Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.

Most chronically and terminally ill patients are cared for in their own homes by family and friends, rather than in hospitals or hospices. These carers are an invaluable free resource and there is an increasing amount of research into their role and the experiences in caring for the terminally ill, patients with cancer and patients with other chronic diseases. This book provides a critique of the theoretical concept of caring, carers and caregivers. Material is based on empirical evidence from recent studies with adults with acquired chronic illnesses, including terminal illness. The empirical data within the book has been gathered from the perspective of those providing personal, domestic or emotional care to others already known to them by virtue of kinship, co-habitation or friendship, rather than carers organised on a professional or voluntary basis. This new evidence is used to make suggestions about possible ways forward within health and social care practice. Students in the fields of health and social care as well as in social sciences undertaking courses with a health focus, practitioners and researchers in palliative care and all those involved in health services provision for the chronically ill will find this book extremely valuable. Other books published by OUP: Palliative care in the home, Derek Doyle & David Jeffrey Integrated cancer care - holistic, complementary and creative approaches, Jennifer Barraclough

Communication in Palliative Nursing presents the COMFORT Model, a theoretically-grounded and empirically-based model of palliative care communication. Built on over a decade of communication research with patients, families, and interdisciplinary providers, and reworked based on feedback from hundreds of nurses nationwide, the chapters outline a revised COMFORT curriculum: Connect, Options, Making Meaning, Family caregivers, Openings, Relating, and Team communication. Based on a narrative approach to communication, which addresses communication skill development, this volume teaches nurses to consider a universal model of communication that aligns with the holistic nature of palliative care. This work moves beyond the traditional and singular view of the nurse as patient and family educator, to embrace highly complex communication challenges present in palliative care-namely, providing care and comfort through communication at a time when patients, families, and nurses themselves are suffering. In light of the vast changes in the palliative care landscape and the increasingly pivotal role of nurses in advancing those changes, this second edition provides an evidence-based approach to the practice of palliative nursing. Communication in Palliative Nursing integrates communication theory and health literacy constructs throughout, and provides clinical tools and teaching resources to help nurses enhance their own communication and create comfort for themselves, as well as for patients and their families.

This volume presents a series of case narratives, following individual patients and families throughout the course of illness and death in the context of hospice and palliative care. Using a variety of qualitative research methods, including participant-observation, interviews, and journal-keeping, the experiences, perceptions, and feelings of the patient, the family and a range of caregivers are recorded, providing the reader with rich, multi-textured narratives. Going beyond conventional case reports in Medicine, typically concentrating on symptoms and treatment, these narratives depict how individuals find personal meaning in illness, and how this influences the experience and outcome of care.

This is the fourth book in a series devoted to research and practice in palliative care. This rapidly evolving field focuses on the management of phenomena that produce discomfort and undermine the quality of life of patients with incurable medical disorders. To highlight the diversity in this field, each volume is divided into sections that address a range of issues. Various sections discuss aspects of symptom control, psychosocial functioning, spiritual orr existential concerns, ethics, and other topics. The four sections in this volume are; Survival Estimation in Palliative Care, Education and Training in Palliative Care, Procoagulant and Anticoagulant Therapy in Palliative Care, and Issues in the Assessment and Management of Common Symptoms. The authors present and evaluate existing data, provide a context drawn from both the clinic and research, and integrate knowledge in a manner that is both practical and readable.

The Textbook of Palliative Care Communication is the authoritative text on communication in palliative care, providing a compilation of international and interdisciplinary perspectives. This volume was uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, and it unites clinicians with academic researchers interested in the study of communication. By featuring practical conversation and curriculum tools stemming from research, this text integrates scholarship and inquiry into translatable content that others can use to improve their practice, teach skills to others, and engage in patient-centered communication. The volume begins by defining communication, explicating debatable issues in research, and highlighting specific approaches to studying communication in a palliative care context. Chapters focus on health literacy and cultural communication, patient and family communication, barriers and approaches to discussing palliative care with specific patient populations, pain, life support, advance care planning, and quality of life topics such as sexuality, spirituality, hope, and grief. Team communication in various care settings is outlined, and current research and education for healthcare professionals are summarized. Unique to this volume are chapters on conducting communication research, both qualitatively and quantitatively, to promote further research in palliative care.

