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Books > Medicine > Other branches of medicine > Palliative medicine
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.
Talking openly with sick and dying children about their illness is always difficult and often agonizing. It is honesty, however, that these children deserve and need. Dietrich Niethammer, a prominent pediatric oncologist, explains why it is so important to speak frankly and respectfully to young patients about their disease. The question at the heart of this book is how children and adolescents feel and think about death and dying. Dr. Niethammer thoroughly examines the literature on the topic, arguing that children and adolescents not only are capable of discussing their illness but benefit from doing so. Puzzled why it took medical practitioners so long to accept truth-telling in their care of dying children, Niethammer traces the development of this notion from the early twentieth-century work of Sigmund Freud to the discomfort surrounding it still today. Severely sick children and adolescents think about the consequences of their disease, whether adults discuss it with them or not. When adults remain silent, they do a disservice to the children. Dr. Niethammer urges doctors to practice not in silence and denial but in open communication with ill children, giving the children an opportunity to express their fears and anxieties and to cope with their disease on their own terms. Dr. Niethammer's compelling personal experiences combined with the latest research make this a compassionate and invaluable resource for physicians, nurses, social workers, teachers, parents--for all who care for sick and dying children and adolescents.
In the 21st century, people in the developed world are living longer. They hope they will have a healthy longer life and then die relatively quickly and peacefully. But frequently that does not happen. While people are living healthy a little longer, they tend to live sick for a lot longer. And at the end of being sick before dying, they and their families are frequently faced with daunting decisions about whether to continue life prolonging medical treatments or whether to find meaningful and forthright ways to die more easily and quickly. In this context, some people are searching for more and better options to hasten death. They may be experiencing unacceptable suffering in the present or may fear it in the near future. But they do not know the full range of options legally available to them. Voluntary stopping eating and drinking (VSED), though relatively unknown and poorly understood, is a widely available option for hastening death. VSED is legally permitted in places where medical assistance in dying (MAID) is not. And unlike U.S. jurisdictions where MAID is legally permitted, VSED is not limited to terminal illness or to those with current decision-making capacity. VSED is a compassionate option that respects patient choice. Despite its strongly misleading image of starvation, death by VSED is typically peaceful and meaningful when accompanied by adequate clinician and/or caregiver support. Moreover, the practice is not limited to avoiding unbearable suffering, but may also be used by those who are determined to avoid living with unacceptable deterioration such as severe dementia. But VSED is "not for everyone." This volume provides a realistic, appropriately critical, yet supportive assessment of the practice. Eight illustrative, previously unpublished real cases are included, receiving pragmatic analysis in each chapter. The volume's integrated, multi-professional, multi-disciplinary character makes it useful for a wide range of readers: patients considering present or future end-of-life options and their families, clinicians of all kinds, ethicists, lawyers, and institutional administrators. Appendices include recommended elements of an advance directive for stopping eating and drinking in one's future if and when decision making capacity is lost, and what to record as cause of death on the death certificates of those who hasten death by VSED.
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.
Are you involved in caring for people at the end of their life? Do you have a role in supporting the families of those who are dying, or is this an area of your work you find personally difficult?This book is an accessible guide for all those working in health or social care and caring for people at the end of their lives. This will include people in roles such as healthcare assistant, hospice worker, volunteer, nurse or other carers.Written by experts with extensive experience in delivering high quality end of life care, this book is full of real life examples, reflection exercises and case studies. It also includes insights into what can help make a good death, and how to help support families at the end of life.The easy to read chapters emphasise treating people who are dying with dignity using a person centred approach.The book supports the delivery of quality care by recognising physical and non-physical symptoms, and thinking about various emotional and physical needs people might have. It is also important that care givers look after themselves and advice is given on how best to do this.An essential purchase for anyone looking for guidance or support in this area, and suitable for those working in the community, care homes, hospices, hospitals or other settings where people are cared for. With a Foreword from Dr. Ros Taylor, MBE, National Director for Hospice Care, Hospice UK."The book strikes a balance between the factual and the personal, and gives the reader detailed information and time to think through reflection exercises. It highlights essential elements of end of life care, including communication, symptom management and personal care during bereavement. It emphasises