This issue of Primary Care: Clinics in Office Practice, guest edited by Drs. Alan R. Roth, Peter A. Selwyn, and Serife Eti, is devoted to Palliative Care. Articles in this important issue include: Introduction to Hospice and Palliative Care; Hospice for the Primary Care Physician; Pain Assessment and Management; Non-Pain Symptom Management; Communication Skills: Delivering Bad News, Conducting a Goals of Care Family Meeting, and Advance Care Planning; Psychosocial Issues and Bereavement; Ethical and Legal Considerations in End of Life Care; Cultural, Religious, and Spiritual Issues in Palliative Care; Palliative Care Approach to Chronic Diseases (CHF/COPD/ESLD/ESRD); Palliative Care in HIV/AIDS; Palliative Care in the Elderly (Dementia, Neurodegenerative Disorders, Functional Decline/Frailty); and Pediatric Palliative Care.

Perinatal hospice is a novel form of care for an unborn child who has been diagnosed with a significantly life-limiting condition. In this book, Aaron D. Cobb develops a virtue-based defense of the value of perinatal hospice. He characterizes its promotion and provision as a common project of individuals, local communities, and institutions working together to provide exemplary care. Engaging with important themes from the work of Alasdair MacIntyre and Robert Adams, he shows how perinatal hospice manifests virtues crucial to meeting the needs of families in these difficult circumstances. As a work of applied virtue ethics, this book has important normative, social, and political implications for the creation and development of structured programs of care. It grounds the view that communities ought (i) to devote resources to ensure that these programs are widely available and (ii) to develop social structures that promote awareness of and accessibility to these forms of care. A Virtue-Based Defense of Perinatal Hospice will be of interest to philosophers working in bioethics and applied virtue ethics, as well as scholars in the fields of neonatology, nursing, palliative and hospice care, and counseling who are interested in the study of perinatal hospice.

Given that treatment with curative intent is possible in only one-half of cancer victims, and that such treatment frequently fails, the majority of patients with cancer will require relief of symptoms and signs caused by their disease. In this book, the specific contribution of radiation therapy to palliation is considered within the context of multidisciplinary management. Individual chapters are devoted to palliative radiation therapy for primary tumours and metastases at different sites. The management of pain is discussed, and chapters are also devoted to end of life care, the management of complications of radiation therapy, and useful medications. This book will prove useful and interesting not only to radiation oncologists but also to medical students of all ages and to doctors from all disciplines who are concerned with the relief or prevention of suffering in patients with cancer.

The International Handbook of Art Therapy in Palliative and Bereavement Care offers a multicultural and international perspective on how art therapy can be of help to individuals, groups, families, communities, and nations facing death and dying as well as grief and loss. Over 50 art therapists from around the world write about the transforming power of art therapy in the lives of those facing terminal illness, dementia, loss, and grief. They offer practical descriptions and techniques for working with adults and children to guide professionals, including those new to using art therapy and creative approaches in end-of-life care services. This international handbook is essential reading for arts therapists, social workers, medical personnel, faith leaders, and psychologists interested in a collaborative and accessible approach to working with patients and families affected by loss.

Life at Home for People with a Dementia provides an evidence-based and readable account of improving life at home for people with a dementia and their families. There are estimated to be 47 million people with a dementia worldwide, the majority of whom will live, or want to live, in their own home. Yet there is a major shortcoming in available knowledge on what life is like for people with a dementia living at home. Most research focuses on care in hospitals or care homes, and takes a medical perspective. This book bridges this gap in knowledge by providing a comprehensive and critical overview of the best available evidence on enabling people with a dementia to live well at home from the viewpoint of those living with the condition, and in the context of global policy drivers on ageing and health, as well as technological advances. The book includes chapters on citizenships - that is, the diversity of people living with a dementia - enabling life at home, rethinking self-management, the ethics and care of people with a dementia at home, technological care and citizenship, and sharing responsibilities. It concludes with a care manifesto in which we set out a vision for improving life at home for people with a dementia that covers the areas of professional practice, education and care research. By covering a wide range of interrelated topics to advance understanding and practice as to how people with a dementia from diverse backgrounds can be supported to live well at home, this book provides a synthesised, critical and readable understanding of the complexities and risks involved.

