This book is a comprehensive guide to Targeted Drug Delivery (TDD), also known as Intrathecal Drug Delivery (IDD), and offers an overview to this unique form of treatment. The medication is delivered by intrathecal pumps and is less common than some other techniques for interventional pain management, but is essential in conditions such as refractory pain, cancer pain, multifocal pain, severe spasticity, and in patients who are not candidates for surgical correction of their underlying condition. This book is the first source to describe both the optimal surgical implantation and patient management aspect of this therapy, and thus will be a valuable single reference guide for interventional radiologists, anesthesiologists, physiatrists, oncologists, neurologists, spine surgeons, palliative care physicians, and primary care physicians.

Spiritual, Religious, and Cultural Aspects of Care is the fifth volume in the HPNA Palliative Nursing Manuals series. Chapters address how to conduct a spiritual assessment of patients and families, spiritual interventions including compassionate presence, listening deeply, bearing witness, and being compassionate, how to partner with the patient and family to ensure culture guides the plan of care, how to find meaning in illness, the many dimensions of hope and its influence on the dying process. 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.

Alzheimer disease afflicts more than twelve million people worldwide, and its incidence is increasing at a staggering rate. People with the disorder are living longer than have those in previous generations, and they require interventions for quality-of-life issues associated with palliative care. However, the symptoms of Alzheimer disease often fail to place such persons into settings where palliative care resources are available to them. Indeed, clinicians and other caregivers may be unsure about what constitutes effective palliation in these cases. At the same time, the ethical issues involved in providing end-of-life care to persons with Alzheimer disease remain on the margins of mainstream bioethics.

In "Ethical Foundations of Palliative Care for Alzheimer Disease," leading ethicists and clinicians from the United States and Europe explore ethical and scientific concerns about the diagnosis and prognosis of Alzheimer disease, challenges arising from applying palliative procedures to its symptoms, key philosophical and theological concepts central to our understanding of the disease and to end-of-life decisions, and the changing patterns of relevant medical, social, and economic policies. Cross-cultural, multidisciplinary, and state-of-the-art, this volume is a unique and important resource for bioethicists, clinicians, and policy makers everywhere.

Contributors: David A. Bennahum, M.D., University of New Mexico; Pierre Boitte, Ph.D., Catholic University of Lille, France; Roger A. Brumback, M.D., Creighton University Medical Center; Wim J. M. Dekkers, M.D., Ph.D., University Medical Centre Nijmegen, The Netherlands; Elizabeth Furlong, R.N., Ph.D., J.D., Creighton University Medical Center; Eugenijus Gefenas, M.D., Ph.D., Vilnius University, Lithuania; Bert Gordijn, Ph.D., University Medical Centre Nijmegen, The Netherlands; Amy M. Haddad, R.N., Ph.D., Creighton University Medical Center; Soren Holm, M.D., Ph.D., Dr.Med.Sci., University of Manchester; Franz J. Illhardt, D.D., Ph.D., Freiburg University; Rien Janssens, Ph.D., University Medical Centre Nijmegen, The Netherlands; Givi Javashvili, M.D., Ph.D., State Medical Academy of Georgia, Tbilisi; Judith Lee Kissell, Ph.D., Creighton University Medical Center; Gunilla Nordenram, D.D.S., Ph.D., Karolinska Institute, Stockholm; Richard L. O'Brien, M.D., Creighton University Medical Center; Marcel G. M. Olde Rikkert, M.D., Ph.D., University Medical Centre Nijmegen, The Netherlands; Winifred J. Ellenchild Pinch, R.N., Ed.D., Creighton University Medical Center; Patricio F. Reyes, M.D., Creighton University Medical Center; Anne-Sophie Rigaud, M.D., Ph.D., Hopital Broca, Paris; Linda S. Scheirton, Ph.D., Creighton University Medical Center; Jos V. M. Welie, M.Med.S., J.D., Ph.D., Creighton University Medical Center.

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.