the importance of adopting a person-centred approach of people who are dying. The book supports the delivery of quality care by recognizing the physical and non-physical symptoms, and thinking about people's emotional and physical needs. It also makes clear that caregivers should look after themselves and how they should do so." Deborah Preshaw, doctoral nursing student, Queens University Belfast, UK "This is a beautifully presented learning tool to support the delivery of end of life care. I particularly like the 'signposts' which reinforce the intention of the book to enable 'carers' to apply what they read to their role in practice." Liz Bryan, Director of Education and Training, St Christopher's Hospice, UK "This book is a very welcome addition to the literature on end of life care, as it does exactly what it says - it is a practical guide. It is written by an inter-professional group of clinical experts who have managed to create a concise, accessible resource which would be perfect for carers, volunteers, Health Care Support Workers or health care student working in any clinical setting who wants to make a difference for individuals approaching the end of their lives. The book addresses all of the important aspects of care at this crucial time, including attitudes to death and dying, communication issues, common physical and psycho-social symptoms, and care in the last hours of life. The case studies of three individuals are threaded throughout the book and are an excellent way to illustrate theoretical content and demonstrate its clinical application. The glossary of terms is particularly useful for a non-specialist audience, as are the resources for further reading. I particularly welcome the use of 'signposts' to different activities at key points which encourage the reader to reflect and apply the knowledge to their own situation. I highly recommend this book to any individual who wants to develop their confidence and competence in this challenging, but critically important area of care." Mick Coughlan, Programme Leader, The Royal Marsden School, UK "I found the chapters easy to read and the link to a case study really brought the words 'to life'. The chapter on self-care was helpful - this is an area hospice managers are having to focus on in detail as our staff strive to maintain the high levels of quality care hospices are renowned for with compassion and dignity . Giving emotional support throughout a shift to patients, families and colleagues can lead to a feeling of 'exhaustion' and 'fatigue', which if not recognised and addressed leads to time off sick and a feeling of being 'powerless' for staff . Healthcare professionals must recognise this as well as their managers, who then need to provide different levels of interventions that staff can access - as described in the book. I think all palliative care libraries should have this book on their shelves and perhaps it could be a 'core' reading book for training. I also used it on the ward to discuss with nurses - it's not that what is written is necessarily new but it is well written, concise and relevant. I feel this book would be very useful for those new to palliative care as well as those studying the subject. Relating theory to practice is always powerful and for new nurses and other healthcare professionals this provides context and meaning." Clodagh Sowton, Director of Patient Services, Phyllis Tuckwell Hospice Care, UK "This is a welcome book to the field of end of life care. This practical guide is accessible and is an excellent bridge between the 'Lay Person' and those health care professionals caring for the individual as they approach the end of life. The authors present their subject areas in a most readable and engaging style. While reviewing the case studies (which are weaved throughout the whole book); you feel they have come from experienced carers who have had 'lived experiences' of end of life care. This therefore, makes the chapters much more relatable and applicable to practice and real world life. This is also a personable book and I would recommend it to health care professionals and lay persons alike- who need to address or who may require further insight into the realms of: Physical/psycho-social symptoms, communication challenges and differential perspectives on dying and death. Finally, I will also be directing students of healthcare towards this impressive, insightful book." Robert Murphy, Senior Lecturer - Adult Nursing, London South Bank University, UK "The material covered is very helpful and the range of authors has been well selected from individuals who are active in clinical practice. The book is practical and clear, and Clair deserves high praise for the contribution it will make to clinicians seeking to improve their palliative care knowledge and skills." Professor Max Watson, Medical Director Northern Ireland Hospice, Visiting Professor University of Ulster, UK
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 handbook is an essential guide to caring for the community palliative care patient in relation to COVID-19, when the patient's preferred place of care is at home or the hospice. It will guide you through appropriate care procedures and protocols in managing end-of-life patients who show symptoms of COVID-19. Key features include: Difficult conversations and communication skills Symptom management Advance care planning Caring for stable patients with palliative needs and those who are at end-of-life Supporting the family and friends of the patient Your own well-being as a healthcare professional Supported by applicable case studies from a range of community care settings, this guide will be relevant to anyone affected by the challenges of COVID-19 when managing end-of-life patients or caring for older people, including paramedics, nurses and palliative care providers.
