtained a master’s degree in Asian Studies through the University of Hawaii with a focus on Japanese culture. He has published numerous articles on palliative medicine and geriatrics and is the author of two editions of Palliative Care Perspectives, published by Oxford University Press. The second edition was published in 2023. He is a recognized pioneer in the emerging field of palliative care and a champion for people struggling with chronic and terminal illness. His new book, The Chronic Illness Journey was published in the spring of 2025. Recognized for his ability to explain difficult medical concepts clearly, he is expanding his efforts to writing fiction.

dr. james hallenbeck - portrait photo

Dr. James Hallenbeck

The Chronic Illness Journey – Finding Your Way

The Chronic Illness Journey is a book for people struggling with chronic illness, their families, and caregivers with a focus on common conditions of the elderly, such as heart disease, stroke, and dementia. The modern healthcare system is bewildering. In order to navigate it successfully, people need a plan. This book helps them put one together.
The author guides readers through common barriers they may encounter – knowledge deficits about common illnesses, communication challenges with professionals and family members, and nitty-gritty aspects of medical care – finances, insurance, and ‘tricks of the trade’ regarding care delivery. Finally, end-of-life care and related issues are discussed. Building on decades of clinical and administrative experience, Dr. Hallenbeck shares what he has learned along the way in hopes of helping folks on their journey.
This book should help people:
• Understand common illnesses of the elderly and more skillfully search out additional information about them.
• Establish and communicate goals of care
• Better communicate with clinicians and family members
• Avoid common pitfalls in different venues of care
• Manage insurance and financing challenges
Chronic illness is tough on those afflicted and their loved ones. But with a little planning, the journey can be a bit easier.

palliative care perspectives - book cover - james hallenbeck
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Dr. James Hallenbeck’s Medical Book

Palliative Care Perspectives

Palliative Care Perspectives is a guide to the art and science of palliative care that links real stories of illness with practical advice to delineate clinical practice in a way that reflects the daily concerns of clinicians.

Clearly and compassionately written, this book emphasizes important topics often neglected in formal clinical training, including the history and evolution of palliative care in the United States, as well as how clinicians can better understand aging and dying from both a physiological and human perspective.

Written by a recognized pioneer in the field of palliative care, each chapter highlights this human approach to illness with narratives and anecdotes drawn from decades of practice experience. This new edition features thoroughly updated research and citations, a new chapter on burnout and compassion fatigue, and a significant expansion of the topic of intercultural communication.

Well-grounded in the academic literature, Palliative Care Perspectives is an ideal introduction to the emerging field of palliative care for care providers new to practice, as well as lay readers seeking to learn more about chronic and terminal illness, presented in a personal and accessible format.

Dr. James Hallenbeck’s Forthcoming Debut Novel

Operation Reboot

His debut novel in the works, Operation Reboot, in the time-travel/alternate history genre, takes place in pre-colonial North America. Time travelers, fleeing the impending collapse of civilization go back to pre-colonial upstate New York in 1604. They hope to aid the local Mohawks resist impending European aggression and thereby alter the timeline that led to the Fall. One time traveler, Tomoe, is a Japanese martial arts master, who shares her skills with the Mohawks. James has maintained a strong interest in Japanese culture, especially the martial art, Aikido, which he has practiced for more than 30 years, having obtained the rank of 3rd degree blackbelt. In this work James combines his knowledge of martial arts, his love of history, and his writing skills to create a real page turner.

Reviews & Praise for Palliative Care Perspectives

Dr. Hallenbeck has put together an amazing resource for physicians just entering the field of palliative care as well as more experienced clinicians. The book combines abundantly well-referenced clinical information along with frequent pearls of wisdom based on Dr. Hallenbeck’s extensive career. I think Palliative Care Perspectives will become an essential book for both physicians and non-physicians caring for seriously ill and dying patients.

David E. Weissman, MD, FACP, Medical College of Wisconsin

Palliative care Perspectives has earned a place on my desk as a reliable reference and rich resource for clinical teaching… a concise and yet comprehensive guide to palliative care… the clarity and accessibility of writing and Dr. Hallenbeck’s wise and balanced approach to complex clinical problems makes reading Palliative Care Perspectives feel like I am consulting a learned and trusted colleague.

Ira Byock, MD, Author of Dying Well.

Modern medical practice need Hallenbeck’s book – comprehensive, scholarly, wise, and compassionate.

Joanne Lynn, Author of Handbook for Mortals.

5-Star Amazon Reviews for Palliative Care Perspectives

This is a compassionate, approachable discussion of the branch of medicine focused on treating dying patients, making them more comfortable as they near the end of life, rather than on trying to treat their illnesses in the hope of cure. It is written for medical professionals, but I am not a medical professional, and I found it very informative… Throughout the book, the focus is patients’ needs. The author’s approach is humane, open-minded, and oriented to effective results. Dr Hallenbeck clearly believes that listening is a key skill, and has as clearly listened carefully to his patients and learned a great deal from them That orientation has a lot to do with making this book a positive one to read, as well as a source of a great deal of useful information. From other reviews, it seems that medical professionals find it useful. So too did this non-professional – so much so that it will affect the choices I make when I am next responsible for the care of a dear one who is dying, and when my own time comes.