What do you need to know in order to provide the best possible care for sick children of different faiths? What, in the context of the young person's faith, might it be helpful to know to support the child and the family, improve care, communicate sensitively and avoid causing offence? Drawing on extensive, evidence-based research and practice, this practical resource addresses the multi-faith needs of sick and dying children and young people in hospitals and the wider community. Covering Islam, Christianity, Hinduism, Sikhism, Judaism and Buddhism, it provides the key information needed to help multi-disciplinary healthcare staff offer the best, culturally-appropriate care to sick children and their families. The book discusses daily, palliative, end of life and bereavement care in a range of settings, including hospitals, hospices, schools and home. The information provided covers those aspects of the religions discussed that are essential for healthcare staff to understand, including modesty and hygiene, taboos, food and prohibited products, age-related issues, sacred objects, visitors, and the expectations of the family. It includes important information on the issues of disability and mental health in each faith as well as addressing the significance within different faith traditions of the transitions from childhood to adolescence to adulthood. A comprehensive resource that uniquely focuses on the care needs of sick children from different faiths, this book will be of immeasurable value to multi-disciplinary healthcare professionals including doctors, nurses, bereavement support and palliative care workers, carers, counsellors, chaplains and arts therapists.

A focus on intentional communication, team building, and relational maintenance.This text is designed to help form and maintain palliative care teams that survive and thrive. Whether you are starting a new team or hoping to help an existing team, this text addresses aspects of team players, leadership, meetings, organizational culture, and self- and team-care through a combination of empirical data and real voices from health care professionals in palliative care practice. By focusing on the individual professional in relation to team health and success, this text shows how to develop high quality, high-performing palliative care teams. Perfect for both students and the working professional, this text is useful at any time in your career or your team's development. It explores the types of providers involved in palliative care, their roles, possible conflicts, and the opportunity to amplify their work as a team while overcoming the stigma that may be attached to palliative care. This book focuses on the foundational role of communication in leadership, team building, and the delivery of patient care. Designed to provide workable solutions to challenges such as poor team design, siloing, and faulty communication, it provides suggestions that can be implemented immediately by your palliative care team. This focus allows health care professionals who are passionate about palliative care to grow into high functioning teams with a focus on excellent patient care. Key Features: Satisfactory and Unsatisfactory Palliative Care Experiences Stories from nurses, social workers, chaplains, physicians, pharmacists, executives, patients, and families Pearls from the Field: Provider and team takeaways Best practices of team leaders Tips for individuals and teams to communicate with other providers, departments, and senior leadership Discusses how to improve short-term and long-term functionality Outlines the predictors of burnout for palliative care professionals and teams Self-care and team-care suggestions Combines up-to-date research and theory in an accessible writing style

Nutrition, appetite, and involuntary weight loss are issues that affect a large number of cancer patients and cancer survivors. Aspects such as symptom management, behavioural modification, exercise and medication are all important aspects of cancer care, but nutritional issues at the end of life can be accompanied by contentious ethical factors as well as religious and cultural influences that need to be addressed by health professionals. This book enables physicians, nurses and also dieticians to better discuss these complex issues with patients and their families.
This comprehensive reference book provides both background information and practical, clinical advice for managing the cancer patient at all stages of their disease trajectory. It includes information that relates to patients who are continuing to receive disease-specific therapy, the cancer survivor, as well as patients with advanced or recurrent cancer receiving palliative care.
Basic principles such as epidemiology and physiology set the scene, leading into the cachexia/anorexia syndrome, treatment options, nutritional counselling, enteral and parenteral nutrition, complementary/alternative therapies, exercise, clinical outcomes measures in each of the clinical groups, and focus on special populations and their specific needs. Multidimensional, interdisciplinary clinical evaluation and treatment is emphasised, and ethical, religious, and cultural factors are also addressed.
Multidisciplinary in nature, this book draws on the experience of the editors' work across the fields of oncology, palliative care, surgery, primary care, nursing, dietetics and nutritional science. It will prove invaluable to all general practitioners, internists, medical oncologists and surgeons, nurses, palliative care specialists and related professionals involved in the care of the cancer patient.

