Many cancer patients are seen in outpatient clinics, general medical wards and general and specialist surgical wards as well as oncology units. There patients can have varied palliative care needs and it is the responsibility of those nursing them to be aware of these needs and how to respond to them. This informative and practical text starts with the premise that care delivery with a palliative approach is a core skill that every health professional, in whatever setting, should possess if dealing with patients who have an incurable disease. The palliative approach has as the main priority the promotion of physical, psychological and spiritual well--being of the patient and their family. By focusing on quality of life, best possible symptom control and quality death in a holistic manner, the nursing management of patients is enhanced.

Palliative care affirms the value of holistic support for persons facing death from advanced disease. Increasingly the approach of palliative care is seen as relevant not only to terminal cancer (its initial concern), but also to many other incurable conditions. To date, the major emphasis of specialist neurology has been on diagnosis, and the continuing long term management of the many major diseases has received far less attention. This handbook aims to provide succinct and practical advice on the management of major neurological disorders in both their supportive and terminal phases, recognizing that these conditions are increasing in prevalence in virtually every society as the proportion of elderly persons grows. It demonstrates how the discomforts encountered in dementia, stroke, Parkinson's disease, ALS, Huntington's disease, muscular dystrophies, and multiple sclerosis can benefit from the same comprehensive approach to palliation as has evolved in specialist care for cancer.

The first volume in the "What Do I Do Now?: Palliative Care" series, Pediatric Palliative Care uses a case-based palliative care approach to cover common and important topics in the examination, investigation, and management of children with serious illness. Each chapter provides a discussion of the diagnosis, key points to remember, and selected references for further reading. The book addresses a wide range of topics, including the goals of care, symptom management, care for neonatal and adolescent populations, and the emotional, social, cultural and spiritual needs of ill children and their families. Written by authors from a variety of fields such as nursing, chaplaincy, social work, and psychology, this book is suited for pediatricians, palliative care and hospice providers, nurses, and allied health practitioners. Pediatric Palliative Care is an engaging collection of thought-provoking cases which clinicians can utilize when they encounter difficult patients. The volume is also a self-assessment tool that tests the reader's ability to answer the question, "What do I do now?"

Portrait therapy reverses the traditional roles in art therapy, utilising Edith Kramer's concept of the art therapist's 'third hand' to collaboratively design and paint their clients' portraits. It addresses 'disrupted' self-identity, which is common in serious illness and characterised by statements like 'I don't know who I am anymore' and 'I'm not the person I used to be'. This book explores the theory and practice of portrait therapy, including Kenneth Wright's theory of 'mirroring and attunement'. Case studies, accompanied by colour portraits, collages and prose-poems, provide insight into the intervention and the author highlights the potential for portrait therapy to be used with other client groups in the future.

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

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

The many unfounded myths and fears that surround working with people at the end of their lives are dispelled in this thoughtful book, and the authors provide both practical and emotional support for those involved in caring for dying patients. The book covers everything from the philosophy behind the practice to the diverse roles in the multi-disciplinary team, as well as current challenges and opportunities facing end of life care, with an emphasis on how therapy and arts therapies can be integrated effectively. It also looks at palliative care models that address all aspects of a patient's wellbeing and conveys the latest research and challenges in the field, bridging the gap between theory and the realities of working with patients on a daily basis. Using material from artists and therapists working in the field, the varying demands of inpatient, outpatient and home care are described, as well as the processes of bereavement, how to handle the practicalities of loss and the help that therapists can give at this stage. How artists and therapists with experience of working at the end of life can be involved in other areas of care such as supporting older people in care homes and those living with dementia is also discussed. The book also introduces the important area of health promotion, and how there is a growing responsibility to change people's attitudes towards death, dying and bereavement. Clear, practical examples are given as to how this might be achieved. Full of professional advice and career guidance, this book will be an invaluable tool for those working with patients nearing the end of life and those considering working in this area, as well as students in training.

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

Provides comprehensive, current information for addressing the physical, psychological, and spiritual needs of hospice patients and their families Substantially updated and expanded, the second edition of this quick-access reference for hospice nurses continues to deliver the most current information on the clinical and administrative duties of the hospice nurse. It encompasses important regulatory changes and milestones, providing timely information on cultural issues, special communication considerations, and hospice care's enduring growth. This resource provides new content on levels of care, assessment and symptom management, and occupational stress, burnout, and self-care. New treatment guidelines and algorithms are included, as are updates on quality measures, the reimbursement schedule, compliance initiatives, and electronic documentation with specific examples. An indispensable clinical resource, the book is a valuable reference for nurses who are seeking to specialize in hospice, those who work in long-term care settings, post-acute care settings, acute care setting, and those who are seeking to enhance their knowledge of end-of-life care within other specialties. New to the Second Edition: Includes new regulatory changes/milestones, such as The National Quality Forum New Priorities for Action 2019 Provides updated information about levels of care, particularly the Last 7 Days rule from Medicare Covers the use of cannabis, non-pharmacological pain management interventions, care of the dying patient, and post-mortem care New chapters are included on the hospice nurse's role as case manager, patient discharge, religious and cultural influences on end-of-life care, pain assessment and interventions, wound care, care of the dying patient, and post-mortem care. Key Features: Reflects key competencies for the hospice nurse as designated by the Hospice and Palliative Nurses Association Delineates clinical and administrative responsibilities of the hospice nurse Simplifies complex information such as Medicare regulations and compliance Provides screening tools for depression, anxiety, and wound risk Includes the Palliative Performance Scale and the Karnofsky Performance Scale Serves as a concise study resource for certification