Now in paperback, the Oxford Textbook of Communication in Oncology and Palliative Care integrates clinical wisdom with empirical findings. Written by an international team of authors, it draws upon the history of communication science, providing the reader with a comprehensive curriculum for applied communication skills training. An essential resource, the Oxford Textbook of Communication in Oncology and Palliative Care is filled with tips and strategies for effective communication in difficult and challenging scenarios. In focusing on cancer and the end-of-life, it deals with the existential and spiritual challenges found across all of medicine, providing deep insights into what is at stake and how clinicians might optimally respond. This authoritative and wide-ranging book provides clinicians with state-of-the-art and evidence-based guidelines to achieve effective, patient-centred communication in the clinical settings of oncology and palliative care. This edition includes sections on the curriculum for nurses, the core curriculum, and an introductory section on communication science. The chapters embrace specialty issues across the clinical disciplines, from enrolling in clinical trials, working in teams, and discussing genetic risk, to talking about sexuality, infertility, and intercultural issues. An educational perspective is also provided, with chapters covering communication skills training, how to evaluate courses, and international models of training.
50 Studies Every Palliative Care Doctor Should Know presents key studies that have shaped the practice of palliative medicine. Selected using a rigorous methodology, the studies cover topics including: palliative care, symptom assessment and management, psychosocial aspects of care and communication, and end-of-life care. 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.
Palliative care is an essential element of our health care system and is 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, and nurses are at the center of the palliative care team across settings and populations. The sixth volume in the HPNA Palliative Nursing Manuals series, Social Aspects of Care provides an overview of the financial and mental stress illness places, not just on the patient, but on the family as well. This volume contains information on how to support families in palliative care, cultural considerations important in end-of-life care, sexuality and the impact of illness, planning for the actual death, and bereavement. The content of the concise clinically focused volumes in the HPNA Palliative Nursing Manuals series is an ideal resource for nurses preparing for certification exams and provides a quick-reference in daily practice.
Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. 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.
Cancer-related bone pain is experienced by patients with primary bone tumours such as myeloma and osteosarcoma, but is more commonly seen in patients with malignant tumours that have metastasised to bone. Bone pain is one of the most common and severe forms of pain associated with breast, prostate and lung cancer, yet little is known about the underlying mechanisms responsible for the pain. Cancer patients identify bone pain as the most disruptive cancer-related event in terms of their quality of life and daily functioning, and it is also associated with increased incidence of morbidity, depression, and anxiety. Part of the Oxford Pain Management Library, this volume summarises the latest evidence-based and practical information on the management of cancer-related bone pain. Chapters cover the pathophysiology and clinical features of bone pain, general principles of management and the use of opioids and other agents. It will be an invaluable reference for all health care professionals involved in the management of patients with bone pain from various disciplines including palliative care, anaesthetics, oncology and general practice.
Wish to die statements are becoming a frequent phenomenon in terminally ill patients. Those confronted by these statments need to understand the complexity of such wishes, so they can respond competently and compassionately to the requests. If misunderstood, the statements can be taken at face-value and the practitioner may not recognise that a patient is in fact experiencing ambivalent feelings at the end of life, or they may misinterpret the expressed wish to die as a sign of clinical depression. Public debate about the morality and ethics of various end-of-life care options has exploded in recent years. However, it has never been sensitive to the finer aspects of clinical reality or the experiences of patients. The Patient's Wish to Die: Research, Ethics, and Palliative Care brings together that reality and the patient's voice, combining them with different research approaches. It presents the best available knowledge and research methodologies about patients' wishes at the end-of-life, together with a series of ethical views and a discussion about the clinical implications for palliative care. The book presents material in an open and unbiased manner whilst remaining sensitive to the spiritual and existential dimensions of dying, and to the different cultural views that provide meaning to the individual. Written by the best specialists and ethics scholars from around the world, including palliative care practitioners and end-of-life scholars from countries where assisted dying practices are legalized and from those where it isn't, The The Patient's Wish to Die: Research, Ethics, and Palliative Care will prove essential reading for all those working or studying in the field of palliative care.
