Palliative care is an essential element of our health care system and becoming increasingly significant amidst an aging society and organizations struggling to provide both compassionate and cost effective care. Palliative care is also characterized by a strong interdisciplinary approach. Nurses are at the center of the palliative care team across settings and populations. The second volume in the HPNA Palliative Nursing Series, Physical Aspects of Care: Pain, Nausea and Vomiting, Fatigue and Bowel Management, provides an overview of the principles of symptom assessment and management for symptoms including: pain, fatigue, nausea and vomiting, constipation, diarrhea, obstruction, and ascites. The content of the concise, clinically-focused volumes in the HPNA series prepares nurses for certification exams as well as quick-reference in daily practice. Plentiful tables, figures, and practical tools such as assessment instruments, pharmacology tables, and patient teaching points make these volumes useful resources for nurses.

Life and Death in Intensive Care offers a unique portrait of the surgical intensive care unit (SICU), the place in medical centers and hospitals where patients with the gravest medical conditions-from comas to terminal illness-are treated. Author Joan Cassell employs the concept of \u0022moral economies\u0022 to explain the dilemmas that patients, families, and medical staff confront in treatment. Drawing upon her fieldwork conducted in both the United States and New Zealand, Cassell compares the moral outlooks and underlying principles of SICU nurses, residents, intensivists, and surgeons. Using real life examples, Life and Death in Intensive Care clearly presents the logic and values behind the SICU as well as the personalities, procedures, and pressures that characterize every case. Ultimately, Cassell demonstrates the differing systems of values, and the way cultural definitions of medical treatment inform how we treat the critically ill.

Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness-whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family.Research has demonstrated palliative care's positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle 16 key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.

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

The growing geriatric population in the United States has created an increasing need for palliative medicine services across the range of medical and surgical specialties. Yet, palliative medicine lacks the resources to carry such a workload itself. Geriatric Palliative Care addresses this need by encouraging individual specialties to "own" the management of elderly with the same vigor as they "own" other key management competencies within their specialty. This clinically focused and highly practical handbook, which compliments the more comprehensive text Geriatric Palliative Care by Sean Morrison and Diane Meier (Oxford University Press, 2003), encourages this process of learning and ownership across many medical specialties. Designed to be readable and easily accessible to a range of health care providers, Geriatric Palliative Care outlines specific strategies for caring for specific palliative care issues common in elderly patients. The handbook also provides evidence based advice for helping patients, relatives, and staff cope with such issues as polypharmacy, dementia and consent, multiple pathologies, home care, elderly caregivers, and supporting the elderly in the place where they would like to be.

Patients with advanced cancer may develop a number of clinical complications related to tumor progression or a variety of aggressive treatments. The majority of these patients are elderly, often with multiple co-morbidities that require appropriate assessment and management. In the palliative stage of their disease, patients undergo a progressive transition from active acute care to community-based hospice care. This transition requires modification in the diagnostic tests, monitoring procedures and pharmacological treatments to adjust them to the palliative and short-term nature of the care. Internal Medicine Issues in Palliative Cancer Care looks at internal medicine through a prognosis-based framework and provides a practical approach to maximizing comfort and quality of life while minimizing aggressive investigations and therapies for patients with life-limiting disease. Forty-six common internal medicine conditions are organized into nine clinical categories: pulmonary, cardiovascular, nephrologic and metabolic, gastrointestinal, hematologic, infectious, endocrine, rheumatologic, and neuro-psychiatric. This evidence-based resource is ideal for educating clinicians delivering palliative care to cancer patients in acute care facilities about complex internal medicine problems, decision-making regarding diagnostics and therapeutics which require a good understanding of state-of-the-art internal medicine and palliative care principles.

One of the most challenging roles of the psycho-oncologist is to help guide terminally-ill patients through the physical, psychological, and spiritual aspects of the dying process. Patients with cancer, AIDS, and other life-threatening illnesses are at increased risk for the development of major psychiatric complications, and have an enormous burden of both physical and psychological symptoms. Concepts of adequate palliative care must be expanded beyond the current focus on pain and physical symptom control to include the psychiatric, psychosocial, existential, and spiritual aspects of care. The psycho-oncologist, as a consultant to or member of a palliative care team, has a unique role and opportunity to fulfill this promise of competent and compassionate palliative care for those with life-threatening illnesses. Psychosocial Palliative Care guides the psycho-oncologist through the most salient aspects of effective psychiatric care of patients with advanced illnesses. This handbook reviews basic concepts and definitions of palliative care and the experience of dying, the assessment and management of major psychiatric complications of life-threatening illness, including psychopharmacologic and psychotherapeutic approaches, and covers issues such as bereavement, spirituality, cultural sensitivity, communication and psychiatric contributions to common physical symptom control. A global perspective on death and palliative care is taken throughout the text, and an Appendix provides a comprehensive list of international palliative care resources and training programs.