Anne Mills

This is a beautifully written summary of the essentials with lots of clinical vignettes and practical tips by an experienced and obviously dedicated clinician.

Vincent G. Winters

This book is spectacular. It covers all the major points in palliative care giving the reader very practical and useful information. The chapters on non-pain symptom management and communication are fabulous. I just can’t say enough good things about this book. It is an excellent overview for students, residents and even beginning palliative care fellows.

Dr. Pink

(For Palliative Care Perspectives, second edition.)

Excellent book. Covers a very complex subject in an easy to read way. Very valuable to both Health Care Professionals and also the general public.

Fernando Kawai

Awards

Pioneer in Palliative Care

California Hospice and Palliative Care Association

Pioneer in Palliative Care

Journal of Palliative Medicine

Pioneer in Palliative Care

American Academy of Hospice and Palliative Medicine

Henry J Kaiser Award for Outstanding and Innovative Contributions to Medicine Education

Stanford School of Medicine, Palo Alto, CA

Resources

Articles

Hallenbeck J. – Palliative care in the final days of life – they were expecting it at anytime.

JAMA. 293(18) 2005:2265-2271.

Hallenbeck J. – Pathophysiologies of dyspnea explained: Why might opioids relieve dyspnea and not hasten death?

15 (8) 2012: 848-853.

Presentations

When Does Dying Begin?

Seatbelts Are Carcinogenic!

The Evolution of Hospice and Palliative Care Historical Perspectives

Squaring The Curve

Clinical Practice and the Changing Demographics of Aging and Illness

Toward a Better Healthcare System

If You Build It, They Will Come

Other Books

Palliative Care: A Resource Guide for Physician Education 4rd Ed.

Weissman DE, Ambuel B, Hallenbeck JL.
Medical College of Wisconsin. Madison. 2007.

Blog

The Changing Role of Families and Chronic Illness

One of the things I write about in The Chronic Illness Journey is how families have changed. It used to be that when a family member got old and frail, needed care was provided by families.  Indeed, prior to the 1960’s, when Medicare/Medicaid came online, you might say that families were the main form of insurance most people had.   While private health insurance was expanding during the 1950’s, by the late 1950’s only 25% of Americans over 65 had insurance.

Prior to widespread availability of birth control, large families were common.  My paternal great grandparents had 7 children!  They were needed around the farm, but it was more than that.  It was a common expectation that at least some of the offspring, especially the girls, would live nearby and provide support for their elderly parents, when it became necessary.

Obviously, much has changed since the 1960’s in terms of healthcare and insurance – some for the better and some for the worse.  Underappreciated has been the changing roles and expectations of family members in terms of support for ailing elders.

Two big things stand out – 1) fewer elders have family members living nearby and 2) more families have dual incomes.  In the 1950’s about 65% of families had a working husband and a ‘non-working’ wife.  Today about 60% of married couples are dually employed.  The reasons for these changes are obvious – greater social mobility, changing gender roles, especially for women, and economic necessity requiring a dual income.

The changing role of women, now more likely to live at some distance and more likely to be employed, has had a great impact on elders.  The explosive growth in assisted living and nursing homes reflect this change.  That we now have more old people with more chronic conditions also undoubtedly contributed to this expansion.  The first inventory of nursing homes in 1954 estimated approximately 270,000 people lived in 9,000 nursing homes.  In 2025 there are approximately 15,600 nursing homes with 1.7 million licensed beds.

It almost goes without saying that despite more assisted living facilities and nursing homes being available, there is a massive unmet need for caregivers.  The problem is not just a lack of warm bodies to do the work; we haven’t figured out how to pay for the care that is needed.  Medicare does not pay for long-term care. Medicaid, as described in more detail in The Chronic Illness Journey, requires people to be functionally impoverished.  Even if a person has Medicaid, the per-diem rate for nursing home care does not adequately cover costs.  Something has to give.

Barring some radical, positive change in how we pay for care of the elderly, which looks most unlikely in the near future, things look to get worse before they get better.    There is no federal white knight riding to rescue us. It will be up to us to protect those we love.  And that may require a re-thinking of what family means.

It may be that some adult children see far enough ahead that they decide to live near elderly parents in order to help.  They may build accessory dwelling units (ADUs) for parents to live with them (assuming they have the necessary funds).  They may even adjust expectations regarding dual incomes to accommodate future caregiving obligations.  Still, I am doubtful that many will do this or that it will be enough.  Such adjustments may be possible for those who are well-off, but impossible for many others.

Another, more radical possibility is rethinking the very notion of family.  Groups of people might consider banding together as mutual aid societies – with formalized expectations and responsibilities for other members – something like the “communes” of the 1960’s come to mind, without the hippy trappings.  I imagine any such arrangements would be driven less by cultural or political sentiment than economic necessity and survival.

Hillary Clinton famously wrote that “It takes a village.”   The saying has almost become trite.  But she’s got a point.  If there is one thing I would think Americans of all political stripes would agree on is that the current system of healthcare in general and how we care for elders in particular isn’t working.   I don’t claim to have the answers, but solutions will require a clear-eyed acknowledgement of the challenges we face and a willingness to experiment with new ways of doing things.

 

Contact Dr. James Hallenbeck