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 book addresses the problems faced by people and hospitals dedicated to providing optimal end-of-life care and asks whether ethicists can function as experts on this subject. Though ethics consultation is a growing practice in medical contexts, difficult questions surrounding the role of ethicists in professional decision-making remain. The chapters in this book examine the nature and plausibility of moral expertise, the relationship between character and expertise, the nature and limits of moral authority, the question of how one might become a moral expert, and the trustworthiness of moral testimony. This volume not only engages with the growing literature in the debate on end-of-life care but also offers new perspectives from both academics and practitioners. Such perspectives include ways on how to get together to optimize end-of-life care. This book is of particular interest to bioethicists, clinicians, ethics committees, students of social epistemology, patient groups, and institutions, especially religious, who may not be sufficiently imparting the social teachings of end-of-life care. It also shows how they are indeed stakeholders for what is today called 'a good death'. These new essays advance discussions and provide practical information on dying as well as acting as a guide to those interested in actively effecting change.

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 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.

This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients' values has been recognized as the essential moral component of clinical decision-making. Technology's promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book comprises six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as a way to address the psychosocial and ethical problems of death and dying.

The quality of cancer and palliative care is going through unprecedented change and development as a result of policy initiatives. The impact of these policies on education is unparalleled and it is essential that clinicians and educationalists are aware of the policy formation processes and educational strategies that meet the demands of these changing times. This book takes a holistic approach to patient care and draws on the diverse experience in hospices and highlights best practice to present a comprehensive and practical guide. However, it does more. New topics are given an educational perspective; those with limited educational experience are given sound advice; the implication of policy change is outlined. This is an important book and one which should be read by all clinicians, educators and managers responsible for improving services in cancer and palliative care.

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

Clinical medicine, as a thinking discipline, is concerned not only with what clinicians do, but why. When physicians act in medicine they have some purpose or goal in mind. What they actually do and how they go about it is in the service of their purposes and their goals. Such goals cover a wide range of topics centering on patients, the doctor-patient relationship, the acts of doctoring patients, and the goals involved in being a physician among other physicians working within the institutions of medicine. The Nature of Clinical Medicine takes its direction from a catalog of goals of medicine that range from the expected diagnosis and treatment of diseases to wider concerns for patients, for physicians, and for medicine itself. The chapters are specific in teaching the kinds of knowledge that clinicians require in order to be able to achieve these goals. The central focus of the clinician and of this book is the patient. According to Eric Cassell, everything else, including the disease, is secondary. Using many examples from real-life medical practice, each chapter examines the different kinds of thought involved in caring for the patient. Cassell takes on a variety of difficult issues, from thinking about values to developing wisdom. The care of the dying, what thinking itself is, and finally, why would one want to do this exciting and rewarding but difficult work, come under discussion in this book.

As we live longer and die slower and differently than our ancestors, we have come to rely more and more on end-of-life caregivers. These workers navigate a changing landscape of old age and death that many of us have little preparation to encounter. "How We Die Now" is an absorbing and sensitive investigation of end-of-life issues from the perspectives of patients, relatives, medical professionals, and support staff.aKarla Erickson immersed herself in the daily life of workers and elders in a Midwestern community for over two years to explore important questions around the theme of OC how we die now.OCO She moves readers through and beyond the many fears that attend the social condition of old age and reveals the pleasures of living longer and the costs of slower, sometimes senseless ways of dying.aFor all of us who are grappling with the OC elder boom, OCO "How We Die Now" offers new ways of thinking about our longer lives."

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

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.

Advances in medical science and technology are saving the lives of more children worldwide than ever. Some survive and live out a normal life expectancy, others have a life-limiting/life-threatening diagnosis where death may come early, and still others will live on well past projected life trajectories into adulthood. With so many different care pathways, children, parents and communities often find themselves facing challenges for which neither they nor their healthcare systems are prepared. This book opens a global discussion of these issues. Extending Rita Pfund's text Palliative Care Nursing of Children and Young People, it invites paediatric palliative care professionals, parents and children from around the globe to share their knowledge and experience. This book is of vital interest to palliative care professionals, parents, policy makers and academics. It is an important move towards ensuring that all children and their families, regardless of geographical location, gender, ethnicity or socio-economic class have equal and guaranteed access to comprehensive paediatric palliative care services.