The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs are?and are not?being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do not?and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury. Table of Contents Front Matter Summary 1. Introduction 2. Patterns of Childhood Death in America 3. Pathways to a Child 4. Communication, Goal Setting, and Care Planning 5. Care and Caring From Diagnosis Through Death and Bereavement 6. Providing, Organizing, and Improving Care 7. Financing of Palliative and End-of-Life Care for Children and Their Families 8. Ethical and Legal Issues 9. Educating Health Care Professionals 10. Directions for Research References Appendix A: Study Origins and Activities Appendix B: Prognostication Scores Appendix C: Assessing Health-Related Quality in End-of-Life Care for Children and Adolescents Appendix D: Cultural Dimensions of Care At Life Appendix E: Bereavement Experiences After the Death of a Child Appendix F: End-of-Life Care in Emergency Medical Services for Children Appendix G: Education in Pediatric Palliative Care Appendix H: Progress in Pediatric Palliative Care in New York State--A Demonstration Project Appendix I: Committee Biographical Statements Index

This volume contains invited lectures presented at the Sixteenth International Conference of Indian Association of Palliative Care held at All India Institute of Medical Sciences, New Delhi (Feb. 13-15, 2009). The objective is to improve the knowledge base and clinical skills in addressing the issues of pain in Cancer and HIV/AIDS patients. Divided into 13 main sections, this volume is a collection of 49 invited lectures provided by practicing doctors, research scientists and academicians from more than 21 countries. This volume would be of immense value and use to: (a) Palliative care giver in the field of Cancer Pain Management and Palliative Care of the terminally sick patients, (b) Post graduate students, Residents and Interns in a Cancer or HIV/AID center, (c) On duty doctors/nurses in an ICU/pain ward/day care center, (d) care givers at Old Age homes. This collection of lectures will definitely offer insight, new perspectives and directions in this socially relevant and desirable area of Pain and Palliative Care.

Over a period of almost 10 years, the work of the Project on Death in America (PDIA) played a formative role in the advancement of end of life care in the United States. The project concerned itself with adults and children, and with interests crossing boundaries between the clinical disciplines, the social sciences, arts and humanities. PDIA engaged with the problems of resources in poor communities and marginalized groups and settings, and it attempted to foster collaboration across a range of sectors and organizations. Authored by medical sociologist David Clark, whose research career has focused on mapping, archiving and analyzing the history and development of hospice, palliative care and related end of life issues, this book examines the broad, ambitious conception of PDIA - which sought to 'transform the culture of dying in America' - and assesses PDIA's contribution to the development of the palliative care field and to wider debates about end of life care within American society. Chapters consider key issues and topics tackled by PDIA grantees which include: explorations of the meanings of death in contemporary American culture; the varying experiences of care at the end of life (in different settings, among different social and ethnic groups); the innovations in service development and clinical practice that have occurred in the US in response to a growing awareness of and debate about end of life issues; the emerging evidence base for palliative and end of life care in the US; the maturation of a field of academic and clinical specialization; the policy and legal issues that have shaped development, including the ethical debate about assisted suicide and the Oregon experience; the opportunities and barriers that have been encountered; and the prospects for future development. A final chapter captures developments and milestones in the field since PDIA closed in 2003, and some of the challenges going forward.

The process of patients with advanced illnesses entering the emergency department is fraught with uncertainty for both patients and medical providers. Yet, there is a lack of definitive and accessible resources which provide immediate guidance for the care of these patients. Palliative Care in the Emergency Care is a practical guide designed to fill this void. From the paramedic struggling with difficult and/or conflicting information in the home through the palliative care specialist trying to interface effectively with the emergency department, this user-friendly handbook offers practical help from experts in the interdependent fields of Emergency Medicine and Hospice and Palliative Medicine. This evidenced-based book covers the prognostication and assessment of relevant, advanced-illness clinical problems, the management of symptoms, and the physical and spiritual treatment of palliative patients in the emergency department through their last hours of living. Also included are chapters focusing on hospice care, communication techniques, and the legal and ethical issues of palliative care in the emergency department. This guide is a must-have resource for clinicians looking for concise, point-of-care information, and for hospital administrators working to address palliative care needs in emergency departments through best practice recommendations.