Leading palliative care experts illustrate how you can improve both communication with cancer patients and their quality of life. For more than twenty years, this guide has been the go-to resource for busy practicing oncology and palliative care clinicians. This fourth edition, now titled Comprehensive Guide to Supportive and Palliative Care for Patients with Cancer, provides physicians, advanced practice clinicians, and patients and their families with detailed information and advice for alleviating the suffering of cancer patients and their loved ones. Drawing on the work of experts who have developed revolutionary approaches to symptom management and palliative care, as well as on lessons learned during her decades as a teacher and clinician, Dr. Janet L. Abrahm and her coauthors illustrate how to help patients and families understand their prognosis, communicate their care preferences, and minimize their distress. This edition reflects important updates in the field while addressing the informational needs of a broader market of health care providers, including social workers, psychologists, psychiatrists, bereavement counselors, and chaplains. This new edition features three new chapters-"Spiritual Care in Palliative Care," "Psychological Considerations," and "Bereavement"-as well as specific guidelines about * advance care planning at all phases of cancer * understanding complex family dynamics and communication challenges * partnering with interpreters in the care of patients and family members with limited English-language proficiency * special considerations to take into account for LGBTQ+ patients and their loved ones * caring for patients who have a serious mental illness along with a cancer diagnosis * nonpharmacologic management of pain and other symptoms associated with cancer or its treatment The book features self-reflective exercises that encourage readers to consider their own biases before having discussions with patients and family members, as well as numerous patient stories that illustrate the techniques and insights clinicians can use to provide holistic, multidimensional care for a diverse cancer patient population.

Palliative Care Within Mental Health: Ethical Practice explores the comprehensive concerns and dilemmas that occur surrounding people experiencing mental health problems and disorders. Working beyond narrow, stereotypical definitions of palliative care as restricted to terminal cancer patients, this balanced and thought-provoking volume examines the many interrelated issues that face the individual, families, and caregivers, setting the groundwork for improved, ethical relationships and interventions. Chapters by experts and experienced practitioners detail the challenges, concerns, and best practices for ethical care and responses in a variety of individual and treatment contexts. This is an essential and thoughtful new resource for all those involved in the fast-developing field of palliative mental health.

This is the first book to explore how religion, belief and spirituality are negotiated in hospice care. Specifically, it considers the significant place that spiritual care has in hospice care and claims that the changing role of religion and belief in society highlights the need to re-examine how such identities are integrated in professional practice. Using religious literacy as a framework, the author explores how healthcare professionals in hospice care respond to religion, belief and spiritual identities of service users. Part 1 provides a comprehensive account of the content and history of the place of religion, belief and spirituality in hospice care. Part 2 examines how these topics are negotiated in hospice care by looking at three key areas: environment, professional practice and organisation. Part 3 proposes a religious literacy model applicable to hospice care and explores implications for practice and policy. Lastly, the author identifies future trends in research, policy and practice. Drawing on a range of theories and concepts and proposing a working model that can impact the training of future and current professionals, Religious Literary in Hospice Care should be considered essential reading for students, researchers and practitioners.

aThis is a beautifully written account from the front lines of a struggle between a federal drug war complex determined to keep demonizing marijuana and the growing movement of patients and doctors who have found marijuana to be a valuable medicine. Voters in California and many other states have strongly supported the patients. The moving stories in this book show why.a
--Craig Reinarman, co-author of "Crack in America: Demon Drugs and Social Justice"

aChapkis and Webb have done a masterful job in describing the intricacies of the drug debate and offer brilliant analysis on a complex and controversial subject. Both baby boomers and the current teenage population will find this book important and compelling reading.a
--Terry Williams, author of "Crackhouse: Notes from the End of the Line"

Marijuana as medicine has been a politically charged topic in this country for more than three decades. Despite overwhelming public support and growing scientific evidence of its therapeutic effects (relief of the nausea caused by chemotherapy for cancer and AIDS, control over seizures or spasticity caused by epilepsy or MS, and relief from chronic and acute pain, to name a few), the drug remains illegal under federal law.

