Currently, there is no comprehensive source of information available to non-specialist physicians and nurses providing end-of-life care for advanced cancer patients at a level between specialist oncology texts and nursing texts. Two eminent physicians from one of the world's foremost cancer centers have drawn together a remarkable team to provide a handbook which covers the full range of problems non-specialists will encounter. This highly accessible text covers general principles in oncology, each of the primary tumors, and management of specific symptoms and syndromes.

This book examines the ethics of end of life care, focusing on the kinds of decisions that are commonly made in clinical practice. Specific attention is paid to the intensification of treatment for terminal symptoms, particularly pain relief, and the withdrawal and withholding of care, particularly life-saving or life-prolonging medical care. The book is structured into three sections. The first section contains essays examining end of life care from the perspective of moral theory and theology. The second sets out various conceptual terms and distinctions relevant to decision-making at the end of life. The third section contains chapters that focus on substantive ethical issues. This format not only provides for a comprehensive analysis of the ethical issues that arise in the context of end of life care but allows readers to effectively trace the philosophical, theological and conceptual underpinnings that inform their specific interests. This work will be of interest to scholars working in the area as well as clinicians, specialists and healthcare professionals who encounter these issues in the course of their practice.

This book will be the first of its kind to offer intensive conversation analysis on patient-clinician interactions in the context of palliative medicine. The book focuses on a series of individual case studies of conversations that revolve, in each case, around one key critical term that is often evoked or understood differently by clinicians and patients.

The first resource on end-of-life care for healthcare practitioners who work with the terminally ill and their families, "Living with Dying" begins with the narratives of five healthcare professionals, who, when faced with overwhelming personal losses altered their clinical practices and philosophies. The book provides ways to ensure a respectful death for individuals, families, groups, and communities and is organized around theoretical issues in loss, grief, and bereavement and around clinical practice with individuals, families, and groups.

"Living with Dying" addresses practice with people who have specific illnesses such as AIDS, bone marrow disease, and cancer and pays special attention to patients who have been stigmatized by culture, ability, sexual orientation, age, race, or homelessness. The book includes content on trauma and developmental issues for children, adults, and the aging who are dying, and it addresses legal, ethical, spiritual, cultural, and social class issues as core factors in the assessment of and work with the dying. It explores interdisciplinary teamwork, supervision, and the organizational and financing contexts in which dying occurs.

Current research in end-of-life care, ways to provide leadership in the field, and a call for compassion, insight, and respect for the dying makes this an indispensable resource for social workers, healthcare educators, administrators, consultants, advocates, and practitioners who work with the dying and their families.

This book explores how, in encounters with the terminally ill and dying, there is something existentially at stake for the professional, not only the patient. It connects the professional and personal lives of the interviewees, a range of professionals working in palliative and intensive care. Kjetil Moen discusses how the inner and outer worlds, the psychic and the social, and the existential and the cultural, all inform professionals' experience of work at the boundary between life and death. Death at Work is written for an academic audience, but is accessible to and offers insights for practitioners in a variety of fields.

This insightful study examines the deeply personal and heart-wrenching tensions among financial considerations, emotional attachments, and moral arguments that motivate end-of-life decisions. America's health care system was built on the principle that life should be prolonged whenever possible, regardless of the costs. This commitment has often meant that patients spend their last days suffering from heroic interventions that extend their life by only weeks or months. Increasingly, this approach to end-of-life care is coming under scrutiny, from a moral as well as a financial perspective. Sociologist Roi Livne documents the rise and effectiveness of hospice and palliative care, and growing acceptance of the idea that a life consumed by suffering may not be worth living. Values at the End of Life combines an in-depth historical analysis with an extensive study conducted in three hospitals, where Livne observed terminally ill patients, their families, and caregivers negotiating treatment. Livne describes the ambivalent, conflicted moments when people articulate and act on their moral intuitions about dying. Interviews with medical staff allowed him to isolate the strategies clinicians use to help families understand their options. As Livne discovered, clinicians are advancing the idea that invasive, expensive hospital procedures often compound a patient's suffering. Affluent, educated families were more readily persuaded by this moral calculus than those of less means. Once defiant of death-or even in denial-many American families and professionals in the health care system are beginning to embrace the notion that less treatment in the end may be better treatment.