The care of patients with advanced and terminal illness can be extremely rewarding but often causes professionals a considerable amount of discomfort. This is especially so when you feel under confident in your abilities to provide a high quality of symptom management and relief from distress and to communicate appropriately with patients. Patients with advanced disease present some of the most challenging ethical, physical, psychological and social issues to clinicians and indeed to society. Patients need us to be knowledgeable, skilful and understanding. The fully revised and updated new edition of Palliative Care outlines the fundamental principles and facts which will enable you to make a very real difference to your patients and their families. Information is provided in an accessible, user-friendly way and covers a wide range of physical and non-physical symptom management. Multi-professional team work is addressed, as is the role and support of families. There is also a consideration of the dilemmas and decisions that may be encountered by doctors around the end of a patient's life. This practical resource, designed to provoke contemplative professional development, and enhance learning will be essential reading for nursing and medical practitioners, and other professionals who support patients in their homes, in care homes, and in hospital.
UEbersichtlich und kompakt bietet Ihnen dieses Lehrbuch einen vollstandigen UEberblick uber alle prufungsrelevanten Inhalte der Palliativmedizin. Es leitet Sie leicht verstandlich und GK-orientiert durch das gesamte Basiswissen und beinhaltet die Therapie, Versorgung und Begleitung Sterbender, sowie besondere Situation wie z.B. Notfallsituationen, der Umgang mit Kindern und LSBTI. Profitieren Sie von der langjahrigen Erfahrung der Dozenten, die sorgfaltig das Wesentliche fur Sie ausgewahlt und aufbereitet haben. Der Inhalt Das bewahrte didaktische Konzept ermoeglicht ein effizientes Lernen: * Prufungsteil - Fur eine optimale Vorbereitung auf MC-Fragen und Fallstudien * Kernaussagen - Bringen das Wichtigste auf den Punkt * Fallbeispiele - Stellen einen anschaulichen Bezug zur Praxis her * 29 Videos uber die kostenlose MoreMediaApp - Geben einen Einblick in die Arzt- und Patientensituation
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.
The importance of spiritual well-being and the role of "meaning" in moderating depression, hopelessness and desire for death in terminally-ill cancer and AIDS patients has been well-supported by research, and has led many palliative clinicians to look beyond the role of antidepressant treatment in this population. Clinicians are focusing on the development of non-pharmacologic interventions that can address issues such as hopelessness, loss of meaning, and spiritual well-being in patients with advanced cancer at the end of life. This effort led to an exploration and analysis of the work of Viktor Frankl and his concepts of logotherapy, or meaning-based psychotherapy. While Frankl's logotherapy was not designed for the treatment of patients with life-threatening illnesses, his concepts of meaning and spirituality have inspired applications in psychotherapeutic work with advanced cancer patients, many of whom seek guidance and help in dealing with issues of sustaining meaning, hope, and understanding cancer and impending death in the context of their lives. Individual Meaning-Centered Group Psychotherapy (IMCP), an intervention developed and rigorously tested by the Department of Psychiatry & Behavioral Sciences at Memorial Sloan-Kettering Cancer Center, is a seven-week program that utilizes a mixture of didactics, discussion and experiential exercises that focus around particular themes related to meaning and advanced cancer. Patients are assigned readings and homework that are specific to each session's theme and which are utilized in each session. While the focus of each session is on issues of meaning and purpose in life in the face of advanced cancer and a limited prognosis, elements of support and expression of emotion are inevitable in the context of each group session. The structured intervention presented in this manual can be provided by a wide array of clinical disciplines, ranging from chaplains, nurses, palliative care physicians, to counselors, psychotherapists, social workers, graduate psychology students, psychologists and psychiatrists.
Worldwide, more than 50 million people die each year and it is estimated on the basis of the conditions leading to death that up to 60% of them could benefit from some form of palliative care. It is a public health challenge to ensure that these people can access good palliative or end-of-life care. Pursuing good population health essentially also implies striving for a 'good enough death' and a good quality of care at the end of life. Safeguarding a good quality of the end of life for patient populations for whom it is appropriate requires a public health approach. In most developed countries ageing populations that increasingly die from chronic diseases after a prolonged -often degenerative- dying trajectory make up the public health challenges for palliative care. The very large baby boom generation will soon reach old age and can be expected to pose strong demands regarding the circumstances and care at their end of life. Only by applying a public health approach to palliative care (instead of individual patient perspectives), can societies successfully help to organize and plan end-of-life care in accordance with these aspirations. A Public Health Perspective on End of Life Care presents a synthesis and overview of relevant research and empirical data on the end of life that can bear a basis for a more systematic 'public health of the end of life'. The book focuses on population health, rather than clinical interventions or other aspects of individual health, and discusses studies using different methodologies (not only epidemiological research). The focus is on the quality of the end-of-life of populations, in particular from social sciences, environmental sciences, and humanities perspectives.
