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.

Sterben, Sterbehilfe (Beschaftigung mit "Dignitas") und Tod sind in den letzten Jahren - (auch) durch die Thematisierung in den Medien - verstarkt zu Objekten kontroverser Diskussionen in Deutschland geworden. Im Kontext dieser Entwicklung differenziert diese Arbeit elementare Wortbedeutungen, ordnet diese Begriffe in die aktuelle Debatte um unterschiedliche Formen der Sterbehilfe ein und entwickelt hieraus eine eigene Perspektive zum individuellen und gesellschaftlichen Umgang mit Sterben und Tod. Die Arbeit mit Sterbenden und deren Angehoerigen stellt unter anderem fur AErzte, Juristen, Theologen und Sozialarbeiter eine besondere Aufgabe dar. Trotz der oeffentlichen Diskussion uber Sterben, Sterbehilfe und Tod werden diese Themen im gesellschaftlichen und privaten Zusammenleben meist tabuisiert. Dieses Buch dient der Professionalisierung zuvor genannter Berufsgruppen und moechte einen Teil zur gesellschaftlichen Enttabuisierung von Sterben und Tod beitragen.

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.

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.

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 rapidly evolving field of Palliative Care focuses on the management of phenomena that produce discomfort and that undermine the quality of life of patients with incurable medical disorders. The interdisciplinary clinical purview includes those factors - physical, psychological, social, and spiritual - that contribute to suffering, undermine quality of life, and prevent a death with comfort and dignity. Palliative Care is a fundamental part of clinical practice, the "parallel universe" to therapies directed at cure or prolongation of life. All clinicians who treat patients with chronic life-threatening diseases are ingaged in palliative care, continually attempting to manage complex symptomatology and functional disturbances.
The scientific foundation of palliative care is advancing, and similarly, methods are needed to highlight, for practitioners at the bedside, the findings of empirical research. TOPICS IN PALLIATIVE CARE has been designed to meet the need for enhanced communication in this field.
To highlight the diversity of concerns in palliative care, each volume of the TOPICS IN PALLIATIVE CARE Series is divided into sections that address a range of issues. Addressing aspects of symptom control, psychosocial functioning, spiritual or existential concerns, ethics, and other topics, the chapters in each section review the given area and focus on a small number of salient issues to analysis. The authors present and evaluate existing data, provide a context drawn from both the clinical and research settings, and integrate knowledge in a manner that is both practical and readable. The specific topics covered in Volume 2 are Neuropathic Pain, Cachexia/Anorexia, Asthenia, and Psychological Issues in the Caregiver.

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.

Death studies have, over the last twenty years, witnessed a flourishing of research and scholarship particularly in areas such as dying and bereavement, cultural practices and fear of dying. But, despite its importance, a specific focus on the nature of personal mortality has attracted surprisingly little attention. Reflecting on the Inevitable combines evidence from several disciplinary fields to explore the varying ways each of us engages with the prospect of personal mortality. Chapters are organized around the question of how an ongoing relationship might be possible when the threat of consciousness coming to an end points to an unspeakable nothingness. The book then argues that, despite this threat, an ongoing relationship with one's own death is still possible by means of conceptual devices, or 'enabling frames', that help shape personal mortality into a relatable object. In each chapter the subtleties and applicability of key ideas are enhanced through a series of illustrative narratives built up around the lives of four people at different ages living in two adjacent houses. Reflecting on the Inevitable is relevant not only to academics of death studies, but also those training and practicing in people-helping professions, as well as anyone experiencing or attempting to make sense of major life events.

The Oxford American Handbook of Hospice and Palliative Medicine and Supportive Care is an easily-navigable source of information about the day-to-day management of patients requiring palliative and hospice care. The table of contents follows the core curriculum of the American Board of Hospice and Palliative Medicine, thus meeting the educational and clinical information needs of students, residents, fellows, and nurse practitioners. Succinct, evidence-based, topically-focused content is supplemented by extensive tables, algorithms, and clinical pearls. This edition includes new sections on grief and bereavement, medical marijuana, and physician assisted suicide, and has been updated throughout to incorporate National Consensus Project for Quality Palliative Care Clinical Practice Guidelines.