A widely adopted practitioner resource and course text, this book shows how to apply knowledge about behavior change in general -- and the stages-of-change model in particular -- to make substance abuse treatment more effective. The authors are leaders in the field who describe ways to tailor interventions for clients with varying levels of motivation or readiness to change. They draw on cutting-edge theory and research on the transtheoretical model to explain what works (and what doesn't work) at different stages of change. Rich clinical examples illustrate the "whats," "whys," and "how-tos" of using the stages-of-change model to inform treatment planning and intervention for individuals, groups, couples, and families. New to This Edition *Reflects the ongoing development of the stages-of-change model and research advances over the past decade. *Chapter on stage-based brief interventions in health care, social service, and community settings. *Group treatment chapter has been significantly revised. *Expanded coverage of the change processes relevant to each stage. See also Group Treatment for Substance Abuse, Second Edition, by Mary Marden Velasquez et al., a manual for a group-based approach grounded in the transtheoretical model.

This practical guide summarizes the principles of working with dying patients and their families as influenced by the commoner world religions and secular philosophies. It also outlines the main legal requirements to be followed by those who care for the dying following the death of the patient. The first part of the book provides a reflective introduction to the general influences of world religions on matters to do with dying, death and grief. It considers the sometimes conflicting relationships between ethics, religion, culture and personal philosophies and how these differences impact on individual cases of dying, death and loss. The second part describes the general customs and beliefs of the major religions that are encountered in hospitals, hospices, care homes and home care settings. It also includes discussion of non-religious spirituality, humanism, agnosticism and atheism. The final part outlines key socio-legal aspects of death across the UK. Death, Religion and Law provides key knowledge, discussion and reflection for dealing with the diversity of the everyday care of dying and death in different religious, secular and cultural contexts. It is an important reference for practitioners working with dying patients, their families and the bereaved.

Experiencing a parent or guardian with cancer is extremely difficult for children and adolescents with healthcare professionals and cancer support centres often lacking the specialised knowledge needed to also support these individuals. This practical guide provides a comprehensive and current understanding of the impact of parental cancer on children, young people and families. It offers a longitudinal account of the impact of cancer through the different stages of the illness and explores the impact of culture and international contexts on how families experience parental cancer. The book also crucially focuses on how to support children, young people and families by examining existing interventions. Important chapters on death and bereavement, and on self-care for practitioners also supplement the book. A valuable handbook for healthcare practitioners from a range of specialities working with patients and families affected by cancer, including clinical psychology, counselling, nursing, oncology, palliative care and social work.

Structured around a personal account of the illness and death of the author's partner, Jane, this book explores how something hard to bear became a threshold to a world of insight and discovery. Drawing on German Idealism and Jane's own research in the area, The Aesthetic Experience of Dying looks at the notion of life as a binary synthesis, or a return enhanced, as a way of coming to understand death. Binary synthesis describes the interplay between dynamically opposing pairs of concepts - such as life and death - resulting in an enhanced version of one of them to move forward in a new cycle of the process. Yet what relevance does this elegant word game have to the shocking diagnosis of serious illness? Struggling to balance reason with sense, thought with feeling, this book examines the experience of caring for someone from diagnosis to death and is illustrated with examples of the return enhanced. The concluding chapter outlines how the tension of Jane's dying has been resolved as the rhythmic patterns of the lifeworld have been understood through the process of reflecting on the experience. This creative and insightful book will appeal to those interested in the medical humanities. It will also be an important reference for practising and student health professionals.

