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

Improving care for the patients who are in the last phase of their lives has been a field that most health care providers have struggled with during last few years. Having worked with hundreds of providers throughout the country, these experienced authors know what providers need when it comes to implementing a quality improvement project. This guide will provide user-friendly, step-by-step instructions on how to implement a quality improvement project in the full range of care settings. The instructions will be brought to life with specific examples from actual successful projects and key information on the best practices in the industry. Readers will also be pointed to resources available online and elsewhere, with information on how to access them. The guide will be written in an informal, maximally helpful style, with checklists, tables, and boxed information. Answering 80% of the questions in less than half the space, The Common Sense Guide is the perfect portable companion to Dr. Lynn's desk reference, Improving Care for the End of Life. The book will be of great interest to all health care professionals involved in the care of those with serious chronic illness -- doctors, nurses, social workers, chaplains, clinic administrators, quality improvement experts, and so forth.

This title contains foreword by Ian Maddocks, formerly Foundation President, Australian Association of Hospice and Palliative Care and Foundation President, Australian and New Zealand Society of Palliative Medicine. This book is a practical and pragmatic distillation of the psychiatry of relevance to the terminally ill. It reviews the major psychiatric syndromes encountered in palliative care - depression, anxiety, delirium - and examines psychopharmacological and psychological interventions in detail. It considers the psychiatric aspects of pain, sleep, cognitive impairment, terminal neurodegenerative diseases, sedation and artificial feeding. The dying chronically ill psychiatric patient is also discussed. The author has drawn on his great experience in both consultation-liaison psychiatry and palliative medicine to produce an essential guide for all healthcare professionals involved in palliative care, including consultants and senior nurses, as well as psychiatrists, especially consultation-liaison psychiatrists, and trainees. 'Illness that threatens imminent death challenges the mental and social well-being of affected individuals and their families. Consistent specialist psychiatric care has nevertheless not been readily available to the dying. Because there may never be sufficient numbers of psychiatrists interested in bringing their expertise to this field, working with the dying mind depends on staff with limited training in behavioural medicine and psychiatry. To redress the inadequate engagement of psychiatry, Sandy Macleod has concentrated on those important areas in palliative medicine where a pragmatic knowledge of psychiatry can make a difference. Here is sensible guidance that will enable staff to serve their client patients and families more adequately. I find this an immensely sympathetic book, beautifully written. It is a testimony to the summation of specialist psychiatric knowledge, broad scholarship and a rich personal practice in bedside palliation.' - Ian Maddocks in the Foreword.

Palliative and End-of-Life Care, 2nd Edition provides clinicians with the guidelines and tools necessary to provide quality, evidenced-based care to patients with life-limiting illness. This text describes the care and management of patients with advanced disease throughout the disease trajectory, extending from diagnosis of advanced disease until death. Four units provide the general principles of palliative and end-of-life care, important concepts, advanced disease management, and clinical practice guidelines. Clinical practice guidelines offer in-depth discussions of the pathophysiology of 19 different symptoms, interventions for specific symptom management (including in-depth rationales), and suggestions for patient and family teaching. Defines dying as a normal, healthy process aided by the support of an interdisciplinary team. Provides in-depth pathophysiology, assessment, and intervention information based upon the disease trajectory. Highlights opportunities for patient and family teaching. Describes psychosocial issues experienced by patients and their families. Reviews uncomplicated and complicated grief and mourning, providing suggestions to help the family after a patient's death. Includes case studies at the end of chapters to reinforce key concepts of compassionate care. New chapters including Advance Care Planning, Ethical Issues, Spiritual Care Across Cultures, Pharmacology, Sleep, and Nutrition. Includes a new appendix on Assessment Tools and Resources for more comprehensive coverage of palliative and end-of-life care.