Illuminating the Diversity of Cancer and Palliative Care Education examines a myriad of original approaches, techniques, methods, educational strategies and imaginative innovations within this vital field of medicine. Its contributors share a range of educational techniques and tactics from Neuro-Linguistic Programming to creative teaching strategies for bereavement support, allowing readers to reflect on best practice and inventive ways of working which can be used or adapted to suit. This book is an ideal companion to its sister volumes Innovations in Cancer and Palliative Care Education and Delivering Cancer and Palliative Care Education.

The incidence of cancer is alarmingly increasing worldwide. The major problem that the medical profession is currently facing refers to "late presentation" patients who, for the most part, have reached the terminal stage of the illness. For these people, the only treatment option left is palliative care. Various patterns of palliation have been in practice in every culture and in every ethnic group for generations. Unfortunately, we still lack significant and sustained investment in research related to the practice of palliative care. Authors from around the globe seek more investment of public and private funds to investigate ways to improve the bedside practice of palliative care. Modern palliative care concepts were established by Dame Cicely Saunders, from London, UK, right after World War II. It is only in the past 15 to 20 years that this new discipline started to develop in the developing world. However, we still lack the essential basic biological processes involved in relieving the suffering of cancer patients while receiving palliative measures throughout the trajectory of the disease. This book owes its origins in large measure to physicians and nurses in 30 countries globally, who decided to devote their time, energy, compassion and goodwill, to the promotion of palliative care in their countries and communities, yet they lack solid evidence-based data to rely upon while extending their treatment to both patients and family members. The goal, in part, is to bridge the gap between scientists and clinicians from developed countries and those in developing countries. We have been aware of the variances between cultures, traditions, beliefs and practices. I am continually struck by the seemingly diametrical views of "knowing" and cultures and the strong overlaps that might give rise to new ideas. We hope that these new volumes will serve to inspire health professionals' and administrators' interests and appreciation for the investment in basic and clinical research that will serve to advance our understanding of the underlying physical and emotional factors involved while extending palliative care to patients suffering from cancer and other non-communicable illnesses.

This thought provoking and highly practical book is not just about caring for the dying within mental health, but also applying the quality care and practice of palliative care within mental health practice. Multidisciplinary in its approach, it focuses on intervention, treatment, care and practice, and the similarities in practice between palliative care and mental health. This common ground is an excellent foundation for integrating palliative care into mental health care, practice and service delivery, succinctly covering all aspects of psychological, physical, social, spiritual, sexual and emotional health. Featuring authoritative contributions from international experts, each chapter develops a theoretical framework before broadening its scope to include application in practice - addressing what, when, where and why with a definite focus on implementation in practice. Self-assessment exercises, advice for further reading, ideas for reflective practice and summaries of key points are also included, aiming above all else to improve the relationships, responses, care and practice necessary to be effective in interventions and treatment with those experiencing mental health concerns and dilemmas. Ideal for all health, social, psychological, legal and spiritual care students and professionals wanting sound theoretical and practical guidance, this book is highly recommended for General Practitioners and General Practice Registrars, healthcare assistants studying NVQ and health visitors. Educationalists, managers and service developers in health and social care will also appreciate its solution-focused, practical approach.