In Dying to Get High, noted sociologists Wendy Chapkis and Richard J. Webb investigate one community of seriously-ill patients fighting the federal government for the right to use physician-recommended marijuana. Based in Santa Cruz, California, the Wo/Menas Alliance for Medical Marijuana (WAMM) is a unique patient-caregiver cooperative providing marijuana free of charge to mostly terminally ill members. For a brief period in 2004, it even operated the only legalnon-governmental medical marijuana garden in the country, protected by the federal courts against the DEA.

Using as their stage this fascinating profile of one remarkable organization, Chapkis and Webb tackle the broader, complex history of medical marijuana in America. Through compelling interviews with patients, public officials, law enforcement officers and physicians, Chapkis and Webb ask what distinguishes a legitimate patient from an illegitimate apothead, a agooda drugs from abad, a medicinal effects from ajust getting high.a Dying to Get High combines abstract argument and the messier terrain of how people actually live, suffer and die, and offers a moving account of what is at stake in ongoing debates over the legalization of medical marijuana.

Nearly half of people at the end of life will receive hospice care, but few psychologists, nurses, physicians, chaplains, and hospice workers have been trained specifically to recognize and address the psychological, social, and emotional issues that may arise in patients who are dying. Patients in the midst of advanced terminal illness may experience a variety of distressing emotions, and may feel anxious, frightened, regretful, or desperate. This guide was created specifically to guide helping professionals of all kinds through the process of working through patients' psychological issues to allow them peace and comfort in their final moments.

The Helping Professional's Guide to End-of-Life Care clarifies the spiritual and emotional care that patients need and presents an evidence-based approach integrating cognitive behavioral therapy (CBT), transpersonal psychotherapy, hypnosis, mindfulness, and guided imagery to help patients manage emotional distress at the end of life. Through case conceptualizations and detailed treatment planning guidance, readers learn to formulate comprehensive assessment and treatment plans for patients and gain skills that will help them manage the emotional intensity of this work. This secular, professional treatment model can be applied to patients of any religious or spiritual background. The book also addresses integrating the patient's therapeutic team with the medical team, addressing the emotional needs of friends and family of the dying, crisis intervention for suicidal patients, working with clients on psychotropic medications, and how helping professionals can manage their own emotions to become more effective clinicians.

This book provides healthcare professionals with a practice theory for the care and management of patients who have been diagnosed with cancer. It explores what patients experience and how healthcare professionals can assist them in dealing with their uncertainty and fear as well as planning for the future. Unique to the book is its explication of the emerging theory, 'The Omnipresence of Cancer', which is set in the context of a discussion of earlier theories also concerned with cancer care. Chapters demonstrate how 'The Omnipresence of Cancer' has been developed, validated through research and being further tested in relation to cancer care. In particular, a chapter on philosophical reflections using theory to produce knowledge for practice is included. Each chapter provides essential background, a synthesis of the current state of knowledge, and practice examples associated with cancer care. The combination of theoretical reflection and practice examples is designed to promote comprehension and guidance on implementation of the theory, as well as recommendations for practice. This book will be of significant interest to healthcare students and professionals working in the field of cancer care and oncology, particularly healthcare professionals working in advanced practice roles and nurse educators. It is also anticipated that professionals working in pastoral care, occupational therapy, social work and radiography will be interested in this book.