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.

In Tuberculosis Then and Now leading scholars and new researchers in the field reflect on the changing medical, social, and cultural understanding of the disease and engage in a wider debate about the role of narrative in the social history of medicine and how it informs current debates and issues surrounding the treatment of tuberculosis and other infectious diseases. Through a case study of the history of tuberculosis and its treatment, this collection examines medicine and health care from the perspectives of class, race, and gender, providing a challenging and refreshing addition to the field of bacteria-centred accounts of the history of medicine.
Contributors include Peter Atkins (University of Durham), David Barnes (University of Pennsylvania), Alison Bashford (Harvard and University of Sidney), Tim Boon (Science Museum, London), Linda Bryder (University of Auckland), Flurin Condrau (University of Manchester), Jorge Molero-Messa (Universitat Autonoma de Barcelona), Helen Valier (University of Houston), John Welshman (University of Lancaster), and Michael Worboys (University of Manchester).

Supportive Care for the Renal Patient Second Edition provides a comprehensive, evidence-based overview of supportive care for the nephrology patient. An international group of contributors emphasise the continuum of palliative care from the time of diagnosis through to end-of-life care and the issues surrounding withdrawal of dialysis. The book addresses the psychological impact of the disease, the importance of involving the patient in making decisions about their care, ethical considerations, the role of the family and the multidisciplinary team. This new edition includes two new chapters on conservative management of advanced kidney disease (AKD) and dialysis in the very elderly. The chapters covering non pain symptoms, advance care planning, quality of life, psychological and psychiatric consideration and end-of-life care have also be completely revised to include new evidence and current thinking. This book will be of particular interest to palliative care practitioners; nephrologists, who increasingly need to know more about palliative care; nurse practitioners, dialysis nurses, social workers, dieticians, and psychiatric consultants. ABOUT THE SUPPORTIVE CARE SERIES Supportive care is the multidisciplinary holistic care of patients with chronic and life-limiting illnesses and their families - from the time around diagnosis, through treatments aimed at cure or prolonging life, and into the phase currently acknowledged as palliative care. It involves recognising and caring for the side-effects of active therapies as well as patients' symptoms, co-morbidities, psychological, social and spiritual concerns. It also values the role of family carers and helps them in supporting the patient, as well as attending to their own special needs. Unlike traditional palliative care, which grew from the terminal care of cancer patients, supportive care is not restricted to dying patients nor to cancer. This series covers the support of patients with a variety of long-term conditions, who are currently largely managed by specialist medical teams in hospital and by primary care teams in community settings. Each volume therefore provides a practical guide to the supportive care of patients at all stages of illness. Series Editor: Sam H. Ahmedzai

Sportive care can be thought of as an extension of palliative care so that the person with dementia receives good quality, holistic care that makes no distinctions between the dichotomies of care and cure from the time of diagnosis until, and beyond, death. It recognizes the need for an inter-disciplinary approach for continuity of care. Supportive care in dementia must, therefore, be broad in its scope and application.
Supportive Care of the Person with Dementia provides just such a broad and full perspective, drawing upon the experience and expertise of a wide range of internationally-based professionals to outline a model of supportive care that will provide good quality and holistic care for people with dementia. Making use of real-life reports from both patients and carers to help readers fully understand the reality of dementia, the book examines the key principles that guide the practice of supportive care. It looks at how supportive care can be used, and specific benefits a care model of this type can bring to the complex problems that are frequently encountered when treating this condition.
It is an ideal resource for all clinicians who are part of an interdisciplinary team caring for sufferers with this debilitating illness.

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.

