When a person suffers from advanced, progressive illness, palliative care -- treatments that improve the physical and psychological quality of life of patients and their families -- can be just as important as treatments that aim to slow or prevent disease progression. Aimed at general practitioners and trainees in the field, Palliative Care in Clinical Practice offers an accessible and practical introduction to palliative medicine, including a chapter devoted to each of the key areas of symptom management. Clearly and concisely written and fully illustrated throughout, it will be a useful resource for all healthcare professionals who wish to gain an understanding of this important aspect of medicine.

The Art and Science of Compassion, A Primer offers a succinct, all-in-one introduction to the full gamut of compassion, from the evolutional, biological, behavioural, and psychological, to the social, philosophical, and spiritual. Drawing on her diverse background as a clinician, scientist, educator, and chaplain, Dr. Wong presents a wealth of scientific evidence supporting that compassion is both innate and trainable. By interleaving personal experiences and reflections, she shares her insights on what it takes to cultivate compassion to support the art of medicine and caregiving. The training described in this book draws on both contemplative and scientific disciplines to help clinicians develop cognitive, attentional, affective, and somatic skills that are critical for the cultivation of compassion. With striking illustrations for key concepts and concise summaries for each chapter, this book provides a solid conceptual framework and practical approaches to cultivate compassion. Advance Praise for The Art and Science of Compassion, A Primer "Well-written, deeply personal and scientifically-grounded, this book provides strong physiological, psychological, and ethical reasons why cultivating compassion is essential-and provides a thoughtful roadmap for promoting compassion in healthcare and in all of life." - Ron Epstein, MD, author of Attending: Medicine, Mindfulness, and Humanity "Dr. Agnes Wong, a highly distinguished physician and exceptional researcher at the University of Toronto, has written an absolutely uplifting masterpiece about meaning, compassionate care, and the universal journey that all healers must take to sustain their inner being and nobility of purpose. This book is partly her journey to a deeper state of being that places compassionate care in its rightful place in the healing art; it is also a fabulous scientific presentation of the practice and impact of compassionate care on patients and on one's own flourishing as a physician. This is a book that touches the soul and should be read by every medical student or clinician worldwide as they reflect on what it means to really succeed in their "whole selves" as healers and human beings." - Stephen G. Post, PhD, Director, Center for Medical Humanities, Compassionate Care and Bioethics; Professor of Family, Population and Preventive Medicine, Stony Brook University "Compassion and empathy are traits that make us human, and as Dr. Wong shows, these qualities can be developed, encouraged, and cultivated. In our struggling world, we need this awareness as never before. The future of our species likely depends on it. This book is an example of how science and spirituality can come together in a brilliant synthesis." - Larry Dossey, MD, author of One Mind: How Our Individual Mind Is Part of a Greater Consciousness and Why It Matters

Political, economic, social, cultural and technological changes have led to profound transformations in the ways that death and loss are perceived and managed in contemporary society. Over the last few decades, the long term shift to chronic illness as a major causal factor has significantly increased the time scale of dying. Most people die in institutions and 'care' is typically medical. Many communities and ordinary citizens now relinquish control and involvement to experts in the last stages of life.
At global and local levels, however, new arrangements are emerging to govern the changing face of death, and a reorientation model is being developed to counter claims of the 'creeping medicalisation' of death and dying. With an international authorship and scope, this book illustrates the interlinking nature of society, death and loss, and it gives examples of governance that promotes the empowerment, participation and the increasing need for the involvement of ordinary people and communities in differing social and cultural contexts.
Chapters come from collaborations of academics and practitioners in end of life care - from sociologists, anthropologists or the arts but also from nursing, social work, or medicine. The result is a reflective, academic and practical discussion of the outline of the problem we face in the contemporary governance of death, and an exploration of the critical, theoretical and practice-based ways forward for us all.

Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This unique book provides guidelines for the care of the dying based on the Liverpool Integrated Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes.
The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template which describes the process of care which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education and quality improvement programmes. This book also includes chapters on symptom control, ethical issues, communication skills, and spiritual care written by experts in the field which underpin the use of the LCP.
Care of the Dying Second Edition will prove invaluable to all healthcare professionals involved in the care of the dying patient, organisations and Trusts who want to develop demonstrable measures and outcomes of care.

