Around one in three people in the western world will develop cancer at some stage in life and complementary therapies are increasingly being used alongside orthodox treatments as part of the 'integrative' approach to cancer care. Enhancing Cancer Care is a practical, evidence-based guide to complementary cancer therapies, also described as natural or holistic therapies. More and more patients are turning to these therapies as there is now considerable evidence that they can help with symptom-control and quality-of-life, and that some may also extend survival. Complementary therapies can also provide the patient with a greater sense of control regarding the management of their illness. From the editor of Integrated Cancer Care, this new title provides detailed commentary on a broad range of complementary therapies and features practical advice on how to implement therapies to enhance current practice. The first part of the book deals with the general principles behind complementary therapies and the factors driving their growing popularity, the challenges of evaluating their benefits and unwanted effects, and experience of using them in oncology units, hospices, the private sector and primary care. The second part includes chapters on specific interventions, including complementary therapies such as acupuncture and aromatherapy massage; lifestyle modifications through diet and exercise; creative therapies using art and music; and psychological and spiritual support for individuals and groups. These chapters provide descriptions of the therapies, a summary of the evidence for their benefits in cancer care, and illustrative case histories. The emphasis throughout this book is on enhancing practice; that is, using the therapies alongside conventional medicine, rather than as alternatives to it.

Caring for terminally ill patients and their families is challenging. Patients with life limiting illness require the skills of many professionals but also the support of their community. While most clinicians are comfortable in assessing a broad range of physical problems, it is often the psychosocial issues that prove the most complex. These issues range from psychosocial assessment to the treatment and care of patients with life limiting illnesses. Evaluating emotional, social and spiritual needs, in particular, requires excellent teamwork. This fully-updated and expanded new edition takes a comprehensive look at current practice and provision of psychosocial support as applied to a range of palliative care patients. A number of important areas are covered including community approaches of psychosocial care, neonatal palliative care, the provision of psychosocial care to families, the role of volunteers in supporting palliative care professionals, and the needs of the frail elderly, marginalised patients, and those with dementia. Including multiple case study examples, this highly practical text examines current literature and evidence to demonstrate the best research-based practice in psychosocial care. It is an essential resource for professionals working within hospitals and communities in the fields of medicine, nursing, social work, chaplaincy, counselling, primary care, and mental health.

This book provides a practical, evidence-based overview of the supportive care of patients with urological failure, covering issues such as quality of life measurements, the role of the multidisciplinary team, and psychological and social support for patients, families and carers. The book focuses on chronic symptoms such as chronic prostatitis. It begins by looking at quality of life measurements, self-help strategies, the role of the interdisciplinary team, and psychological and social support. It then moves on to clinical chapters which cover issues such as patients who present with hematuria, urinary retention, urinary incontinence, neurological disease affecting the urinary tract, chronic prostatitis, and infertility; ending with a chapter on supportive care for the urology patient and family in the future. The book places a special emphasis on symptomatic interventions, particularly in the setting where the course of the illness cannot be modified.

Cicely Saunders is universally acclaimed as a pioneer of modern hospice care. Trained initially in nursing and social work, she qualified in medicine in 1958 and subsequently dedicated the whole of her professional life to improving the care of the dying and bereaved people. Founding St Christopher's Hospice in London in 1967, she encouraged a radical new approach to end of life care combining attention to physical, social, emotional and spiritual problems, brilliantly captured in her concept of 'total pain'. Her ideas about clinical care, education and research have been hugely influential, leading to numerous prizes and awards in recognition of her humanitarian achievements. In this book the sociologist and historian David Clark presents a selection of her vast correspondence, together with his own commentary. The letters of Cicely Saunders tell a remarkable story of vision, determination and creativity. They should be read by anyone interested in how we die in the modern world.