There is a growing conflict in medicine between the research imperative, with its implicit goal of overcoming death itself, and the re-emergent clinical imperative to treat death as a part of life, and to make the process of dying as tolerable as possible. Central to this conflict is the rise of scientific medicine and the decline of religious and associated moral discourses. Many of the Anglo Saxon countries are also marked by a moral and religious pluralism which breeds controversy over bioethical issues such as euthanasia.
It seems that modern medicine has put the cure of bodies before the care of persons. Some scholars attribute this to a metaphysical heritage of dualism and reductionism. This heritage has become problematic in the modern age when waning belief in a divine order leaves the individual self as the bearer of meaning. At the same time, knowledge about nature and society has been increasing at such an accelerated pace, it has become even more difficult to develop a unified secular worldview. When the dying self contemplates its own disintegration in this context, the search for meaning may rest heavy indeed.
Chapters one and two address these larger issues. Chapter three focuses on medicine's approach to cancer as a prime example of the strengths and weaknesses of the research imperative. Chapter four looks at the diffusion of the theory and practice of palliative care throughout the Anglo Saxon world. The fifth chapter discusses the development of effective pain control, essential to palliative care and one of modern medicine's unsung triumphs. The sixth chapter addresses the changing meaning of euthanasia in Western history in the past century, as ittransitioned from a philosophical position to a widely-debated policy proposal.
This book is for palliative care practitioners, and all health care professionals with an interest in end-of-life care. It is also for students in palliative care and the history of medicine, and for anyone interested in the history of this intriguing field.

This book is a thoughtful, informative, and practical guide for anyone involved in caring for the seriously and chronically ill or dying. The connection between spirituality and medicine has been receiving a lot of attention in both the scientific and lay presses recently, but research and anecdotal evidence all indicate that spirituality is central to the care of the chronically ill and dying. It is therefore critical that healthcare providers who interact with seriously ill patients know how to address their spiritual needs.
This book presents current thinking on how spiritual care can be integrated into traditional caregiving. Part one discusses aspects of spirituality, such as presence, ethics, and relationships. Part two delves into a number of specific religious and theological traditions. Part three offers practical applications and tools, including storytelling, psychotherapy, dance, music, and the arts. Part four focuses on patients' stories and reflections. The book concludes with appendices that have sample advance directives for Protestant, Catholic, Jewish, and Muslim patients.
Volume editor Christina Puchalski is the director of the George Washington Institute of Spirituality and Health. She is also an associate professor of medicine at the George Washington University Medical Center and an active practicing physician and medical educator. Dr. Puchalski is nationally and internationally recognized as a pioneer in the integration of spirituality and healthcare. Chapters are authored by an impressive group of medical and religious experts, and patients' stories also appear throughout, offering real-world examples. The book features a foreword by the Dalai Lama.

Two cogent arguments about end-of-life careand carefully reasoned responses from experts End-of-Life Care: Bridging Disability and Aging with Person Centered Care features two primary papers on the controversial issue of end-of-life care within the disabled and aging populations. Each paper explainsclearly and honestlythe multitude of issues involved in using person centered care. The first is from a father and nationally known advocate for the disabledRud Turnbullspeaking from a disability perspective about his disabled son. The second is from respected theologian M. J. Iozzio speaking from the aging perspective about her father's Alzheimer's disease. Responses from experts in the field follow, thoughtfully raising further points to consider about policies, ethics, quality of life, and consent. The two central papers from End-of-Life Care focus on person centered, interdependent care using the personal reflections of two close family members and their views about end-of-life care. The responses that follow each are direct, thoughtful, and concentrate on the issues in end-of-life planning using person centered care. This difficult and important issue is discussed in detail by lawyers, theologians, clinical practitioners, and professional service providers, and includes several revealing personal stories about end-of-life experiences. Helpful resources for both policy and practice are also presented to assist the reader to learn more. End-of-Life Care discusses: who, how, and on what grounds end-of-life decisions should be made for the developmentally/intellectually disabled best practices information from Volunteers of America's Last Passages project the unique challenges faced by individuals with disabilities and their families when confronting issues of death and dying the protection of the rights of the disabled from discrimination person centered care for the aging with complicating health conditions like Alzheimer's Disease helping all people to clearly communicate their end-of-life wishes End-of-Life Care explores explores policy, theological, and personal dimensions of end of life care, and the ways that person centered care can bridge the fields of aging and disabilty.