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.

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.

Individuals with serious and incurable illnesses often require care that goes beyond the body. As they face the challenges of living with and eventually dying from their conditions, they may need to acquire new skills to cope and increase their quality of life. Even those at the beginning of the end of life can take an active role in their treatment.
This skill-based program emphasizes flexibility and should be tailored to individual clients. The first module introduces stress management techniques, including cognitive restructuring, relaxation, and problem-focused and emotion-focused coping. The second module targets mood management, with sessions on depression, anxiety, and anger. Social support is addressed in the third module where clients learn communication and conflict resolution skills. Special attention is paid to supporting caregivers and working with medical providers. The fourth module focuses on quality of life and covers symptom management, goal setting, positive psychology, and spiritual issues. An adaptation chapter details how to run the program as a group and discusses other possible formats.
Incorporating a wide variety of CBT techniques, this program can benefit patients suffering from a range of chronic and terminal diseases. The corresponding workbook helps clients personalize the content of sessions and practice new skills. The facilitator guide is invaluable to any mental health professional working in a medical or other palliative care setting.

Palliative Care Nursing at a Glance is the perfect companion for nursing students, health and social care practitioners, and all those involved in palliative care delivery, both in the clinical and home setting. Written by an expert team of academics, nurses, educators and researchers it provides a concise and easy-to-read overview of all the concepts and clinical decision-making skills necessary for the provision of good-quality palliative and end-of-life care. Divided into six sections, the book includes coverage of all key clinical applications, principles of symptom management, palliative care approaches for a range of conditions and patient groups, exploration of the roles of the multi-professional team, as well as ethical challenges. * Superbly illustrated, with full colour illustrations throughout * Provides information on delivery of care in a range of settings * Broad coverage makes it ideal reading for anyone involved in palliative care delivery * User-friendly and accessible resource for those working in both specialist and non-specialist adult settings

Palliative care is rapidly evolving as a multidimensional therapeutic model devoted to improving the quality of life of all patients with life-threatening illness. Symptom control, management of psychosocial and spiritual concerns, decision making consistent with values and goals, and care of the imminently dying that is appropriate and sensitive to the unique needs of the individual and family - these are among the critical issues addressed through palliative care. As this discipline has evolved, the need for research in all these areas has become widely acknowledged. Issues in Palliative Care Research describes both the progress that already has been made in the investigation of these issues and the methodological elements that must be addressed in future studies. The perspective is broad and the overriding goal is to inform about the state of the art in these rapidly evolving areas of research.

Now fully revised and in its fourth edition, the Oxford Handbook of Oncology has been the essential go-to guide for students and practitioners in oncology for over a decade. The scientific basis and diagnosis of cancers is covered, as well as drugs, biomarkers, and the presentation and psychosocial aspects of oncology. Concise, practical, and comprehensive, there is no better companion for both common conditions and challenging emergencies. The field of oncology has surged forward since the last edition was published and the Oxford Handbook of Oncology has been fully revised and updated to reflect these recent advances so you can be sure that the vital information you need is in your hands. This handbook incorporates changes such as the understanding of the science of cancer, novel therapies in breast, lung, renal, and melanoma, molecular sub-classification of common solid cancers, personalized therapy approaches, new agents in hard to treat cancers, the benefits of new technologies in radiotherapy, and the emerging data on the importance of the immune response. Written by experts in the field to ensure that it is grounded in real life clinical practice, this handbook provides a concise guide to all aspects of oncology for all students, nurses, and junior faculty responsible for the care of cancer patients, while also providing further reading and highlighting areas of controversy for those who need a more detailed understanding.