Palliative Care Perspectives is a guide to the art and science of palliative care that links real stories of illness with practical advice to delineate clinical practice in a way that reflects the daily concerns of clinicians. Clearly and compassionately written, this book emphasizes important topics often neglected in formal clinical training, including the history and evolution of palliative care in the United States, as well as how clinicians can better understand aging and dying from both a physiological and human perspective. Written by a recognized pioneer in the field of palliative care, each chapter highlights this human approach to illness with narratives and anecdotes drawn from decades of practice experience. This new edition features thoroughly updated research and citations, a new chapter on burnout and compassion fatigue, and a significant expansion of the topic of intercultural communication. Well-grounded in the academic literature, Palliative Care Perspectives is an ideal introduction to the emerging field of palliative care for care providers new to practice, as well as lay readers seeking to learn more about chronic and terminal illness, presented in a personal and accessible format.

The Oxford Handbook of Palliative Care returns for a third edition, maintaining the concise yet comprehensive format suited to the busy practitioner for quick access to key information, and fully updated to reflect changes in the palliative care landscape. Featuring an increased emphasis on non-malignant diseases such as dementia, this authoritative text combines evidence-based care with the bedside experience of experienced palliative care professionals to give the reader a complete overview of the physical, emotional, and spiritual aspects of care for the end-of-life patient. Symptom management is covered in detail, with updated formulary tables and syringe driver protocols, and a new chapter on international perspectives to broaden the reader's perception of methods for delivering end-of-life care. The third edition of the Oxford Handbook of Palliative Care is the essential companion for all of those working with adults, children, and families with palliative care needs, in both hospital and community settings. The following correction has been made online and will be included in the first reprint. Readers can get in touch with us directly using the contact details on the back of the book or at our online form via the address below with questions or comments: https://global.oup.com/academic/category/medicine-and-health Chapter 5. Page 109 The dose for Hyoscine butylbromide sc has been amended in line with NICE guidance (https://bnf.nice.org.uk/drug/hyoscine-butylbromide.html): '20-120 mg 4 hourly' has been corrected to '20-80mg 4 hourly'.

Cancer and Creativity is a dialogue between accounts by cancer patients and survivors and a more clinical consideration and theoretical discussion from a psychoanalytic point of view of using creativity in coping with serious illness. The contributions featured demonstrate the power of creative expression as a tool for dealing with somatic, chronic and potentially life-threatening illnesses, giving patients a way of expressing and managing their individual cancer journeys and its attendant emotional sequelae. Ten artist-patients and survivors, who were involved in several long-term art therapy groups, give accounts of their experiences with cancer and with their support group, where they create paintings, embroidery, digital photography, comic books, maps and other works to express their experiences of being diagnosed and treated for cancer. The contributors describe their symptoms and their relationships to physicians and family members in words and visual representations. The book also addresses the experience of the public when they are confronted with art by cancer patients. Dreifuss-Kattan's own work as a psychoanalyst and art therapist informs her approach to the art space as what Winnicott calls a "transitional space," influenced by both the personal psychological experience and the physical environment. Dreifuss-Kattan closes her discussion with a reflection on terminal cancer care and the complex transferential and countertransferential relationship between patient and therapist. The book ends with a practical guide for both therapy groups, as well as individuals at home, to creatively address their experiences with cancer and its treatments. Cancer and Creativity will be of great interest to psychoanalysts, psychoanalytic psychotherapists, psychooncologists and art therapists, as well as health professionals working in oncology and in palliative care.