Over the last thirty years, the concern of Pain Medicine practitioners about the potential for their patients to develop a dependence on opioids has left opioid therapy as a largely underutilized treatment. While there is no simple answer to chronic pain, opioids remain the only class of drugs capable of providing relief to patients experiencing serious pain. Opioid Therapy in the 21st Century, Second Edition fills a dearth of clinical knowledge about analgesics to aid practitioners in weighing the risks versus the benefits of opioid therapy for their chronic pain patients. Part of the Oxford American Pain Library, this concise guide serves as a practical, user-friendly reference for physicians across the range of primary care and medical specialties. It includes an overview of appropriate clinical applications of opioids, covering such topics as opioid pharmacology, route selection, and individualization of therapy, as well as strategies for managing and mitigating the risk of abuse, addiction, and diversion. There are also special sections dedicated to the unique needs of pediatric, geriatric, and palliative care patient populations. This second edition discusses opioids approved for use since publication of the first edition, such as Butrans (buprenorphine patch); fentanyl patch and nasal spray; abuse resistant version of Oxycontin; and Embeda (morphine sulfate). Approved indications for older opioids as well as clinical trial information have also been updated.

"I found this book to be a well-written, sensitively presented, and important resource for those engaged in this critical area of work. Thank you, Dr. Werth, for making such a substantial contribution to this field."--Journal of Palliative Care

" This book offers] over 20 contributors, all with impeccable credentials, covering many perspectives that we need to consider more frequently and in greater depth...There is much that awaits you in this book."--Illness, Crisis, and Loss

""Counseling Clients Near the End of Life" is a marvelous resource for mental health providers who are searching for useful information in areas such as the following: resolving ethical dilemmas; assisting clients in planning for the end of life; counseling caregivers of clients who are near the end of life; and assisting people in dealing with grief. The editor of this work, Dr. James Werth, has done a splendid job of gathering various experts to share their perspectives on end of life care and choices at this time of life--and he has also written an excellent chapter on counseling clients who are dying." Gerald Corey, EdD, ABPP
Professor Emeritus of Human Services and Counseling
California State University, Fullerton

This highly accessible guide to counseling people who are terminally ill and their families fills a critical need in the counseling literature. Written for front-line mental health professionals and counseling graduate students, the text integrates research with practical guidance. It is replete with the experiences of contributing authors who are leaders in counseling terminally ill individuals, real-life case examples, clinical pearls of wisdom, and tables of practice pointers that provide quick access to valuable knowledge.

The text offers information that is requisite for all counselors who provide services to persons who are terminally ill and their families. It addresses common issues that influence different types of counseling approaches, such as how the age, ethnicity, or religion of a client affects counselor conceptualizations and actions. The book discusses how to manage symptoms of depression, anxiety, and cognitive impairment near the end of life. It explains how advance directives can be used to assist dying individuals and their loved ones. The counseling needs of family members before and after death are addressed as well as counseling loved ones experiencing complicated grief. The text also examines the particular concerns of counselors regarding self-care and the benefits of working as part of a professional team. Woven throughout are important considerations such as cultural diversity, ethical challenges, laws, and regulations; and advocacy at client and social policy levels. Readers will also benefit from the inclusion of additional references for more in-depth study. Key Features:

Integrates research with practical and accessible information Provides clinical "pearls" that can be put to use immediately Provides a reader-friendly format that includes real-life case studies and tables with important pointers Describes the counseling experiences of leading practitioners that include examples of successful and unsuccessful interventions Based on a comprehensive framework developed by a Working Group of the American Psychological Association

Given our aging population, there will sadly be an increasing number of terminally-ill patients over the next ten to twenty years. A Patient-Centered Approach to Medicine for the Terminally-Ill explains that a more humane patient-centered approach is necessary to ensure that terminally-ill patients are cared for effectively at the end of life. It is a well-known fact that terminally-ill patients are very difficult to care for by their physicians and other medical specialists, and paternalism is no longer a viable way of caring for the terminally-ill. In this book, Switankowsky argues that there are five conditions for physicians to bring about patient-centered medicine. These are: effective physician-patient disclosure of treatments, successful decision-making, effective communication, development of effective physician-patient relationships, and advance directives. By following these five necessary conditions, physicians could ensure that all terminally-ill patients die with some degree of dignity and are given essential, humane care until the end of their days.

Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience 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 take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.

