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

Geriatric Palliative Care covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and cultural context of old age and frailty, this volume details with specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes, dementia) as well as individual symptoms (e.g. pain, fatigue, anxiety.). Communication between care-givers and patients, in a variety of settings, is also discussed.

The theme of this book is that palliative care is the best approach to the care of chronically ill and frail elderly because of its focus on quality of life, support for functional independence, and the centrality of the patient's values and experiences in determining the goals of medical care. Geriatric Palliative Care provides a comprehensive medical reference for all clinicians who care for older adults.

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

When the first edition of A House Called Helen was published in 1993, there were only a handful of children's hospices in existence, all of them within the UK. There are now more than twenty in operation, and a significant number at the project stage, in the UK alone, and children's hospices have been set up in Canada, the USA, Australia and continental Europe. The concept of a children's hospice, seen as innovative when the first, Helen House, opened in Oxford in 1982, is now well established and the growth in the number of children's hospices has seen corresponding important developments in the field of paediatric palliative care. This book provides an authoritative account of how Helen House came into being. It records the events surrounding the foundation of the hospice and how it stemmed directly from what was learnt from the events following the sudden illness of the author's eldest daughter Helen, after whom it was named. The book sets out the philosophy which underpinned the hospice, which was taken up as the guiding philosophy of children's hospice care. It describes the hospice's operational framework and details the service provided by Helen House, which is widely cited as a model for children's hospice care worldwide. It provides valuable insight into the needs of the families who use hospice services and touches both on the difficulties they face caring, often over a long period of time, for a child with a life-limiting illness, and on the role and attitudes of professionals and indeed of the public at large. In this new edition an additional chapter reviews the growth of children's hospices and reflects on the challenges they face in their maturity. It considers the development of children's hospice care in relation to wider service provision and examines current and future issues surrounding the care of children with life-limiting illness.

The Oxford American Handbook of Hospice and Palliative Medicine and Supportive Care is an easily-navigable source of information about the day-to-day management of patients requiring palliative and hospice care. The table of contents follows the core curriculum of the American Board of Hospice and Palliative Medicine, thus meeting the educational and clinical information needs of students, residents, fellows, and nurse practitioners. Succinct, evidence-based, topically-focused content is supplemented by extensive tables, algorithms, and clinical pearls. This edition includes new sections on grief and bereavement, medical marijuana, and physician assisted suicide, and has been updated throughout to incorporate National Consensus Project for Quality Palliative Care Clinical Practice Guidelines.

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.

The Oxford Textbook of Palliative Social Work is a comprehensive, evidence-informed text that addresses the needs of professionals who provide interdisciplinary, culturally sensitive, biopsychosocial-spiritual care for patients and families living with life-threatening illness. Social workers from diverse settings will benefit from its international scope and wealth of patient and family narratives. Unique to this scholarly text is its emphasis on the collaborative nature inherent in palliative care. This definitive resource is edited by two leading palliative social work pioneers who bring together an array of international authors who provide clinicians, researchers, policy-makers, and academics with a broad range of content to enrich the guidelines recommended by the National Consensus Project for Quality Palliative Care.

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 relationship between spirituality and healthcare is historical, intellectual and practical, and it has now emerged as a significant field in health research, healthcare policy and clinical practice and training. Understanding health and wellbeing requires addressing spiritual and existential issues, and healthcare is therefore challenged to respond to the ways spirituality is experienced and expressed in illness, suffering, healing and loss. If healthcare has compassionate regard for the humanity of those it serves, it is faced with questions about how it understands and interprets spirituality, what resources it should make available and how these are organised, and the ways in which spirituality shapes and informs the purpose and practice of healthcare? These questions are the basis for this resource, which presents a coherent field of enquiry, discussion and debate that is interdisciplinary, international and vibrant. There is a growing corpus of articles in medical and healthcare journals on spirituality in addition to a wide range of literature, but there has been no attempt so far to publish a standard text on this subject. Spirituality in Healthcare is an authoritative reference on the subject providing unequalled coverage, critical depth and an integrated source of key topics. Divided into six sections including practice, research, policy and training, the project brings together international contributions from scholars in the field to provide a unique and stimulating resource.

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.

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.

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

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.

Over the past thirty years, the way Americans experience death has been dramatically altered. The advent of medical technology capable of sustaining life without restoring health has changed where, when, and how we die. In this revelatory study, medical anthropologist Sharon R. Kaufman examines the powerful center of those changes: the hospital, where most Americans die today. She deftly links the experiences of patients and families, the work of hospital staff, and the ramifications of institutional bureaucracy to show the invisible power of the hospital system in shaping death and our individual experience of it. In doing so, Kaufman also speaks to the ways we understand what it means to be human and to be alive.
"An act of courage and a public service."--"San Francisco Chronicle
""This beautifully synthesized and disquieting account of how hospital patients die melds disciplined description with acute analysis, incorporating the voices of doctors, nurses, social workers, and patients in a provocative analysis of the modern American quest for a 'good death.'"--"Publishers Weekly
""Kaufman exposes the bureaucratic and ethical quandaries that hover over the modern deathbed."--"Psychology Today
""Kaufman's analysis illuminates the complexity of the care of critically ill and dying patients and] the ambiguity of slogans such as 'death with dignity, ' 'quality of life, ' and 'stopping life support.' . . . Thought-provoking reading for everyone contemplating the fate of us all."--"New England"" Journal of Medicine
"

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.

Accessible and instructive,Palliative Careguides and inspires health social workers to incorporate palliative care principles into their current clinical practice. Through the lenses of environmental theory and intersectionality, rich case narratives highlight opportunities for social workers to enhance their work, advancing whole-person care in the face of serious illness. Chapters include questions to concretize ideas and demonstrate real-world application, while case narratives cover a range of settings, diagnoses, and populations. This book is a useful tool for educators, learners, and practicing social workers working with individuals and families navigating complex health care systems.

While many effective interventions have been developed with the potential to significantly reduce morbidity and mortality from cancer, they are of no benefit to the health of populations if they cannot be delivered. In response to this challenge, Advancing the Science of Implementation across the Cancer Continuum provides an overview of research that can improve the delivery of evidence-based interventions in cancer prevention, early detection, treatment, and survivorship. Chapters explore the field of implementation science and its application to practice, a broad synthesis of relevant research and case studies illustrating each cancer-focused topic area, and emerging issues at the intersection of research and practice in cancer. Both comprehensive and accessible, this book is an ideal resource for researchers, clinical and public health practitioners, medical and public health students, and health policymakers.

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.