Informal caregivers - family members, friends, and other loved ones - are an essential, uncompensated and significantly burdened extension of the healthcare team. Rapid advances in cancer care, including new drugs and immunotherapies and more sophisticated diagnostic tools, have markedly improved the ability to medically extend lives and enhance survival. As patients are living longer, with today's shorter hospital stays and shift towards increased outpatient care, however, the demands placed on all caregivers and their needs have substantially increased. Cancer Caregivers reveals the field of Psycho-Oncology's exploration of the depth of complexities of caregiving experiences and identifies the vast expanses left to be understood. This text describes the characteristics and experiences of cancer caregivers based on their life stage, relationship to the patient, and ethnic group membership, as well as patients' disease and treatment type. It highlights the significant progress in research focused on the development and dissemination of psychosocial interventions for cancer caregivers, and includes in-depth case studies to illustrate their delivery and application. The text also explores the provision of support to caregivers in the community and the legal and ethical concerns faced by caregivers throughout the caregiving process. Cancer Caregivers offers both fundamental and practical information and is the essential resource for all healthcare professionals who work with patients and families facing cancer.

In Caring for Patients at the End of Life: Facing an Uncertain Future Together, Dr. Quill uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section one utilizes the near death experiences of two patients to explore values underlying medical humanism, and then presents the case of "Diane" to explore the fundamental clinical commitments of partnership and non-abandonment. Section two explores, illustrates, and provides practical guidance for clinicians, patients, and families about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In section three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assisted suicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In a final chapter, Dr. Quill discusses the tragic death of his brother which occurred as this book was being completed, and how his family made the most emotionally challenging decisions of their lives.

Dr. Quill exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision-making, ensuring medical and palliative care expertise and of committing to see the dying process through to the patient's death is vividly illustrated

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades.

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.

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.

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.

Advance Care Planning (ACP) is an essential part of end of life care in the UK and most developed countries. It enables more people to live well and die as they would choose, and has significant implications for the individual person, their family and carers, and our wider society. In the context of an ageing population and increasing possibilities for medical interventions, ACP is a particularly important aspect of quality care. Expanded and fully updated throughout, this new edition gives a comprehensive overview of ACP and explores a wide range of issues and practicalities in providing end of life care. Written by experts from around the world, the book takes a comprehensive look at the subject by exploring the wide range of issues and practicalities in providing ACP; framing the purpose, process, and outcomes of these plans; and providing an important update on national and international research, policy and practice. Chapters also discuss values, goals and priorities, and include detailed case examples to aid best practice. This book is an invaluable resource for all clinicians involved in the caring for people in their final stages of life. It is of particular value to GPs, palliative care specialists, geriatricians, social care teams, researchers and policy leads interested in improving end of life care.

Crossing Over provides a unique view of patients, families, and their caregivers in the face of incurable illness. Twenty richly-detailed narratives bring vividly to life the experiences of dying and bereavement, weaving together emotions, physical symptoms, spiritual concerns, and the stresses of family life, as well as the professional and personal challenges of providing hospice and palliative care. Drawing on a variety of qualitative research methods, including participant-observation, interviews, and journal keeping, the narratives depict the sights, sounds, tastes, and smells of daily life in patients' homes and in the palliative care unit. Crossing Over moves far beyond conventional case reports in medicine, which typically concentrate narrowly on symptoms and treatments, and beyond cliches about "dying with dignity." It provides intimate views of the anger and fear, tenderness and reconciliation, jealousy and love, unexpected courage and unshakable faith, social support and "falling through the cracks," which are all part of facing death in North American society. It provides an extraordinary portrait of the processes of giving and receiving hospice and palliative care in the real world, as opposed to idealized versions in many textbooks. This edition of Crossing Over has been thoroughly revised and updated to reflect changes in hospice and palliative care and in North American society since the first edition in 2000. Chief among these are the expansion of hospice and palliative care as a field, the ravages of the COVID-19 pandemic, the wider availability of medical aid in dying, and a heightened awareness of how structural racism, classism, and other forms of discrimination shape individuals' and families' experiences right up to the close of life.

Specifically designed to enhance your knowledge and skills within generalist palliative care, this informative textbook provides a comprehensive overview of the principle areas you may encounter whilst working with adult palliative and end-of-life patients, and their families. The development of the text has been backed by Macmillan Cancer Support and each chapter has been written by a range of specialist and generalist authors. The topics covered include approaches to palliative care and symptom management in a wide range of conditions and populations, with chapters linked to case studies to encourage interactive learning and understanding. Communication skills are also highlighted to help aid confidence when engaging in open and difficult conversations. The text is in line with Scottish Palliative Care Guidelines and the NES Framework for Palliative and End of Life Care. The book may either be used as course reading for relevant training programmes, such as the Enhanced Palliative Care course, as well as by healthcare professionals hoping to develop their skills and practice. It is aimed at anyone involved in management and prescribing within non-specialist palliative care, both in hospitals and in the community, including paramedics, nurses, doctors, pharmacists, and other key health professionals.