There is increasing recognition of the burden of venous thromboembolism (VTE) in patients with advanced incurable disease and the clinical, ethical, and philosophical challenges they may pose. With a growing elderly population and oncological therapies helping patients live longer with malignant disease, VTE is likely to be an ongoing problem. Whilst presentation, diagnosis, and treatment of VTE in general medicine is well established, its management within the palliative care setting is less clear-cut. Clinical presentation is often masked by other palliative symptoms, and symptoms can be consistent with those of other conditions; diagnosis is therefore underappreciated, and the condition can be difficult to manage.
Bringing together contributions from international experts in the field of VTE and palliative care, this book explores the increasing challenges faced by healthcare professionals when managing VTE in advanced disease. Topics such as the epidemiology and pathogenesis of the condition are discussed. It appraises the current evidence informing the prevention, diagnosis, and treatment of VTE, with particular emphasis on its application to patients with incurable malignancy and non-malignant disease. Chapters are illustrated with key learning points and, where appropriate, case studies are presented to illustrate the decision-making processes that may occur when balancing the evidence with its impact on patient quality of life.
This practical resource is invaluable for healthcare professionals working in all areas of medicine where patients with advanced cancer and non-malignant disease are cared for.

While many effective interventions have been developed with the potential to significantly reduce morbidity and mortality from cancer, they are of no benefit to the health of populations if they cannot be delivered. In response to this challenge, Advancing the Science of Implementation across the Cancer Continuum provides an overview of research that can improve the delivery of evidence-based interventions in cancer prevention, early detection, treatment, and survivorship. Chapters explore the field of implementation science and its application to practice, a broad synthesis of relevant research and case studies illustrating each cancer-focused topic area, and emerging issues at the intersection of research and practice in cancer. Both comprehensive and accessible, this book is an ideal resource for researchers, clinical and public health practitioners, medical and public health students, and health policymakers.

Psycho-Oncology in Palliative and End-of-Life Care provides expert advice and clinical management guidelines on the impact of advanced cancer and its treatment on the life and wellbeing of a patient in palliative and end-of-life care. Employing a practical toolkit format, this volume addresses a variety of key challenges including: discussions of death and dying, poor prognoses, wishes and values of the dying person, advance care plans, anxiety, demoralization and problems with coping, depression and delirium, the needs of partners, children, families, and caregivers, and spiritual and bereavement care. Each chapter considers presenting symptoms, differential diagnoses and assessment methods to achieve the best diagnosis, so that a detailed formulation can be developed for each person that guides a comprehensive management plan. Each section concludes with professional and service issues ranging from ethical dilemmas, legal requirements, cultural needs, and training and service development issues, through to basic human rights. Part of the Psycho-Oncology Care: Companion Guides for Clinicians series, this concise pocket guide is a resource for oncology specialists, psycho-oncologists in training, consultant nurse specialists and nurse practitioners, and allied health professionals to use as a quick reference in everyday practice. Pitched at intermediate to advanced level skills, this companion guide can be used as a standalone, or alongside existing oncology and psycho-oncology training programs.

This book is a comprehensive guide to Targeted Drug Delivery (TDD), also known as Intrathecal Drug Delivery (IDD), and offers an overview to this unique form of treatment. The medication is delivered by intrathecal pumps and is less common than some other techniques for interventional pain management, but is essential in conditions such as refractory pain, cancer pain, multifocal pain, severe spasticity, and in patients who are not candidates for surgical correction of their underlying condition. This book is the first source to describe both the optimal surgical implantation and patient management aspect of this therapy, and thus will be a valuable single reference guide for interventional radiologists, anesthesiologists, physiatrists, oncologists, neurologists, spine surgeons, palliative care physicians, and primary care physicians.