This Second Edition of The Psychiatry of Palliative Medicine remains a practical and pragmatic distillation of the psychiatry relevant to the terminally ill. Revised throughout and greatly expanded by the addition of two entirely new chapters, it reviews the major psychiatric syndromes encountered in palliative care - depression, anxiety, delirium - and examines psychopharmacological and psychological interventions in detail. It succinctly considers the psychiatric aspects of pain, sleep, cognitive impairment, terminal neurodegenerative diseases, sedation, artificial feeding and euthanasia. The dying, chronically ill psychiatric patient is also discussed. The author has drawn on his great experience in both consultation-liaison psychiatry and palliative medicine to produce an essential, evidence-based guide for all healthcare professionals involved in palliative care. These include consultants and senior nurses, as well as psychiatrists, especially consultation-liaison psychiatrists, and trainees. 'I find this an immensely sympathetic book, beautifully written. It is a testimony to the summation of specialist psychiatric knowledge, broad scholarship and a rich personal practice in bedside palliation.' From the Foreword by Ian Maddocks Reviews of the first edition: '...a relevant, highly readable and reasonably priced book which will be of interest to all, whether from a psychiatric or palliative care background, who seek to improve the care of dying patients INTERNATIONAL PSYCHOGERIATRICS 'Practical, scientifically based and scholarly, addressing a comprehensive set of common and important clinical problems in palliative care. The book will doubtlessly be highly valued by palliative care clinicians for its practical and thorough overview of some of the most challenging clinical problems they face. Excellent and timely.' AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY

A practicing music thanatologist provides an insider's history of this remarkable profession, which combines music, medicine, and spirituality to help the terminally ill and their families face the end of life. Reflecting on the author's experiences as a music-thanatologist, Jennifer Hollis's Music at the End of Life: Easing the Pain and Preparing the Passage is an enlightening and emotional examination of the ways in which the experience of dying can be transformed with music. Music at the End of Life highlights the unique role music has come to play in hospice and palliative medicine. Jennifer Hollis interweaves narrative memoir, the personal experiences of fellow music-thanatologists and caregivers, and extensive research to demonstrate the transformative power of music when curing is no longer an option. Through story after unforgettable story, Hollis offers a new vision of end-of-life care, in which music creates a beautiful space for the work of letting go, grieving, and saying goodbye.

Every one of us will die, and the processes we go through will be our own unique to our own experiences and life stories. It is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and inured patients. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories. He discusses three types of end-of-life patient populations adults with decision-making capacity, adult without capacity, and children (with a strong focus on infants) to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients.

Drs. Eduardo D. Bruera and Russell K. Portenoy have completely revised and updated the widely respected Cancer Pain: Assessment and Management for the second edition of this unanimously praised book. This is a comprehensive, clinically oriented review of all aspects of the complex and multidimensional problem of cancer pain. The unique characteristics of cancer pain, including pathophysiology, clinical assessment, diagnosis, and pharmacological and nonpharmacological management are all discussed here in detail. Internationally recognized leaders in cancer pain research have contributed to many new chapters, including neuraxial analgesia, hospice and institution-based palliative care programs, bone pain, and cancer pain and palliative care in the developing world. Cancer Pain continues to be a scholarly but accessible text that is an essential resource for physicians, nurses, and medical students who treat suffering from cancer pain. Per the New England Journal of Medicine, This book should be in the library of every physician who comes into contact with patients with pain. It is truly superb.

A book for nurses, doctors and all who provide end of life care, this essential volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. Divided into two parts, it introduces and explains clinical decision-making processes about which there is broad consensus, in line with guidance documents issued by WHO, BMA, GMC, and similar bodies. The changing political and social context where 'patient choice' has become a central idea, and the broadened scope of patients' best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These include patient choice, consent, life prolonging treatment, and symptom relief including sedation. Part two explores the more controversial current end of life care initiatives, such as advance care planning, preferred place of care and death, euthanasia and assisted suicide, extended ideas of 'best interests', and the view that there are therapeutic duties to the relatives of patients. Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of consumerist choice, they reject its place in the health service, proposing a realistic, fair, humane, and widely adoptable system of end of life care.
As knowledge of ethical theories is required in training courses, and the vocabulary of ethical theory is widespread in current discussions, a substantial appendix on ethical theories and terms is available online.
Written by the same authors as The Philosophy of Palliative Care: Critique and Reconstruction, which won the Medical Journalists' Association Specialist Book Award 2007, this new book for non-specialists is essential reading for all health care professionals involved in providing end of life care.