This work includes Foreword by Nigel Sykes, Medical Director, St Christopher's Hospice, London. This practical, evidence-based guide has been specifically designed for teachers in cancer and palliative care. It is completely up-to-date and covers the recent complex changes in cancer and palliative care delivery, offering a range of different, creative approaches. Ideal for training, the text includes highlighted key points, self help questions for reflection, and references where applicable. It provides invaluable guidance for all healthcare professionals with palliative care teaching responsibilities, including undergraduate and postgraduate healthcare educators and Macmillan lecturers. '[This] book gives us a three-dimensional view of how to respond to the demands on cancer and palliative care education today, set particularly in a British context but, of course, capable of extrapolation to other settings. These three dimensions of innovation can be summarised as: What do you teach? How do you teach it? To whom do you teach it? Innovation in all three aspects simultaneously may be difficult to achieve, but all who have a responsibility for education are faced with the challenges of making their teaching more effective (and demonstrating that they have done so), keeping abreast of advancing knowledge and clinical practice, and of reaching out to groups of learners who hitherto have been neglected. Of significant help to anyone in this field whose concern is the delivery of effective and appropriate education.' - Nigel Sykes, in the Foreword.

This book offers an extensive range of ideas and practical developing service users' creativity including songmaking, drama, dance, creative writing, music, video and visual arts. It promotes innovation and encourages a fresh and enthusiastic approach to care that will appeal to anyone with a love of creative arts as a means of expression. The wide-ranging approach encompasses many different voices from patients, artists and healthcare professionals. "Creative Engagement in Palliative Care" is highly recommended for all palliative health and social care professionals and volunteers, including occupational therapists, and art and music therapists. It is a wonderful resource for health and social care educators, teachers and trainers and will be a immense source of inspiration for patients and their families.'This book is about user involvement. It is concerned with sharing knowledge and experience about user involvement in palliative care and making it more real for the future. In modern times, the importance of 'end of life care' was highlighted by the pioneers of the voluntary hospice movement. They emphasised the importance of palliative care being based on an holistic approach that took account of all aspects of people's lives and deaths; medical, social, spiritual and material. More recently the work of the independent hospice movement has been complemented by the development and expansion of specialist palliative care in state provision. The aim has been to enable people to be able to 'do it their way' with a real sense of control and to be able to communicate their unique words, voices and experience. This is and will always be a key potential of user involvement.' - Suzy Croft and Peter Beresford, in the Preface.

`There is much to learn about easing suffering from John's reflective narrative. The journal is both evocative and illuminating. The attention given to individuals patients experiences and to the manner in which practitioners can help to relieve suffering is the main strength of the book' -Journal of Advanced Nursing `Christopher Johns has written an exquisite book detailing the experience of being a palliative care nurse. He has taken a unique approach in chronicling his practice through a journal, which serves a model for the reader on reflective practice. Johns' book is insightful on several levels. He offers a poignant book about the practice of palliative care, which will certainly evoke deep feelings and memories for many who have cared for dying patients. The narrative serves a model for reflective practice for students and practitioners alike who wish to explore this method of research and self-inquiry. John also, as the postscript writer describe, addresses some of the lessons that can be learned in palliative care work, the importance of living in the moment, and acknowledgement of the constantly changing nature of life.' - Mary L. Wilby, MSN, CRNP, La Salle University School of Nursing `Chris Johns has produced a book that is, I believe, unique in the field of nursing practice. In his personal and philosophical reflections on palliative care he pin-points...the very essence of nursing practice... This text should be at the heart not only of nursing but also the way in which we should live our lives.' - Denise Rankin-Box, Editor in Chief, Complementary Therapies in Nursing and Midwifery Written by an experienced palliative care nurse, trainer, and complementary therapist, Being Mindful, Easing Suffering is an essential resource for professionals working with the seriously ill and the dying. Chris Johns describes how he has combined traditional medical, and more reflective models in his palliative practice, enabling him to work mindfully to alleviate physical and non-physical pain and suffering throughout the health-illness cycle. With reference to ideas from Buddhist philosophy around compassion and reflective knowing, this important book shows how the core task of those working in palliative care is to nurture the spiritual growth and development of their patients and, in turn, themselves.

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.