So much emphasis in paramedic practice is placed on saving lives, and so how can you provide the best care for patients who are approaching the end of theirs? Knowing when it is appropriate to transfer palliative and end of life patients to hospital can be challenging as there are often many complex factors at stake which can have an impact on both patients and their families. Digging deep into the ethical and clinical aspects of working with palliative patients as a paramedic, this book is the go-to resource to enable you to act within the patient's best interests and provide the most appropriate and effective care. Key features include: Twenty-four case studies covering a range of relevant topics to help apply principles to your own practice Clinical information on symptom control and pain management Written specifically for paramedics, by a range of specialist authors Designated chapters on the role of the paramedic in palliative care, palliative care emergencies and personal resilience Full-colour diagrams throughout. Since the onset of the COVID-19 pandemic, we are all more aware of the importance of patient-centred palliative care; this book is full of tips and techniques to help you feel more confident in ensuring patients not only die 'well' but also live with dignity and comfort.

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.

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

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.

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.

This sensitive and compassionate book provides older people who are nearing the end of life and their loved ones, as well as the professionals who work with them, with a greater depth of understanding of spiritual issues surrounding death and dying. Illustrated with the experiences of many older people, it explores important themes such as grief and loss; fear; pain, distress and suffering; acceptance; transcendence; prayer; the healing of relationships; and intimacy, and shows that the final journey towards death can be one of the most spiritually meaningful times in the life of an older person - a time in which there is still hope, and in which the person who is dying and their loved ones can grow spiritually, strengthened by the difficult times they face together. Spiritual issues for older people with dementia who are nearing the end of life are also explored, as are ethical and moral issues in death and dying, and the ways in which bereaved partners and relatives may come to terms with the loss of a loved one. This concise and accessible book will be a valuable resource for those in the caring professions and a rich source of guidance and support for older people who are nearing the end of life and their families.

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.

The first resource of its kind, Palliative and Serious Illness Patient Management for Physician Assistants provides a fundamental framework for physician assistants and physician associates to incorporate palliative care medicine, including end-of-life care, into their practice. The book focuses on pharmacologic and integrative medical therapeutic modalities, as well as the evaluation and treatment of special populations, which reflects the reality of a physician assistant's day-to-day job. It uses a patient-centered approach to address the comprehensive management of serious illness patients, as well as their designated families, significant others, caregivers, and health care providers. Chapters are organized into six sections that cover the essential aspects of care, symptom management, and transitioning care at the end-of-life. This book is ideal for physician assistant trainers (didactic or clinical), students, and practicing clinicians who seek to enhance their communication and medical skills in the treatment of all seriously illness patient populations in any specialty, and in the management of their symptoms at any stage of their disease or condition.

The Oxford Textbook of Palliative Social Work is a comprehensive, evidence-informed text that addresses the needs of professionals who provide interdisciplinary, culturally sensitive, biopsychosocial-spiritual care for patients and families living with life-threatening illness. Social workers from diverse settings will benefit from its international scope and wealth of patient and family narratives. Unique to this scholarly text is its emphasis on the collaborative nature inherent in palliative care. This definitive resource is edited by two leading palliative social work pioneers who bring together an array of international authors who provide clinicians, researchers, policy-makers, and academics with a broad range of content to enrich the guidelines recommended by the National Consensus Project for Quality Palliative Care.

Monitoring the Critically Ill Patient is an invaluable, accessible guide to caring for critically ill patients on the general ward. Now fully updated and improved throughout, this well-established and handy reference guide text assumes no prior knowledge and equips students and newly-qualified staff with the clinical skills and knowledge they need to confidently monitor patients at risk, identify key priorities, and provide prompt and effective care. This new edition includes the following five new chapters: * Monitoring the critically ill child * Monitoring the critically ill pregnant patient * Monitoring the patient with infection and related systemic inflammatory response * Monitoring a patient receiving a blood transfusion * Monitoring pain

This book describes the current state of the art in the field of palliative care in children and adults. Special emphasis is placed on addressing the efficacy and effectiveness of palliative care models, pain and symptom management, and on measuring quality of life. In addition the book evaluates current research methods in palliative care and suggests suitable alternatives. Finally the book bridges the gap between science and practice by providing the reader with the current evidence and how it can be applied in the practice setting.