Lesions of the oral cavity have an enormous impact on the quality of life of patients with advanced disease. They cause considerable morbidity and diminish a patient's physical and psychological well-being. Oral complications impair oral nutrition and can cause a variety of problems including malnutrition, anorexia, and cachexia. Psychological problems relate to the role that the oral cavity plays in communication and social life. This book provides comprehensive, clinically relevant, evidence-based guidelines on oral problems to ensure first rate care. The scientific foundations and research base for their management underpin the discussion throughout.
A multi-disciplinary group of contributors provide authoritative guidelines on clinical features, investigations, and pharmacological and non-pharmacological treatment, as well as complementary therapies. Chapters cover oral assessment, hygiene, domiciliary dental care, infections, taste disturbance, pain, HIV infection and AIDS, neurological diseases, and paediatric problems. Highly illustrated throughout, the book also includes an extensive colour plate section.
This book should appeal to all members of the multi-disciplinary team working in palliative care, care of the dying and care of the elderly including hospice dentists and speech therapists working with chronically ill patients.

Listening carefully to patients at the end of life is at the heart of good palliative care and this book provides a means of recognizing and talking about spiritual needs even when religious language is not used. The author refers to this as a 'language of spirit'. The book is based on interviews with patients who are dying and the language that they use to describe their experiences. It deals with death, dying, the experiences of patients and the relief of spiritual pain by looking closely at patient stories, drawings and behaviour. The book explains why it is often easier to recognize than to explain spiritual issues. Part One explores the psychological, spiritual and theological interpretations of human experience. A detailed account is given of how the patients' own stories were collected. Drawing on a broad literature which is grounded in patients' words and deeds, Part Two introduces a non-religious 'language of spirit'. Illuminated by patient art, Part Three shows what patients use this language to 'say' about their situation and how it is mediated through various metaphors. Part Four suggests ways of responding positively to patients' spiritual needs. Aimed primarily at palliative care specialists and specialist nurses, this book will also appeal to health care chaplains, pastoral support workers, theologians, social researchers, and psychotherapists. 'The numerous illustrations, given by patients comments as they tell their story, make this book a truly fascinating journey through an important area of end of life care.' Dame Cicely Saunders, OM, DBE, FRCP, Founder/President, St Christopher's Hospice, London 'The emphasis on allowing patients to speak for themselves is striking... the author has presented the topic in a sensitive and refreshing way... I think this book will be well-received and it will be an important contribution to the literature of palliative care.' Dr Odette Spruyt, Head of Pain and Palliative Care Department, Peter MacCallum Cancer Institute, East Melbourne, Australia

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.

Gastrointestinal symptoms such as anorexia-cachexia, chronic nausea, vomiting and bowel obstruction are highly distressing for patients with advanced cancer. Approximately one in three adults will be diagnosed with cancer in their lives and approximately fifty per cent of them will die because of malignancy. More than eighty per cent of patients who die of cancer will present severe gastrointestinal symptoms before death.

This book presents detailed, evidence-based information on each of the gastrointestinal symptoms for a multi-disciplinary audience. Comprehensive guidelines have been included on how to assess the patient, in order to ensure effective treatment, in which prescribing is tailored to the cause of the symptoms and to the patient's individual needs. The book recognises that the aim of good cancer management and palliative care is to assess, diagnose, manage and treat these symptoms to ensure best quality of life.

Aimed primarily at hospice and palliative care specialists, medical, radiation and surgical oncologists and selected family physicians and internists who have an interest in cancer care. The book will also appeal to oncology and academic nurses, nutritionists as well as clinical psychologists with an interest in oncology and/or palliative care.

ALSO PUBLISHED BY OXFORD UNIVERSITY PRESS

Cancer Pain Management - a comprehensive approach Edited by Karen H Simpson & Keith Budd

Integrated Cancer Care - holistic, complementary and creative approaches Edited by Jennifer Barraclough

The Syringe Driver: continuous subcutaneous infusions in palliative care Andrew Dickman, Clare Littlewood & Jim Varga

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

Spiritual, Religious, and Cultural Aspects of Care is the fifth volume in the HPNA Palliative Nursing Manuals series. Chapters address how to conduct a spiritual assessment of patients and families, spiritual interventions including compassionate presence, listening deeply, bearing witness, and being compassionate, how to partner with the patient and family to ensure culture guides the plan of care, how to find meaning in illness, the many dimensions of hope and its influence on the dying process. 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.