This volume examines crucial concerns in palliative care, including the proper balance between comfort and cure for the patient, the integration of spiritual well-being, and the challenges of providing care in the absence of basic medical services and supplies. In the first section, palliative-care pioneers Constance Dahlin, Eduardo Bruera, Neil MacDonald, and Declan Walsh recount the early history of the discipline. Part 2 discusses the role of poetry, prose, plays, and other aspects of the humanities in the practice of palliative care. Part 3 explores essential current issues in the field, including autonomy, the use of opioids, and the impact of artificial intelligence on the evolution of palliative care. The final section focuses on the spiritual dimensions of pain and suffering. Rich with anecdotes and personal stories and featuring contributions from pioneers and current practitioners, The Pursuit of Life is an essential assessment of the past, present, and future of palliative care. In addition to the editors, the contributors include W. Andrew Achenbaum, Stacy L. Auld, Elena Pagani Bagliacca, Costantino Benedetti, Courtenay Bruce, Eduardo Bruera, Joseph Calandrino, Jim Cleary, Constance Dahlin, Andrea Ferrari, Mauro Ferrari, Joseph J. Fins, Bettie Jo Tennon Hightower, Kathryn B. Kirkland, Robin W. Lovin, Neil MacDonald, Charles Millikan, Dominique J. Monlezun, Tullio Proserpio, Giovanna Sironi, Daniel P. Sulmasy, and Declan Walsh.

This book presents a timely and multidisciplinary update on the modalities currently available for treating the most feared symptom of patients diagnosed with cancer. The various cancer pain syndromes are explored in detail, covering those related directly to malignancy and those due to the after-effects of cancer therapy. Treatment modalities, including pharmacologic approaches, interventional procedures, and palliative surgical options, are discussed clearly and concisely, with provision of recommendations for the practitioner. Further topics include new and emerging treatments for cancer pain, survivorship considerations, pain management in special populations, and implementation of systems-based pain programs. The book has been written by a multidisciplinary group of experts, reflecting the evolution in pain and symptom management that has occurred in parallel with progress toward more targeted oncologic treatments. Oncologists, palliative care physicians, allied health professionals, and other practitioners involved in caring for cancer patients will find Fundamentals of Cancer Pain Management to be a rich source of evidence-based insights into effective pain management.

Palliative care supports patients suffering from life-limiting illnesses by providing relief from physical, emotional and spiritual suffering, improving the quality of life for them and their families. It is an important component of good patient care, an integral part of the continuum of support for patients suffering with advanced cancer and end stage organ diseases. Providing good palliative care requires both sound clinical knowledge and compassion.With new chapters on end stage organ diseases, spiritual care and medical ethics, all healthcare professionals will find wisdom and practical advice in this book by the patient's bedside. The editors and contributors of the 2nd Edition of The Bedside Palliative Medicine Handbook have taken great care to provide readers with an evidence-based, updated guide to the practice of palliative medicine.

This book provides insights into the care of cancer patients in the intensive care unit in a comprehensive manner. It provides an evidence-based approach to practitioners and postgraduate students to understand about the critical care needs of the patients suffering from malignancies. It helps the readers to develop critical thinking and encourage discussion towards improving the overall care of the patients and their families as their optimal management requires expertise in oncology, critical care, and palliative medicine and there is a dearth of books explaining about the special requirements and critical care needs of cancer patients. Each chapter is prepared by an expert in the field and contains well-prepared illustrations, flowcharts and relevant images. Chapters include latest evidence-based information which is useful for the readers. The book is useful for residents, fellows and trainees in the field of onco-anaesthesia, onco-critical care, onco-surgery, critical care and anaesthesia; practitioners and consultants in anaesthesia and onco-anaesthesia as well as intensivist, critical care experts and postgraduates in nursing.