The first comprehensive, clinically focused guide to help hospitalists and other hospital-based clinicians provide quality palliative care in the inpatient setting. Written for practicing clinicians by a team of experts in the field of palliative care and hospital care, Hospital-Based Palliative Medicine: A Practical, Evidence-Based Approach offers: * Comprehensive content over three domains of inpatient palliative care: symptom management, communication and decision making, and practical skills, * Detailed information on assessment and management of symptoms commonly experienced by seriously ill patients, * Advise on the use of specific communication techniques to address sensitive topics such as prognosis, goals of care, code status, advance care planning, and family meetings in a patient- and family-centered manner, * Targeted content for specific scenarios, including palliative care emergencies, care at the end of life, and an overview of post-hospital palliative care options, * Self-care strategies for resilience and clinician wellness which can be used to help maintain an empathic, engaged, workforce and high quality patient care, * A consistent chapter format with highlighted clinical pearls and pitfalls, ensuring the material is easily accessible to the busy hospitalist and associated hospital staff. This title will be of use to all hospital clinicians who care for seriously ill patients and their families. Specialist-trained palliative care clinicians will also find this title useful by outlining a framework for the delivery of palliative care by the patient s front-line hospital providers. Also available in the in the Hospital-Based Medicine: Current Concepts series: Inpatient Anticoagulation Margaret C. Fang, Editor, 2011 Hospital Images: A Clinical Atlas Paul B. Aronowitz, Editor, 2012 Becoming a Consummate Clinician: What Every Student, House Officer, and Hospital Practitioner Needs to Know Ary L. Goldberger and Zachary D. Goldberger, Editors, 2012 Perioperative Medicine: Medical Consultation and Co-Management Amir K. Jaffer and Paul J. Grant, Editors, 2012 Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine James C. Pile, Thomas E. Baudendistel, and Brian J. Harte, Editors, 2013 Inpatient Cardiovascular Medicine Brahmajee K. Nallamothu and Timir S. Baman, Editors 2013

When Professionals Weep speaks to the humbling and often transformational moments that clinicians experience in their careers as caregivers and healers-moments when it is often hard to separate the influence of our own emotional responses and worldviews from the patient's or family's. When ProfessionalsWeep addresses these poignant moments-when the professional's personal experiences with trauma, illness, death, and loss can subtly, often stealthily, surface and affect the helping process. This edition, like the first, both validates clinicians' experiences and also helps them process and productively address compassion fatigue, burnout, and secondary traumatic stress. New material in the second edition includes increased emphasis on the burgeoning fields of hospice and palliative care, organizational countertransference, mindfulness, and compassionate practice. It includes thought-provoking cases, self-assessments, and exercises that can be used on an individual, dyadic, or group basis. This volume is an invaluable handbook for practitioners in the fields of medicine, mental health, social work, nursing, chaplaincy, the allied health sciences, psychology, and psychiatry.

Full of practical, evidence based advice, 'Heart Failure and Palliative Care' encourages a multidisciplinary team based approach. It stimulates joint working between primary care, cardiology and palliative care teams - raising awareness of the problems associated with supportive and palliative care for heart failure patients. The second edition has been significantly revised and updated with brand new chapters and sections on shared decision making, advance care planning, devices, ACP and non-LVSD failure. 'Heart Failure and Palliative Care' offers optimum care solutions vital to all palliative care professionals in a wide variety of hospital and community settings.

The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.

Palliative care is within the remit of all health care professionals in any setting. "An Integrated Approach to Generic Palliative Care" is an accessible practical guide to the delivery of good palliative care, combining theory and practice, aimed at all members of the multidisplinary team. It explains and complements the government led End of Life Care programme which is being coordinated by Strategic health Authorities, incorporating the Gold Standards Framework, the Preferred Place of Care and the Liverpool Care Pathway.

An integrated approach is advocated throughout this book- in all sections the orthodox approach to treatments and care is discussed alongside a complementary approach. This text provides a highly practical approach to pain and symptom approach support including a pain assessment tool for the severely cognitively impaired and a detailed account on how to titrate morphine to individual patients. It also explores hope and spiritual pain showing that these two existential notions are actually part of every day practice.e

This easy-to-read, practical guide distils and compiles all the disparate literature on cancer into one succinct volume. It includes the essential, evidence-based clinical guidelines needed for the safe and effective management of patients with cancer, and has a clear layout to allow for quick reference whilst on the ward. All aspects of cancer and its management are covered, including prevention, screening, diagnosis, and treatment. The text begins by outlining the clinical approach to suspected cancer and the principles of multidisciplinary prevention and management. It then progresses through site-specific cancer management, including head and neck, CNS, thoracic, breast, gastrointestinal system, genitourinary system, female genital system, skin, musculoskeletal system, haemopoietic system, and endocrine. Later chapters cover oncological emergencies and acute oncology, and special situations such as cancer in younger and older people, and pregnancy and fertility. The guide also offers information about coping with the lifestyle and social issues that may arise with a diagnosis of cancer, such as insurance, travel and support, and includes a chapter dedicated to palliative care for the cancer patient. A unique appendix of clinical management flowcharts assists fast, appropriate decision-making.