Death is the destiny we all share. This will not change. But the way we die, which had been the same for many generations, has changed drastically in a relatively short time for those in developed countries with access to healthcare. For generations, if people were lucky enough to reach old age, not having died in infancy or childhood, in childbirth, in war, or by accident, they would take to bed, surrounded by loved ones who cared for them, and fade into death. Most likely, they would have seen their parents and grandparents die the same way, so this manner of dying would be familiar. It was part of the natural cycle of life. Now less than 25 per cent of Americans die at home, at much older ages than people would have dreamed of in past generations, often after surviving many illnesses and even diseases that would have been terminal for their grandparents. We are fortunate to live (and die) today, supported by myriad scientific, medical, and technological advancements. But we also face new problems as a result of the new way that we die. We cannot look forward to a peaceful waning when we know our lives will likely end in hospitals, having endured very expensive care, rather than at home with family. We have to decide what decisions we want our loved ones, or care-givers, to make when we cannot choose for ourselves. We have to think about whether in any circumstances we would seek physician-assisted death. We know we face other questions as well, but we may not even know where to start. In the face of these decisions, we can feel daunted and afraid. The best remedy is information and planning. In this book, Gregory Eastwood - a physician who has cared for dying patients, served as an ethics consultant, and taught end of life issues to medical and other health profession students - draws from his substantial experience with patients and families to provide the information that will help us think clearly about the choices and issues we will face at the end of our lives, and the end of our loved ones'. With sensitivity and profound insight, Eastwood guides us through all the important questions about death and dying in straightforward, clear language and through real-life stories. Throughout, he shows us how we can take ownership of the way we want to die, when we must die, and feel more in control as death approaches.

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

All physicians are involved in the management of pain at some level or the other, but of the various specialties and health professions, orthopedic surgeons are at the frontline of delivering perioperative pain care for a wide variety of problems that range from skeletal trauma, joint replacement procedures, bone tumors and spinal conditions. Perioperative Pain Management for Orthopedic and Spine Surgery offers a concise yet comprehensive overview of the surgical spine pain management field to help practitioners effectively plan and enhance perioperative pain control. Chapters provide guidance on solving common dilemmas facing surgeons who are managing patients with pain related problems and clinical decision-making, and explore essential topics required for the trainee and practitioner to quickly assess the patient with pain, to diagnose pain and painful conditions, determine the feasibility and safety of surgical procedure needed, and arrange for advanced pain management consults and care if needed. This text also explores the latest evolving techniques and appropriate utilization of modern equipment and technology to safely provide care. Highly accessible and written by experts in the field, Perioperative Pain Management for Orthopedic and Spine Surgery is an ideal resource for practicing orthopedic and spine surgeons, anesthesiologists, critical care personnel, residents, medical students.

Therese Vanier, founder of L'Arche in the UK, was also a distinguished doctor who worked with Cecily Saunders at the world-renowned St Christopher's Hospice in London, and a tireless contributor to Christian ecumenism and interfaith understanding. This biography draws on the memories of nearly fifty people who knew her, as well as her own published and unpublished writings, to offer a tribute to Therese and a critical assessment of her lasting legacy in the three areas of her work. Includes photo section.

Palliative care has become increasingly important across the spectrum of healthcare, and with it, the need for education and training of a broad range of medical practitioners not previously associated with this field of care. Part of the Integrating Palliative Care series, this volume on surgical palliative care guides readers through the core palliative skills and knowledge needed to deliver high value care for patients with life-limiting, critical, and terminal illness under surgical care. Chapters explore the historical, philosophical, and spiritual principles of surgical palliative care, and follow the progression of the seriously ill surgical patient's journey from the pre-operative encounter, to the invasive procedure, to the post-operative setting, and on to survivorship. An overview of the future of surgical palliative care education and research rounds out the text. Surgical Palliative Care is an ideal resource for surgeons, surgical nurses, intensivists, and other practitioners who wish to learn more about integrating palliative care into the surgical field.

The incidence of cancer is alarmingly increasing worldwide. The major problem that the medical profession is currently facing refers to "late presentation" patients who, for the most part, have reached the terminal stage of the illness. For these people, the only treatment option left is palliative care. Various patterns of palliation have been in practice in every culture and in every ethnic group for generations. Unfortunately, we still lack significant and sustained investment in research related to the practice of palliative care. Authors from around the globe seek more investment of public and private funds to investigate ways to improve the bedside practice of palliative care. Modern palliative care concepts were established by Dame Cicely Saunders, from London, UK, right after World War II. It is only in the past 15 to 20 years that this new discipline started to develop in the developing world. However, we still lack the essential basic biological processes involved in relieving the suffering of cancer patients while receiving palliative measures throughout the trajectory of the disease. This book owes its origins in large measure to physicians and nurses in 30 countries globally, who decided to devote their time, energy, compassion and goodwill, to the promotion of palliative care in their countries and communities, yet they lack solid evidence-based data to rely upon while extending their treatment to both patients and family members. The goal, in part, is to bridge the gap between scientists and clinicians from developed countries and those in developing countries. We have been aware of the variances between cultures, traditions, beliefs and practices. I am continually struck by the seemingly diametrical views of "knowing" and cultures and the strong overlaps that might give rise to new ideas. We hope that these new volumes will serve to inspire health professionals' and administrators' interests and appreciation for the investment in basic and clinical research that will serve to advance our understanding of the underlying physical and emotional factors involved while extending palliative care to patients suffering from cancer and other non-communicable illnesses.

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

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.