Fixing You: Neck Pain & Headaches is an easy-to-use self-help guidebook to fixing just about every type of neck pain. This is because, no matter what the diagnosis, painful issues of the neck have the same root causes; that of poor neck function and poor shoulder function. These root problems can be easily corrected through the exercises found in this book. Visit www.FixingYou.net for more information. Rick Olderman MSPT, CPT and Pilates instructor is a physical therapist with over a decade of experience working with difficult chronic and acute injuries. Rick's typical clients are those who have been to a variety of specialists and health care practitioners with little or no change in their pain. Often these clients feel significant if not complete relief in 1-3 sessions after using the Fixing You approach. How does Rick do this? Through assessing and correcting improper biomechanics at the root of all neck pain. Rick reveals his secrets in Fixing You: Neck Pain & Headaches to guide you in assessing your injuries through simple tests and then give you specific exercises correcting the biomechanics leading to your pain. Readers will also have FREE access to video clips of all assessments and exercises found in Fixing You: Neck Pain & Headaches. This ensures that you are both assessing and correcting your injuries properly. No other book has ever done so much to help you beat your pain.

Spiritual sickness troubles American medicine. Through a death-denying culture, medicine has gained enormous power-an influence it maintains by distancing itself from religion, which too often reminds us of our mortality. As a result of this separation of medicine and religion, patients facing serious illness infrequently receive adequate spiritual care, despite the large body of empirical data demonstrating its importance to patient decision-making, quality of life, and medical utilization. This secular-sacred divide also unleashes depersonalizing, social forces through the market, technology, and legal-bureaucratic powers that reduce clinicians to tiny cogs in an unstoppable machine. Hostility to Hospitality is one of the first books of its kind to explore these hostilities threatening medicine and offer a path forward for the partnership of modern medicine and spirituality. Drawing from interdisciplinary scholarship including empirical studies, interviews, history and sociology, theology, and public policy, the authors argue for structural pluralism as the key to changing hostility to hospitality.

Modern medical technology has changed not only the way we live but also the way we die. Until two generations ago, people usually died suddenly, after an accident or serious illness. Now, most of us will live with chronic conditions, and our dying will usually take longer, require more care, and demand more planning than ever before. Handbook for Mortals is warmly addressed to all those who wish to approach the final years of life with greater awareness of what to expect and greater confidence about how to make the end of their lives a time of growth, comfort, and meaningful reflection. Written by Dr. Joanne Lynn and a team of experts, this book provides equal measures of practical information and wise counsel. Readers will learn what decisions they will need to face, what choices are available to them, where to look for help, how to ease pain and other symptoms, what to expect with specific diseases, how the health-care system operates, and how the entire experience affects dying persons, their families, and their friends. Such practical information is indispensable. But equally important are the personal stories included here of how people have come to terms with serious illness and dying, how they have faced their fears and made their choices. These give us moving firsthand insights into a profoundly important process, one that is often kept hidden in our culture. From down-to-earth advice on how to talk to your doctor to inspiring quotes from such writers as Emily Dickinson, W. H. Auden, Jane Kenyon, and others, Handbook for Mortals addresses the needs of both the body and the spirit in our final years.

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives.

Praise for the first edition

"Well written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA.

"Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine.

While palliative care has adopted a holistic approach to treatment, medication driven symptom management ostensibly forms the critical aspect of care. Prescribing in palliative care can be extremely complex because the patient may often have comorbidity, or occasionally multimorbidity. The associated polypharmacy further complicates the pharmacological management of symptoms being caused by the palliative condition. This can be daunting for healthcare professionals and can negatively impact upon the effectiveness of care provided. Fully revised and updated, the third edition of Drugs in Palliative Care provides an accessible and succinct overview of the main drugs that are encountered in palliative care clinical practice. The text begins by providing a clinical pharmacology overview and prescribing guidance, then contains over 160 monographs of palliative care drugs, in an easy to access A-Z format.