The third edition of Hospice and Palliative Care is the essential guide to the hospice and palliative care movement both within the United States and around the world. Chapters provide mental-health and medical professionals with a comprehensive overview of the hospice practice as well as discussions of challenges and the future direction of the hospice movement. Updates to the new edition include advances in spiritual assessment and care, treatment of prolonged and complicated grief, provision of interdisciplinary palliative care in limited-resource settings, significant discussion of assisted suicide, primary healthcare including oncology, and more. Staff and volunteers new to the field along with experienced care providers and those using hospice and palliative care services will find this essential reading.

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America's project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients'rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

Eight years has passed since the first edition of The Handbook of Psychiatry in Palliative Medicine
was published. In that time, psychiatric (or psychosocial) palliative care has evolved; the net effect on palliative medicine has been transformative. Palliation that neglects psychosocial dimensions of patient and family experience, de facto, fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying beginning to take hold.
The first comprehensive textbook of psychiatric palliative care, this new edition has been fully updated, reorganized and expanded to include eleven new chapters. Written by 67 internationally known psychiatry and palliative care experts, the book is truly an essential reference for all providers of palliative care including psychiatrists, psychologists, mental health counselors, oncologists, hsopice workers and social workers. Each chapter has been updated to address new therapeutic modalities and approaches as well as new research trends and opportunities for each topic.

Enter the world of organ transplantation and develop a new understanding of processes and techniques for working effectively with patients in this increasing medical population. This multidisciplinary overview of organ transplantation contains chapters by major figures in the medical arena, internationally known bioethics writers, and experienced chaplains from the clinical setting of transplantation, as well as respected pastoral theologians. The authors, who include Art Caplan, Donald Capps, and Jack Copeland, explain transplantation completely for the nonmedical person and delve into the myriad ethical and religious issues and controversies surrounding organ donation and transplantation. Enlightening chapters clarify issues and help readers better understand the transplantation process, making them more effective in their work with transplant patients.Organ Transplantation in Religious, Ethical and Social Context is divided into three sections. The first emphasizes transplantation as a team effort. Chapters focus on the various roles of chaplains and other team members. Section two addresses ethical questions which arise from transplantation and organ donation and includes interfaith perspectives. The third section is dedicated to theological and pastoral views concerning transplantation.Some specific topics discussed in this book include: a surgeon's perspective of the role of the chaplain influence of psychosocial factors in the heart transplantation decision process ministry to organ recipients and their families the special relationship between the transplant coordinator and the transplant patient Catholic and interfaith perspectives on organ donation using the Psalms as a pastoral resource with transplant patientsHospital chaplains, transplant social workers, transplant coordinators, and other professionals interested or involved in the process of organ transplantation will find this book to be full of interesting and thought-provoking insights and information.

Spirituality and Coping with Loss: End of Life Healthcare Practice describes a research study that reflects nurses' experience of the nature of loss encountered in end of life care settings as well as the ways in which spirituality is a resource in coping in these situations. Key findings indicate how nurses' spiritual development impacts their proficiency in spiritual care. These findings will be of interest to nurses and nurse educators as well as other healthcare professionals.

The concept of a "good death" has been hotly debated in medical circles for decades. This volume delves into the possibility and desirability of a "good death" by presenting the psychosocial measures of care as a crucial component, such as religion, existentialism, hope and meaning-making. The volume also focuses on oncologic psychiatry and the influence of technology as a means to alleviate pain and suffering, and potentially provide relief to those at the end of life. Such initiatives are aimed at diminishing pain and are socially bolstering and emotionally comforting to ensure a peaceful closure with life as opposed to a battle waged. Utilizing the most recent information from medical journals and books to present the latest on healthcare and dying today, this volume crosses the boundaries of thanatology, psychology, religion, spirituality, medical ethics and public health.

* Provides valuable guidance for all student and practising SLTs who are working with older people with communication and swallowing difficulties. * Offers a holistic approach, not only looking at the physiological/biological effects, but taking into account the psychological and social impacts of aging. * Bridges theory and practice, with an emphasis on practical strategies and advice for clinicians to use in their daily work. * Dispels the myths which sound aging (due to a lack of knowledge of what is considered to be within normal range), which can lead to misdiagnosis.