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

Christopher Kerr is a hospice doctor. All of his patients die. Yet he has tended thousands of patients who, in the face of death, speak of love, meaning and grace. They reveal that there is hope beyond cure as they transition to focus on personal meaning. In this extraordinary and beautiful book, Dr. Kerr shares his patients' stories and his own research pointing to death as not purely the end of life, but as a final passage of humanity and transcendence. Drawing on interviews with over 1,200 patients and more than a decade of quantified data , Dr. Kerr reveals why pre-death dreams and visions are remarkable events that bring comfort and exemplify human resilience. These are not regular dreams. Described as "more real than real," they frequently include loved ones long gone and mark the transition from distress to acceptance. These end-of-life experiences help patients restore meaning, make sense of the dying process and assist in reclaiming it as an experience in which they have a say. They also benefit the bereaved who get relief from seeing their loved ones pass with a sense of calm closure. Beautifully written with astonishing stories, this book, at its heart, celebrates the power to reclaim how we die, while soothing the bereaved who witness their loved ones go with unqualified grace.

The new global cancer data suggests that the global burden has risen to 18.1 million new cases per year and 9.6 million cancer deaths per year. A number of factors appear to be driving this increase, in particular, a growing and aging global population and an increase of exposure to cancer risk factors linked to social and economic development. For rapidly-growing economies, the data suggests a shift from poverty- or infection-related cancers to those associated with lifestyles more typical in industrialized countries. There is still large geographical diversity in cancer occurrence and variations in the magnitude and profile of the disease between and within world regions. There are specific types of cancer that dominate globally: lung, female breast and colorectal cancer, and the regional variations in common cancer types signal the extent to which societal, economic and lifestyle changes interplay to deferentially impact on the profile of this most complex group of diseases. Unfortunately, despite advances in cancer care, a significant proportion of patients at home, experience sub-optimal outcomes. Barriers to successful treatment outcomes include, but are not limited to: access to oncologists in the primary health centers, non-adherence, lack of experienced oncology and palliative care nurses in the community, inadequate monitoring and the lack of training of family and pediatric physicians. Telemedicine approaches, including telephone triage/education, telemonitoring, teleconsultation and status tracking through mobile applications, have shown promise in further improving outcomes, in particular for chronic cancer patients following their hospitalization. Lessons can be learned from existing hospices in North America, the United Kingdom, Australia, Centers of Excellence in African (Uganda) and modern community services in India (Kerala). An important goal of this book is to describe and encourage professionals to develop new community programs in palliative care, which include training and empowering physicians and nurses in the community on the principles of palliative care. The Middle East Cancer Consortium (MECC) together with the American Society of Clinical Oncology (ASCO) and the American Oncology Nursing Society (ONS) have conducted multiple courses ranging from basic palliative care to more specialized training in palliative care for multiple nationalities in Europe, Asia and Africa. Our experience clearly indicates that, to promote such activities, one needs strong leadership and confirmed political will to support the endeavor. The new book will emphasize the importance of having a core of multiple stakeholders including community leaders, government, NGOs and media to be actively involved in advocating for the cause and generating public awareness. This text will provide the reader with a comprehensive understanding of the outside-of-the-hospital treatment of cancer patients by medical, paramedical and volunteer personnel. In doing so, this text will encourage the creation of new palliative care services improving upon the existing ones and stimulate further research in this field. Part 1 of the text will begin with an overview of the current state of affairs of services provided to cancer patients while being cared for by primary health centers. It will also review the current literature regarding medical and psychological-based therapy options in the community for cancer patients at different stages of their disease. Part 2 will address the unique role of the community nurse, within the framework of the multidisciplinary team treating the patient, in the attempt to provide optimal evaluation and care in very challenging situations (such as with terminal patients). Part 3 will provide insightful models of this new discipline and serve as a valuable resource for physicians, nurses, social workers and others involved in the care of cancer patients. The book will take a multidisciplinary approach, integrating clinical and environmental data for practical management to enhance the efficacy of treatment while relieving suffering. Part 4 will also discuss the application of modern technological approaches to track symptoms, quality of life, diet, mobility, duration of sleep and medication use (including pain killers) in chronic cancer patients in the community. Part 5 of the book will also be devoted to modes of developing a collaborative program between governmental and non-governmental organization sectors. This includes volunteer workers in close collaboration with medical professionals for providing emotional and spiritual support, nursing care, nutritional support and empowering family caregivers. Such a model makes palliative care in the community a "people's movement", thus transferring part of the responsibility and ownership to the community.

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.