The effective management of pain from cancer is a top priority for
patients, carers and healthcare professionals, and has been the
subject of extensive research. Approximately two-thirds of cancer
patients will experience severe pain, and many of them will have
more than one pain. However, because of the increasing number of
available treatments for cancer, patients are surviving for longer
periods, and are developing complex consequences of their cancer
and its treatment, such as central and peripheral neuropathic pain
syndromes. Approximately 8 - 10% of cancer pain remains unrelieved
by conventional means.
Society has become increasingly diverse; multi-cultural, multi-faith and wide ranging in family structures. The wealthier are healthier and social inequalities are more pronounced. Respecting and working with the range of 'differences' among service users, families and communities in health and social care with ill, dying and bereaved people is a neglected area in the literature. As the principles of palliative and end of life care increasingly permeate the mainstream of health and social care services, it is important that professionals are sensitive and respond to the differing needs of individuals from diverse socio-economic backgrounds, ethnicities, beliefs, abilities and sexual orientations, as well as to the different contexts and social environments in which people live and die. This book explores what underpins inequality, disadvantage and injustice in access to good end of life care. Increasingly clinicians, policy planners, and academics are concerned about inequity in service provision. Internationally, there is an increasing focus and sense of urgency both on delivering good care in all settings regardless of diagnosis, and on better meeting the needs of vulnerable and disadvantaged groups. National initiatives emphasise the importance of resolving disparities in care and harnessing empowered user voices to drive change. This newly expanded, fully revised second edition, with 11 new chapters, provides a comprehensive analysis of discrimination, difference and disadvantage in end of life care, and offers practical guidance for all who seek to support the equitable provision of good end of life care.
Ageing populations mean that palliative and end of life care for
older people must assume greater priority. Indeed, there is an
urgent need to improve the experiences of older people at the end
of life, given that they have been identified as the 'disadvantaged
dying'. To date, models of care are underpinned by the ideals of
specialist palliative care which were developed to meet the needs
of predominantly middle-aged and 'young old' people, and evidence
suggests these may not be adequate for the older population group.
The need for renewal and support for those who care for seriously ill, dying, and bereaved people has been acknowledged from the very beginning of the hospice and palliative care movement. While often referring to the rewards and satisfactions of the work, Dame Cicely Saunders was the -first to acknowledge that helping encounters with dying patients and distressed relatives could be a source of anguish and grief for dedicated and compassionate carers. Caregiver Stress and Staff Support in Illness, Dying, and Bereavement discusses the challenge of finding a balance between the support needs of patients, families, and staff and the resources available. With contributions from practitioners and researchers from around the world, this book recognizes that palliative care today is being provided in many different settings and that there may be wide variations in the way individuals and organizations identify and manage the stressors that arise through the work. This unique collection of international perspectives on the complexities and management of caregiver stress and staff support builds on the firm foundation Mary Vachon built over thirty years ago in her studies, yet broadens the scope to include significant social, political, and cultural variations on the theme.
Recent years have seen increasing interest in the needs of children
facing bereavement, and a corresponding increase in services to
support them. This book addresses and explains the theoretical
concepts and practical implications behind the idea of brief work
with bereaved children and families. Flexible and accessible short
term services delivered at the right time underpin the strengths of
bereaved children, supporting their recovery rather than
pathologizing the grief process. In this way, the book also speaks
to the current interest in the concept of resilience and working
with families' strengths and possibilities, rather than merely
identifying their problems.
Childen's palliative care has developed rapidly as a discipline, as
health care professionals recognize that the principles of adult
palliative care may not always be applicable to children at the end
of life. The unique needs of dying children are particularly
evident across Africa, where the scale of the problem is
overwhelming, and the figures so enormous that they are barely
comprehensible: over 400,000 children in Africa died from AIDS in
2003, and out of the 166,000 children a year diagnosed with cancer,
85% of these are in the developing world. Despite the enormous
need, provision of children's palliative care in Africa is almost
non-existent, with very few health workers trained and confident to
provide care for dying children. The challenges of providing
palliative care in this setting are different to those in more
developed countries, contending with the shortage of physical and
human resources in addition to the vast scope of the care needed.
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