"Anne's contribution to our understanding of the needs of young people with cancer has been unparalleled and without her extraordinary insights our services would be that much poorer." From the foreword by Simon Davies, CEO Teenage Cancer Trust This topical and timely text provides valuable insights into the choices and experiences of palliative and end of life care for young people with cancer and other life limiting illnesses. With a focus on palliative care provision across a range of different clinical settings, this comprehensive new resource explores care in the home, the hospice and hospital. It looks at how and where families and young people can access palliative care, and what support is offered to attain their preferred place of death. Bereavement support for families is discussed, as well as a discussion of multi-disciplinary work, interagency co-operation and resource issues. This will be essential reading for community children's nurses, specialist palliative care teams, children's hospices, school nurses, social workers and student nurses as well as families. * A comprehensive resource on end of palliative are provision for children and young adults with cancer and other life limiting illnesses * Timely and topical, tying in with the latest Department of Health palliative care strategy Better Care: Better Lives' * Written in an accessible style that does not assume either detailed medical or theoretical knowledge * Explores palliative care provision in a range of different clinical settings including the home, hospice, and hospital * Provides valuable insights into the experiences of parents, children and young people

Caring for the Family Caregiver examines the high cost and poorly addressed exigencies of the family caregiver in chronic illness, including health literacy, palliative care, and health outcomes, through the prism of communication. This book uses an interdisciplinary approach to identify the impact of communication and its burdens on the caregiver and presents four caregiver profiles: the Manager, Carrier, Partner, and Lone caregiver, each emerging from a family system with different patterns of conversational sharing and expectations of conformity. By synthesizing current data assessing the experiences of caregivers, as well as integrating the narrative experiences of a range of caregivers living through a variety of illnesses and their specific demands, the authors deliver an unflinching gaze at the journey of the caregiver. With an author team comprised of three health communication researchers and a nurse and health literacy expert, this volume integrates literature addressing caregiver needs and burdens, communication theory and practice, palliative care and health literacy research, and the real stories of caregivers. Caring for the Family Caregiver presents the groundbreaking concept of the Caregiver Types and an innovative set of support resources to facilitate improved pathways to better care for the caregiver, making it an essential resource for providers, students, clinicians, policy makers and family caregivers alike.

A practical, empowering guide to navigating your partner's diagnosis of a terminal or life-limiting illness, or death. Receiving the news that your partner has a terminal or life-limiting illness, or has died unexpectedly, is among the worst experiences in life. At a time when you are least able to cope, you are faced with a multitude of difficult decisions, some of which must be made quickly. What you need is a friend who has experienced everything you are about to face, who can support you as you navigate some tough, important choices. This book is that friend. There is plenty of information out there but where to start looking? What information is needed and how can it be accessed? What decisions are essential in the immediate term and what can be left until later? Throughout the book, the emphasis is on protecting and supporting those left behind by presenting almost every choice you may need to make and the possible implications of each decision. You will learn: - The importance of creating a will, arranging power of attorney, organising advanced decisions of treatment, and even getting married or entering a civil partnership - What you are entitled to from the state, the NHS and your employer - How to stabilise your finances and prepare to run a household alone - Where your partner ought to be during treatment and/or palliative care, and how to go about achieving this - Which decisions need to be made after death, from planning the funeral to accessing your partner's estate - How to navigate the grieving process and take control of a happy future No matter where you are in the process, How to Survive Losing a Loved One is a comprehensive, practical and empowering guide to coping with your partner's terminal illness and death, and building the next chapter in your life.