Medical care of the terminally ill is one of the most emotionally fraught and controversial issues before the public today. As medicine advances and technologies develop, end-of-life care becomes more individualized and uncertain, guided less by science and more by values and beliefs. The crux of the controversy is when to withhold or withdraw curative treatments--when is enough, enough?
Political debates rage about when treatment is no longer effective; difficult cases are contested in courts; and the media devour the most sensational aspects of end-of-life care. In all this excitement and controversy, what is sadly overlooked is the extreme pressure that care of the terminally ill puts on medical staff as they deal with patients and their families and make life-or-death decisions. That pressure--the psychological strain and continuing uncertainties--is magnified when the patients are children.
David Bearison looks at this controversial issue from the perspective of the medical staff caring for dying children. Not just doctors, but nurses and counselors as well. By capturing their stories--as no other book has, Bearison is able to move beyond broad, abstract ideas about end-of-life care to convey the situated contexts of such care, including the complications, disagreements, frustrations, confusions, and unexpected setbacks.
In addition to a discussion of questions surrounding whether to withhold or withdraw curative treatments, When Treatment Fails explores the crucial concerns of those medical practitioners who care for dying children: education and training, relation with one another, communicating with patients and families, and finally, coping and moving on.Ultimately, the threads connecting these themes are the great costs and rewards of this difficult work, and the lessons that can be drawn from the nitty-gritty experiences of medical practitioners who struggle to find the balance between trying to defeat death and trying to provide comfort.

Two cogent arguments about end-of-life careand carefully reasoned responses from experts End-of-Life Care: Bridging Disability and Aging with Person Centered Care features two primary papers on the controversial issue of end-of-life care within the disabled and aging populations. Each paper explainsclearly and honestlythe multitude of issues involved in using person centered care. The first is from a father and nationally known advocate for the disabledRud Turnbullspeaking from a disability perspective about his disabled son. The second is from respected theologian M. J. Iozzio speaking from the aging perspective about her father's Alzheimer's disease. Responses from experts in the field follow, thoughtfully raising further points to consider about policies, ethics, quality of life, and consent. The two central papers from End-of-Life Care focus on person centered, interdependent care using the personal reflections of two close family members and their views about end-of-life care. The responses that follow each are direct, thoughtful, and concentrate on the issues in end-of-life planning using person centered care. This difficult and important issue is discussed in detail by lawyers, theologians, clinical practitioners, and professional service providers, and includes several revealing personal stories about end-of-life experiences. Helpful resources for both policy and practice are also presented to assist the reader to learn more. End-of-Life Care discusses: who, how, and on what grounds end-of-life decisions should be made for the developmentally/intellectually disabled best practices information from Volunteers of America's Last Passages project the unique challenges faced by individuals with disabilities and their families when confronting issues of death and dying the protection of the rights of the disabled from discrimination person centered care for the aging with complicating health conditions like Alzheimer's Disease helping all people to clearly communicate their end-of-life wishes End-of-Life Care explores explores policy, theological, and personal dimensions of end of life care, and the ways that person centered care can bridge the fields of aging and disabilty.

Helping others to learn about caring for people with advanced disease has always been a fundamental part of effective palliative care. This flexible learning material, formally evaluated by the Open University, is based on the Current Learning in Palliative Care (CLIP) worksheets to cover all aspects of palliative care. Easy to use, with activities throughout, they can be reproduced as handouts when presenting to a group, or used individually alongside a tutor, or within a group setting. Each worksheet is carefully structured and assigned a learning level from introductory to advanced, to give the reader an indication of how much experience or knowledge is needed to carry out the exercise. This book provides an essential resource to arm health professionals, carers and teams with the knowledge and skills needed in their daily work.

Dr. Hallenbeck has written a guide for clinicians who want an introduction to palliative care that addresses "big picture" issues as well as provides specific, practical advice. Topics addressed range from an overview of death and dying in the modern world to discussions of pain and symptom management, communication techniques and palliative care consults.