This sixth edition of the Oxford Textbook of Palliative Medicine takes us now into the third decade for this definitive award-winning textbook. It has been rigorously updated to offer a truly global perspective, highlighting the best current evidence-based practices, and collective wisdom from more than 200 experts around the world. This leading textbook covers all the new and emerging topics, updated and restructured to reflect major developments in the increasingly widespread acceptance of palliative medicine as a fundamental public health need. The sixth edition includes new sections devoted to family and caregiver issues, cardio-respiratory symptoms and disorders, and genitourinary symptoms and disorders. In addition, the multi-disciplinary nature of palliative care is emphasized throughout the textbook, covering areas from ethical and communication issues, the treatment of symptoms, and the management of pain. The Oxford Textbook of Palliative Medicine is a truly comprehensive text. No hospital, hospice, palliative care service, or medical library should be without this essential source of information. This sixth edition of the Oxford Textbook of Palliative Medicine is dedicated to the memory of Professor Kenneth Fearon husband of Professor Marie Fallon and a surgeon who became a world leader in the research and management of anorexia and cachexia. He modeled a work-life balance that is so critical in our field, with devotion to both his patients and his family.

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.

Death, dying, loss, and care giving are not just medical issues, but societal ones. Palliative care has become increasingly professionalised, focused around symptom science. With this emphasis on minimizing the harms of physical, psychological, and spiritual stress, there has been a loss of how cultures and communities look after their dying, with the wider social experience of death often sidelined in the professionalisation and medicalisation of care. However, the people we know and love in the places we know and love make up what matters most for those undergoing the experiences of death, loss, and care giving. Over the last 25 years the theory, practice, research evidence base, and clinical applications have developed, generating widespread adoption of the principles of public health approaches to palliative care. The essential principles of prevention, harm reduction, early intervention, and health and wellbeing promotion can be applied to the universal experience of end of life, irrespective of disease or diagnosis. Compassionate communities have become a routine part of the strategy and service development in palliative care, both within the UK and internationally. The Oxford Textbook of Public Health Palliative Care provides a reframing of palliative care, bringing together the full scope of theory, practice, and evidence into one volume. Written by international leaders in the field, it provides the first truly comprehensive and authoritative textbook on the subject that will help to further inform developments in this growing specialty.

Emerging as a new sub-specialization within the hospitalist community, the neurosurgery hospitalist provides preoperative risk stratification, advises on managing pre- and postoperative complications, and helps doctors make decisions about when to involve specialists other than neurosurgeons. This collaborative approach to the neurosurgery patient has been shown to offer effective care since hospitalists can be better attuned than specialists to multiple medical problems that most patients have. Medical Management of Neurosurgical Patients is a first of its kind textbook providing a standardized source of information for neurosurgery hospitalists in order to establish a common ground and improve their knowledge and training. The work will focus on management of CNS infections, management of bleeding in the context of CNS surgery (a potentially catastrophic complication), management of sodium and blood glucose levels including steroid-induced hyperglycemia, perioperative pain control, and management of pressure injuries and rehabilitation in the context of CNS injury.

As humanitarian aid organizations have evolved, there is a growing recognition that incorporating palliative care into aid efforts is an essential part of providing the best care possible. A Field Manual for Palliative Care in Humanitarian Crises represents the first-ever effort at educating and providing guidance for clinicians not formally trained in palliative care in how to incorporate its principles into their work in crisis situations. Written by a team of international experts, this pocket-sized manual identifies the needs of people affected by natural hazards, political or ethnic conflict, epidemics of life-threatening infections, and other humanitarian crises. Later chapters explore topics including pain management, skin conditions, non-communicable diseases, palliative care emergencies, the law and ethics of end of life care, and more. Concise and highly accessible, this manual is an ideal educational tool pre-deployment or during fieldwork for clinicians involved in planning and providing humanitarian aid, local care providers, and medical trainees.