The fifth edition of this seminal reference and text in palliative care nursing helps the practitioner and student offer comprehensive, targeted interventions responsive to the needs of palliative and hospice patients and families. Based on the best level of evidence available, reference to clinical practice guidelines, and palliative care order sets to address critical symptoms, the knowledge presented in this edition supports compassionate, timely, appropriate and cost-effective care to achieve quality health outcomes for diverse palliative care populations across the illness trajectory. Noteworthy features of the new edition include broadening population health management by helping the reader to identify patterns and connections within and across population and utilize information to respond to the needs of populations. This strategy allows the reader to apply strategies that are consistent with IHI's Triple Aim that includes Improving the patient experience of care, Improving the health of populations and reducing the per capita cost of health care. Every Chapter in Sections 1, 2, and 3 includes an Evidence Based Box with a current study including a commentary written by someone from a discipline other than nursing or by an interdisciplinary team.

By bridging the gap between conventional medical interventions and complementary approaches using aromatherapy, palliative care nurse and clinical aromatherapist, Carol Rose, demonstrates how an integrated and evidence-based approach can have the most significant impact on quality-of-life in patients with life-limiting illness. Aromatherapy is already a fundamental practice in many palliative care settings but its benefits remain under-researched and under-represented. Each chapter of this book incorporates a person-centred focus to consider the integration of various aromatherapy approaches for a range of end-of-life symptoms, alongside conventional medical options. The specificity of this approach and the emphasis of empowering patients to be involved in the process of choosing oils and applications, allows for improved results in the palliation of common symptoms. Integrating Clinical Aromatherapy in Palliative Care has a foundation in research from the patient's point of view. The result is a fresh perspective that prioritises support of patient choices, skilful communication and individualised care, alongside the judicious use of essential oils and other botanical products. Collectively, aromatherapy can completely reframe holistic care to allow for greater emotional, social and spiritual expression.

50 Studies Every Palliative Care Doctor Should Know presents key studies that have shaped the practice of palliative medicine. Selected using a rigorous methodology, the studies cover topics including: palliative care, symptom assessment and management, psychosocial aspects of care and communication, and end-of-life care. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for health care professionals and anyone who wants to learn more about the data behind clinical practice.

Now in paperback, the Oxford Textbook of Communication in Oncology and Palliative Care integrates clinical wisdom with empirical findings. Written by an international team of authors, it draws upon the history of communication science, providing the reader with a comprehensive curriculum for applied communication skills training. An essential resource, the Oxford Textbook of Communication in Oncology and Palliative Care is filled with tips and strategies for effective communication in difficult and challenging scenarios. In focusing on cancer and the end-of-life, it deals with the existential and spiritual challenges found across all of medicine, providing deep insights into what is at stake and how clinicians might optimally respond. This authoritative and wide-ranging book provides clinicians with state-of-the-art and evidence-based guidelines to achieve effective, patient-centred communication in the clinical settings of oncology and palliative care. This edition includes sections on the curriculum for nurses, the core curriculum, and an introductory section on communication science. The chapters embrace specialty issues across the clinical disciplines, from enrolling in clinical trials, working in teams, and discussing genetic risk, to talking about sexuality, infertility, and intercultural issues. An educational perspective is also provided, with chapters covering communication skills training, how to evaluate courses, and international models of training.

Structured around a personal account of the illness and death of the author's partner, Jane, this book explores how something hard to bear became a threshold to a world of insight and discovery. Drawing on German Idealism and Jane's own research in the area, The Aesthetic Experience of Dying looks at the notion of life as a binary synthesis, or a return enhanced, as a way of coming to understand death. Binary synthesis describes the interplay between dynamically opposing pairs of concepts - such as life and death - resulting in an enhanced version of one of them to move forward in a new cycle of the process. Yet what relevance does this elegant word game have to the shocking diagnosis of serious illness? Struggling to balance reason with sense, thought with feeling, this book examines the experience of caring for someone from diagnosis to death and is illustrated with examples of the return enhanced. The concluding chapter outlines how the tension of Jane's dying has been resolved as the rhythmic patterns of the lifeworld have been understood through the process of reflecting on the experience. This creative and insightful book will appeal to those interested in the medical humanities. It will also be an important reference for practising and student health professionals.

Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically-focused volumes in the HPNA Palliative Nursing Manuals series prepares nurses for certification exams as well as quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.