This book is a successor to J Griffiths, A Bood and H Weyers, Euthanasia and Law in the Netherlands (Amsterdam University Press 1998) which was widely praised for its thoroughness, clarity, and accuracy. The new book emphasises recent legal developments and new research, and has been expanded to include a full treatment of Belgium, where since 2002 euthanasia has also become legal. The book also includes descriptions written by local specialists of the legal situation and what is known about actual practice in a number of other European countries (England and Wales, France, Italy, Scandinavia, Spain, Switzerland). The book strives for as complete and dispassionate a description of the situation as possible. It covers in detail: - the substantive law applicable to euthanasia, physician-assisted suicide, withholding and withdrawing treatment, use of pain relief in potentially lethal doses, palliative and terminal sedation, and termination of life without a request (in particular in the case of newborn babies); -the process of legal development that has led to the current state of the law; -the system of legal control and its operation in practice; -the results of empirical research concerning actual medical practice. A concluding part deals with some general questions that arise out of the material presented: Is the legalisation of euthanasia an example of the decline of law or should it, on the contrary, be seen as part and parcel of the increasing juridification of the doctor-patient relationship? Does the Dutch experience with legalised euthanasia support the idea of a 'slippery slope' toward a situation in which life-especially of the more vulnerable members of society-is less effectively protected? Is it possible to explain and to predict when a society will decide to legalise euthanasia?

What is it like to live with-and love-someone whose death, while delayed, is nevertheless foretold? In Living in Death's Shadow, Emily K. Abel, an expert on the history of death and dying, examines memoirs written between 1965 and 2014 by family members of people who died from chronic disease. In earlier eras, death generally occurred quickly from acute illnesses, but as chronic disease became the major cause of mortality, many people continued to live with terminal diagnoses for months and even years. Illuminating the excruciatingly painful experience of coping with a family member's extended fatal illness, Abel analyzes the political, personal, cultural, and medical dimensions of these struggles. The book focuses on three significant developments that transformed the experiences of those dying and their intimates: the passage of Medicare and Medicaid, the growing use of high-tech treatments at the end of life, and the rise of a movement to humanize the care of dying people. It questions the exalted value placed on acceptance of mortality as well as the notion that it is always better to die at home than in an institution. Ultimately, Living in Death's Shadow emphasizes the need to shift attention from the drama of death to the entire course of a serious chronic disease. The chapters follow a common narrative of life-threatening disease: learning the diagnosis; deciding whether to enroll in a clinical trial; acknowledging or struggling against the limits of medicine; receiving care at home and in a hospital or nursing home; and obtaining palliative and hospice care. Living in Death's Shadow is essential reading for everyone seeking to understand what it means to live with someone suffering from a chronic, fatal condition, including cancer, AIDS, Alzheimer's, and heart disease.

New York Times Bestseller A poignant love letter to Bloom's husband and a passionate outpouring of grief, In Love reaffirms the power and value of human relationships. In January 2020, Amy Bloom travelled with her husband Brian to Switzerland, where he was helped by Dignitas to end his life while Amy sat with him and held his hand. Brian was terminally ill and for the last year of his life Amy had struggled to find a way to support his wish to take control of his death, to not submerge 'into the darkness of an expiring existence'. Written with piercing insight and wit, In Love is Bloom's intimate, authentic and startling account of losing Brian, first slowly to the disease of Alzheimer's, and then on becoming a widow. It charts the anxiety and pain of the process that led them to Dignitas, while never avoiding the complex ethical problems that are raised by assisted death. 'Poignant, kind, funny and ultimately redemptive' - Alain de Botton, author of The Course of Love 'In Love is a thrillingly beautiful, laser-eyed book about love, life, mortality and, most remarkably, about the ways in which no one of the three can be separated from the others' - Michael Cunningham, author of The Hours and A Home at the End of the World