Through an exploration of the ethical nature of nursing, Caring Matters Most asserts that the act of nursing itself embodies goodness. Nurses can develop this moral character in themselves by cultivating five habits: trustworthiness, imagination, beauty, space, and presence. Practicing these habits will sustain nurses as they meet the challenges of the workplace, the threat of automation, and the incivilities that arise within the nursing community. The volume concludes with thought-provoking discussion questions and exercises designed to help nurses apply concepts in the classroom or in practice. Each chapter combines highly readable explanations of moral theory with real-life examples that can guide nurses in day-to-day practice. Caring Matters Most is an ideal resource for academic or practicing nurses interested in healthcare ethics or philosophy.

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

Delirium is a complex syndrome with a multifactorial aetiology and is characterized by marked disturbances of consciousness, attention, memory, perception, thought, sleep-wake cycle, and by fluctuation of symptoms. This book covers in detail the pathophysiology, epidemiology, clinical aspects, differential diagnosis, and management of the syndrome. Due to the special characteristics of the syndrome, specific chapters deal with different aetiologies and populations at risk, with emphasis on the critically ill and palliative care patients. As delirium often announces or anticipates the proximity of death, family issues are considered in a comprehensive final chapter, covering the impact of terminal illness on the family and the process of bereavement. The book emphasises the need for assessing and diagnosing delirium with reliable instruments, and a chapter on assessment is reinforced by including appendices of many of the most relevant instruments reported in recent literature. The evidence from the literature is always distinguished from the authors' opinions and most chapters are integrated by the presentation of case examples. Updated for the second edition this book contains new material on topics including classification systems, more data on populations at risk, and significant new material on the family and bereavement. Delirium: Acute confusional states in palliative medicine, Second Edition demonstrates that only an interdisciplinary treatment of delirium between neurology, psychiatry and palliative medicine can develop knowledge of the syndrome and improve patient and family care. This book has been written for palliative care physicians and specialist nurses, neurologists, psychiatrists, and other health professionals treating terminally ill patients, offering them a clear account of how to recognize and deal with the syndrome.

Psycho-Oncology in Palliative and End-of-Life Care provides expert advice and clinical management guidelines on the impact of advanced cancer and its treatment on the life and wellbeing of a patient in palliative and end-of-life care. Employing a practical toolkit format, this volume addresses a variety of key challenges including: discussions of death and dying, poor prognoses, wishes and values of the dying person, advance care plans, anxiety, demoralization and problems with coping, depression and delirium, the needs of partners, children, families, and caregivers, and spiritual and bereavement care. Each chapter considers presenting symptoms, differential diagnoses and assessment methods to achieve the best diagnosis, so that a detailed formulation can be developed for each person that guides a comprehensive management plan. Each section concludes with professional and service issues ranging from ethical dilemmas, legal requirements, cultural needs, and training and service development issues, through to basic human rights. Part of the Psycho-Oncology Care: Companion Guides for Clinicians series, this concise pocket guide is a resource for oncology specialists, psycho-oncologists in training, consultant nurse specialists and nurse practitioners, and allied health professionals to use as a quick reference in everyday practice. Pitched at intermediate to advanced level skills, this companion guide can be used as a standalone, or alongside existing oncology and psycho-oncology training programs.

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.

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.

This sixth edition of the Oxford Textbook of Palliative Medicine takes us now into the third decade for this definitive award-winning textbook. It has been rigorously updated to offer a truly global perspective, highlighting the best current evidence-based practices, and collective wisdom from more than 200 experts around the world. This leading textbook covers all the new and emerging topics, updated and restructured to reflect major developments in the increasingly widespread acceptance of palliative medicine as a fundamental public health need. The sixth edition includes new sections devoted to family and caregiver issues, cardio-respiratory symptoms and disorders, and genitourinary symptoms and disorders. In addition, the multi-disciplinary nature of palliative care is emphasized throughout the textbook, covering areas from ethical and communication issues, the treatment of symptoms, and the management of pain. The Oxford Textbook of Palliative Medicine is a truly comprehensive text. No hospital, hospice, palliative care service, or medical library should be without this essential source of information. This sixth edition of the Oxford Textbook of Palliative Medicine is dedicated to the memory of Professor Kenneth Fearon husband of Professor Marie Fallon and a surgeon who became a world leader in the research and management of anorexia and cachexia. He modeled a work-life balance that is so critical in our field, with devotion to both his patients and his family.