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 the 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 engaged 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 practioners at the bedside, the findings of empirical research. Topics in Palliative Care Series is divided into sections that address a range of issues. Addressing aspects of sumptom control, psyshocsoical 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 for analysis. The authors present and evaluate existing data, provide a context drawn from clinical and research settings, and integrate knowledge in a manner that is both practical and readable. The specific topics covered in Volume 5 are Cultural issues in Palliative Care, Palliative Care in Geriatrics, Communication Issues in Palliative Care, Outcomes Research in Palliative Care, Opiod Tolerance; Reality of Myth?, and Pain and other symptoms: Treatment Challenges.

This volume reviews the state of the art in caring for patients dying in the ICU, focusing on both clinical aspects of managing pain and other symptoms, as well as ethical and societal issues that affect the standards of care recieved, The book also addresses the changing epidemiology of death in this setting related to managed care, practical skills needed to provide the highest quality of care to terminal patients, communicating with patients and families, the mechanics of withdrawing life supporting therapies, and the essential role of palliative care specialists in the ICU. The book briefly describes unique issues that arise when caring for patients with some of the more common diseases that preciptate death in the ICU. Contributors for the book were chosed because they have experience caring for patients in the ICU, and are also doing curent research to find ways to improve care for terminal patients in this setting.

This is the fourth book in a series devoted to research and practice in palliative care. This rapidly evolving field focuses on the management of phenomena that produce discomfort and undermine the quality of life of patients with incurable medical disorders. To highlight the diversity in this field, each volume is divided into sections that address a range of issues. Various sections discuss aspects of symptom control, psychosocial functioning, spiritual orr existential concerns, ethics, and other topics. The four sections in this volume are; Survival Estimation in Palliative Care, Education and Training in Palliative Care, Procoagulant and Anticoagulant Therapy in Palliative Care, and Issues in the Assessment and Management of Common Symptoms. The authors present and evaluate existing data, provide a context drawn from both the clinic and research, and integrate knowledge in a manner that is both practical and readable.

This volume presents a series of case narratives, following individual patients and families throughout the course of illness and death in the context of hospice and palliative care. Using a variety of qualitative research methods, including participant-observation, interviews, and journal-keeping, the experiences, perceptions, and feelings of the patient, the family and a range of caregivers are recorded, providing the reader with rich, multi-textured narratives. Going beyond conventional case reports in Medicine, typically concentrating on symptoms and treatment, these narratives depict how individuals find personal meaning in illness, and how this influences the experience and outcome of care.

This singular work offers a truly interdisciplinary team perspective on caring, presented by 21 veterans of hospice service representing the array of disciplines in effective teams-physicians, nurses, certified nurse assistants, social workers, chaplains, music therapists, bereavement counselors, a volunteer coordinator, and a volunteer of more than 26 years. Contributors share professional and personal experiences that encompass the medical, emotional, intellectual, spiritual, interpersonal, social, cultural, and economic dimensions of dying and bereavement. These are brought together through a person-centered approach that champions knowing each person being cared for to create the necessary opportunity for communication and trust that are the hallmarks of high-quality hospice care.

The Textbook of Palliative Care Communication is the authoritative text on communication in palliative care, providing a compilation of international and interdisciplinary perspectives. This volume was uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, and it unites clinicians with academic researchers interested in the study of communication. By featuring practical conversation and curriculum tools stemming from research, this text integrates scholarship and inquiry into translatable content that others can use to improve their practice, teach skills to others, and engage in patient-centered communication. The volume begins by defining communication, explicating debatable issues in research, and highlighting specific approaches to studying communication in a palliative care context. Chapters focus on health literacy and cultural communication, patient and family communication, barriers and approaches to discussing palliative care with specific patient populations, pain, life support, advance care planning, and quality of life topics such as sexuality, spirituality, hope, and grief. Team communication in various care settings is outlined, and current research and education for healthcare professionals are summarized. Unique to this volume are chapters on conducting communication research, both qualitatively and quantitatively, to promote further research in palliative care.

Do you need a succinct introduction to the key theories and principles of palliative care and their application to practice?