The book provides comprehensive, practical guidelines on the responsibilities of those who lead, co-ordinate and manage volunteers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams. Volunteers are key workers, who often perform difficult and important work. In the United Kingdom alone there are thousands of volunteers in hospice work, a small proportion doing work with patients, and the vast majority doing equally valuable work such as driving, sitting with relatives, manning charity shops and telephones. As a result, Europe, Australia, the United States and Canada are very interested in the United Kingdom's use of volunteers. Aimed primarily at Voluntary Services Managers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams, this updated second edition covers volunteer selection, training, supervision and support, and legal and ethical considerations. Information is presented in an easily accessible way, using key points, summary panels and checklists. This book will also appeal to the volunteers themselves.

Fixing You: Neck Pain & Headaches is an easy-to-use self-help guidebook to fixing just about every type of neck pain. This is because, no matter what the diagnosis, painful issues of the neck have the same root causes; that of poor neck function and poor shoulder function. These root problems can be easily corrected through the exercises found in this book. Visit www.FixingYou.net for more information. Rick Olderman MSPT, CPT and Pilates instructor is a physical therapist with over a decade of experience working with difficult chronic and acute injuries. Rick's typical clients are those who have been to a variety of specialists and health care practitioners with little or no change in their pain. Often these clients feel significant if not complete relief in 1-3 sessions after using the Fixing You approach. How does Rick do this? Through assessing and correcting improper biomechanics at the root of all neck pain. Rick reveals his secrets in Fixing You: Neck Pain & Headaches to guide you in assessing your injuries through simple tests and then give you specific exercises correcting the biomechanics leading to your pain. Readers will also have FREE access to video clips of all assessments and exercises found in Fixing You: Neck Pain & Headaches. This ensures that you are both assessing and correcting your injuries properly. No other book has ever done so much to help you beat your pain.

Early stage breast cancer can be stressful and upsetting for both the woman dealing with the disease and her partner. This illness can also place a strain on a couple's relationship. However, couples who are able to provide effective support to one another are more likely to adapt well. Focusing on the couple as a unit can promote effective coping for both patients and their partners .
This couples-focused group program aims to improve a couple's functioning as a "team" and provides a supportive environment for couples facing similar breast cancer-related issues. Over the course of six sessions, couples learn support and communication skills, as well as techniques to manage stress and enhance intimacy. Modeling by group leaders and other couples facilitates skill acquisition. With continued use, the skills learned in group can have long-term benefits for couples .
This guide, along with the corresponding workbook, provides all the information needed to implement this group program. It contains step-by-step instructions for running the group, as well as sample group leader dialogues, in-session activities, and homework assignments. The couple's workbook is designed to be shared by both partners as they work together through the program. By the end of the six weeks, couples will be better equipped as a team to cope with the stresses of cancer and the challenges that may lie ahead.

Death is a natural part of life. But it has become a painful, protracted, humiliating process that is often inappropriate for the healthcare patient, puts an undue financial and emotional burden on the family, and provides a model of improper care for physicians in training. And it's expensive--about 22 percent of all medical expenditures are for people in the last year of their lives. Further, while studies show that 90 percent of all people would prefer to die at home surrounded by family and friends, the reality is that more than 70 percent die in institutions. As Dr. Ken Fisher argues so passionately in this book, it's time for a change. End-of-life care in the U.S. has evolved over the years into a nightmare for patients and family members, and it has created a near-crushing financial burden on the medical system that is not just excessive but unsustainable. It has driven the cost of healthcare out of reach for many people, and it is a large factor in preventing the creation of universal coverage. In Defiance of Death reviews the current state of end-of-life care and highlights its many problems from a variety of economic, political, and social perspectives. Fisher and Rockwell illuminate the ethical dilemmas we all face as technology allows us to prolong life--but at a huge human and financial cost. This book documents these problems and provides a historical perspective of how our medical system evolved. It argues that America's "defiance of death" is far too costly and recommend that all stakeholders--including the public, medical community, Congress, and business leaders--join together to create a system that improves end-of-life care for everyone involved. This book, withworkable solutions to improve our medical system, helps point the way.

Riveting in their emotional clarity and utterly jargon free, these 30 stories from real life penetrate how we grieve and how we can help those who grieve- whether the griever is oneself, someone we care about, or a client or patient. Lynne Dale Halamish, an internationally respected grief counsellor with more than 20 years' experience, and Doron Hermoni, a family physician, researcher, and educator, present vignettes from practice that show how death- lingering, unexpected, violent, or self-inflicted- and the loss of a relationship- to oneself or with a child, sibling, parent, mate, grandparent, or friend- give life to grief, together with the process by which each person fully encounters his or her grief. Each story is no more than two or three pages, and the authors follow each one with a short summary of its teachings and a selection of annotated recent references for those who wish to read more about a topic. Looked at in relief, the stories reveal a master grief counsellor at work.