Fear and Primordial Trust explores fear as an existential phenomenon and how it can be overcome. Illustrated by clinical examples from the author's practice as a psychotherapist and spiritual caregiver working with the severely ill and dying, the book outline theoretical insights into how primordial trust and archaic fear unconsciously shape our personality and behaviour. This book discusses in detail how in our everyday world, we lack primordial trust. Nevertheless, all of us have internalized it: as experiences of another non-dual world, of being unconditionally accepted, then sheltered and nurtured. The book outlines how from a spiritual viewpoint, we come from the non-dual world and experience a transition by becoming an ego, thereby experiencing archaic fear. This book explains fear in terms of two challenges encountered in this transition: firstly, leaving the non-world world when everything changes and we feel forlorn. Secondly, on awakening in the ego when we feel dependent and overwhelmed by otherness. The book also helps readers to understand trust as the emotional and spiritual foundation of the human soul, as well as how fear shapes us and how it can be outgrown. The book makes the case that understanding fear and primordial trust improves care and helps us to better understand dying. It will be of interest to academics, scholars and students in the fields of psychiatry, counselling, psychotherapy and palliative care and to all those interested in understanding fear, trust and the healing potential of spiritual experiences. Chapters 1 and 3 of this book are freely available as a downloadable Open Access PDF under a Creative Commons Attribution 4.0 license available at https://www.taylorfrancis.com/books/mono/10.4324/9781003176572

Living with Uncertainty gives a broad perspective on the complexities and challenges of the practice of end-of-life care, as well as the perceived benefits and limitations of medical intervention. Drawn from research and clinical and pastoral experience, the book examines the feelings associated with the end of life, highlighting the demands that people are faced with and their consequences. It moves into the difficult area of people who feel defeated by their illness and can or want to live no longer, as well as the family, caregivers and professionals who surround them. These perspectives have been built upon around a hundred narratives of lived experience, combined with the wider clinical and practical range of voices. A topical post-script Lessons from Covid-19 captures the choices and challenges on a personal, professional and systemic level which the pandemic acutely revealed with a multiplicity of examples. This will be essential reading for students and professionals in palliative and end-of-life care. Families and friends will also benefit from this book as they try to come to terms with the delicate but universal issues of death and dying.

High quality instruction in an authentic clinical environment is a must for all healthcare programs. Packed with strategies to help clinical instructors develop as educators and strengthen their teaching practice, this text is a key resource for those new to educating in a clinical setting. The first part of this practical book explores becoming a clinical instructor. It looks at the responsibilities of the role as well as the traits of effective clinical instructors. Introducing the concept of teacher identity, it offers suggestions for making the transition from healthcare practitioner to clinical educator. The book's second part provides information on teaching in the healthcare environment. It introduces principles of curriculum design and planning, pedagogy and teaching strategies, performance assessment, and the delivery of constructive feedback. The final chapter in this part discusses helping students prepare for entry into the healthcare workforce. The book ends with a chapter on ways to support clinical instructors. Including reflective practice exercises, practical tips for dealing with challenging situations, and sample rubrics and templates, this useful book provides a foundation for the healthcare practitioner who is beginning a career in clinical education. It is also a valuable guide for more experienced instructors and those who manage clinical instructors.

Collaborative Practice in Palliative Care explores how different professions work collaboratively across professional, institutional, social, and cultural boundaries to enhance palliative care. Analysing palliative care as an interaction between different professionals, clients, and carers, and the social context or community within which the interaction takes place, it is grounded in up-to-date evidence, includes global aspects of palliative care and cultural diversity as themes running throughout the book, and is replete with examples of good and innovative practice. Drawing on experiences from within traditional specialist palliative care settings like hospices and community palliative care services, as well as more generalist contexts of the general hospital and primary care, this practical text highlights the social or public health model of palliative care. Designed to support active learning, it includes features such as case studies, summaries, and pointers to other learning resources. This text is an important reference for all professionals engaged in palliative care, particularly those studying for post-qualification programmes in the area.