Key Concepts in Palliative Care provides just this in a compact, fifty-concept guide to the field. Taking account of the government's "End of Life Care Strategy," contributors set out the key issues affecting practice across a range of health and social care contexts.

The book covers topics ranging from dying and death to symptom management and spiritual care, backed up with practical examples. Each entry comprises:

o a snapshot definition of the topic

o key points

o a discussion of the main debates

o links to practice through thought-provoking case histories, and

o suggestions for further reading.

Key Concepts in Palliative Care is an ideal text and handy source of reference for health and social care professionals who are developing their knowledge and skills in palliative care.

This textbook details the nursing care of babies with life limiting conditions and sets the context within the philosophy of internationally collaborative neonatal palliative care emphasising emotional and practical support for their families. Currently, increasing interest from nursing and medical fields regarding palliative care for babies in the antenatal and neonatal period is evident. This innovative and unique text provides experienced nurses and student nurses alike with realistic guidance in caring for babies with palliative care needs, alongside the crucial support for their families and identifies important strategies for professional self care. Nursing experts in this field collaborated to develop a reference book which supports holistic and integrated clinical practice. Parents' experiences of what they consider helpful or not so helpful are interwoven throughout the chapter. There is currently no other textbook which offers the above information and guidance specifically for nurses and allied health professionals. As such this book will appeal to all nurses and health professionals working within the neonatal palliative care specialty in a global context.

This manual enables individuals working in children's palliative care (CPC) globally to learn through engaging real-world cases. The aim is to provide a clinical case-based resource that is globally relevant and accessible to those working in CPC. Drawing on case histories from around the world that reflect key issues and elements of CPC, it provides a practical approach grounded in experience. It addresses multidisciplinary care in the management of children and their families; discusses cases from an international perspective, and shares examples from a variety of countries, utilising cases across a range of ages and conditions, demonstrating holistic care. It represents the first case-based manual on global CPC and is endorsed and promoted by the International Children's Palliative Care Network (ICPCN). Children's palliative care is a rapidly developing field, both in the UK and internationally. The provision of CPC varies considerably, with provision often being insufficient, and over 65% of countries having no recognised CPC service provision whatsoever. As such, while there are an estimated 21.6 million children who require palliative care, in many areas of the world, CPC is poor or non-existent, and children are treated like little adults without their distinctive needs being recognised or understood. There is also a dearth of literature on CPC, hence this clinical case-based manual fills a gap in the market, and is aimed at a global audience, making it a unique text in the field.

This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults.

This book discusses medicine from an ethical perspective, whereas books on medical ethics more commonly present ethics from a bio-medical standpoint. The book is divided into 23 chapters. The introductory chapters present some basic concepts of medical ethics, such as the relation between the legal system and ethics, ethical documents, ethical theories, and ethical analysis. The following chapters address issues of importance in all fields of medicine: respecting autonomy, communication, relations within a healthcare team, professional malpractice, limited resources, and the portrait of a physician. In turn, the third part of the book focuses on ethical aspects in a broad range of medical activities - preventive medicine, human reproduction, genetics, pediatrics, intensive care, palliative medicine, clinical research, unproven methods in diagnostics and treatment, and the role of physicians who aren't directly responsible for patient care. The last part presents students' seminars with case stories. The book offers a valuable resource for physicians of all specialties, students of medicine, professionals, and students from other fields devoted to human health, journalists, and general readers with an interest in medicine.

The Clinical Pocket Guide to Advanced Practice Palliative Nursing is a companion guide to Advanced Practice Palliative Nursing, the first text devoted to advanced practice nursing care of the seriously ill and dying. Each chapter of this pocket guide presents point-of-care guidance on palliative care issues for quick reference in daily practice. Edited by leaders in the field, this handbook provides consistency in the nursing process from assessment to management and evaluation of symptoms and various clinical situations. The Clinical Pocket Guide to Advanced Practice Palliative Nursing contains clinical pearls developed from the textbook and practical tools on pain and symptom assessment, functional status, and communication, making it an ideal resource for practicing APNs.