The syringe driver is a simple and cost-effective method of delivering a continuous subcutaneous infusion (CSCI). A CSCI provides a safe and effective way of drug administration and can be used to maintain symptom control in patients who are no longer able to take oral medication. There have been several developments in this field since the third edition of this highly successful book. The text in this edition has been completely revised, incorporating new treatment options and an extensive list of new compatibility data. This book serves as a valuable reference source, providing comprehensive review of syringe driver use and administration of drugs by CSCI. The first chapter provides an overview of syringe drivers and CSCIs, including a useful array of frequently asked questions. The second chapter provides information about the chemistry of drug incompatibility and degradation. The third chapter comprises revised and referenced information relating to most drugs likely to be administered by CSCI using a syringe driver. The fourth chapter discusses the control of specific symptoms that are often encountered when CSCIs are required. The fifth and final chapter contains an extensive, referenced list of compatibility and stability data relating to drug combinations administered by CSCI.

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 third volume in the HPNA Palliative Nursing Manuals series, Physical Aspects of Care: Nutritional, Dermatologic, Neurologic and Other Symptoms, provides an overview of the principles of symptom assessment and management for symptoms including: fatigue, anorexia and cachexia, artificial nutrition and hydration, urinary tract disorders, lymphedema, skin disorders such as pressure ulcers, wounds, fistulas, and stomas, pruritus, fever, sweats, neurological disorders, anxiety and depression, and insomnia. 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.

The first volume in the HPNA Palliative Nursing Series, Structure and Processes of Care provides an overview of palliative nursing care, reviews National Consensus Project guidelines, and offers tools for initiating and maintaining palliative care programs. 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.

50 Studies Every Internist Should Know presents key studies that have shaped the practice of internal medicine. Selected using a rigorous methodology, the studies cover topics including: preventative medicine, endocrinology, hematology and oncology, musculoskeletal diseases, nephrology, gastroenterology, infectious diseases, cardiology, pulmonology, geriatrics and palliative care, and mental health. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for health care professionals and anyone who wants to learn more about the data behind clinical practice.

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.

Is there a place for palliative care within mental health? This inspirational book offers an excellent foundation for integrating best-practice specialist palliative care into serious and enduring mental health service delivery. The shared practice values and vision between these two disciplines provide an optimistic starting point from which to address the lack of palliative care service delivery in mental health practice. Focusing on the similarity in philosophy between palliative care and mental health practice, it incorporates: . person-centred practice . relationship-based connectedness . a belief in compassionate care . respect for autonomy and choice . quality-of-life issues. The book addresses the practice skills needed in preparation for competent intervention and treatment. Each chapter develops a theoretical framework which is supported by practical application. Both professionals and students of palliative care will find the interactive text and practical case studies especially valuable, as will the professional working in substance use. Its userfriendly approach will appeal to a wide range of readers in various related disciplines. 'While it could be assumed that mental health has a lot to offer palliative care, we both [feel] that palliative care could offer more to mental health practice...It is a neglected area. There is little or no literature related to palliative care within serious mental health practice, and that which does exist relates to care of the dying in terms of cancer.' From the Preface

For patients and family caregivers the journey through illness and transitions of care is characterized by a series of progressive physical and emotional losses. Grief reactions represent the natural response to those losses. Grief is defined by a constellation of physical, cognitive, emotional and spiritual manifestations, varying in length and severity. While grief reactions are common and expected responses to loss, they have the potential to cause significant suffering. And, while grief is not a disease, it can develop into a pathological process warranting specialized treatment. Additionally, some aspects of grief overlap with the symptoms of clinical depression and anxiety, making diagnosis difficult. Grief and Bereavement in the Adult Palliative Care Setting provides practical, evidence-based, and clinically effective approaches to understanding the multifaceted nature of grief and bereavement in patients with advanced illness and their caregivers. This handbook is an ideal tool for palliative care providers of various disciplines who provide direct clinical services to patients and family members. It assists clinicians in recognizing and identifying grief reactions as unique expressions of patients and caregivers' history and psychological functioning. Primary care physicians who provide care to patients and families will also find this practical assessment and treatment guide helpful. They will learn how to best support bereaved patients and caregivers when grief is uncomplicated, and when to choose more active interventions that may include appropriate referrals to mental health professionals.

Dying at the Margins: Reflections on Justice and Healing for Inner-City Poor gives voice to the most vulnerable and disempowered population-the urban dying poor- and connects them to the voices of leaders in end-of-life-care. Chapters written by these experts in the field discuss the issues that challenge patients and their loved ones, as well as offering insights into how to improve the quality of their lives. In an illuminating and timely follow up to Dancing with Broken Bones, all discussions revolve around the actual experiences of the patients previously documented, encouraging a greater understanding about the needs of the dying poor, advocating for them, and developing best practices in caring. Demystifying stereotypes that surround poverty, Moller illuminates how faith, remarkable optimism, and an unassailable spirit provide strength and courage to the dying poor.Dying at the Margins serves as a rallying call for not only end-of-life professionals, but compassionate individuals everywhere, to understand and respond to the needs of the especially vulnerable, yet inspiring, people who comprise the world of the inner city dying poor.

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.

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.

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.

The family are intimately involved in the care of the dying and themselves require support through their experience of both palliative care and bereavement. This volume describes a comprehensive model of family care and how to go about it - an approach which is new, preventive, cost effective and with proven benefits to the bereaved.;The book has been designed rather like a therapy manual, providing a step-by-step approach to assessment and intervention. Its rich illustration through many clinical examples brings the process of therapy alive for the reader, anticipating the common challenges that arise and describing how the therapist might respond. Families are recognised throughout as a central social unit, pivotal to the success of palliative care. This title should be of use to doctors, nurses, psychologists, social workers, pastoral care workers, psychiatrists and other allied health professionals who work in caring for the dying and for their bereaved relatives. Based soundly on a decade of internationally regarded research, this book will alter the direction of future medical practice and is destined to become a classic in its field.

A handbook for acupuncturists and healthcare practitioners on the use of acupuncture for end-of-life care. The book covers the major hospice and palliative care diagnoses from a Chinese medicine perspective, as well as grief and loss, and includes the roots of Chinese historical perspectives on death and dying. The acupuncturist is introduced to the working medical model of hospice care and the interdisciplinary team approach and provided with evidence-based strategies for the use the acupuncture in symptom management.

800 million people live in Africa, a continent which covers 22% of the world's surface and encompasses some 50 countries. Conflict, poverty, endemic diseases, and lack of clean water pose serious challenges for the population, made worse by a rampaging AIDS pandemic. Huge loss of life has impacted dramatically on both health systems and social and family structures. As the attention of the world focused increasingly on Africa, the International Observatory on End of Life Care was commissioned to conduct a timely review of hospice and palliative care development across the continent. The Observatory undertook this review using an approach specially designed for resource poor settings. Information was collected against an agreed template to allow comparisons between countries and regions. As a result, an insight is given into the challenges, opportunities and successes faced by hospice and palliative care workers, country by country, throughout the 26 countries in Africa where a palliative care initiative is underway. Strategies and models of care are explored, and the development of palliative care is viewed from various standpoints including ethnographic, historical, ethnic, demographic and epidemiological perspectives. This is the first comprehensive reference focusing exclusively on palliative care and hospice development in Africa, and makes fascinating reading.

"I wish I'd had this book when I needed it. Death and dying are not subjects that many people are comfortable talking about, but it's hugely important to be as prepared as you can be - emotionally, physically, practically, financially, and spiritually. This book may be the most important guide you could have." - Elizabeth Gilbert, author of Eat Pray Love ___________ The end of a life can often feel like a traumatic, chaotic and inhuman experience. In this reassuring and inspiring book, palliative care physician Dr BJ Miller and writer Shoshana Berger provide a vision for rethinking and navigating this universal process. There are plenty of self-help books for mourners, but nothing in the way of a modern, approachable and above all useful field guide for the living. And all of us - young, old, sick and well - could use the help. After all, pregnant couples have ample resources available to them as they prepare to bring a new life into the world: Lamaze courses, elaborate birth plans, tons of manuals. Why don't we have a What to Expect When You're Expecting to Die book? An accessible, beautifully designed and illustrated companion, A Beginner's Guide to the End offers a clear-eyed and compassionate survey of the most pressing issues that come up when one is dying, and will bring optimism and practical guidance to empower readers with the knowledge, resources and tools they'll need to die better, maybe even with triumph.