Hospital palliative care teams have been established in rapidly increasing numbers over the last 20 years, as it has been recognized that hospices can never transfer the philosophy and practice of palliative care into the acute sector by simply existing; the often work as 'stand alone units' and remain outside mainstream medicine. However, it has become apparent that improving access to palliative care for patients in acute hospitals is not as easy as employing external palliative care specialists as consultants. Even setting up a team of professionals who work solely in a hospital will often not improve the care of the great majority of patients being treated there.
Based on the extensive experiences and knowledge of three clinicians in the area who have developed palliative care services in acute settings, this book provides those facing the same challenges with practical guidance and down to earth advice on a range of problems they might encounter. Using a problem focused and practical approach, Palliative Care in the Acute Hospital Setting: A Practical Guide is filled with case-based problems to help readers identify realistic, usable, everyday solutions. It also covers the skills and knowledge needed to help teams make progress in the hospital as well as outlining the best training to help them continue to flourish.
Written in an accessible style with short and focused chapters, this clearly laid out book helps readers find the information they need to tackle particular problems easily and with confidence. With a supportive outlook and covering the non-clinical management aspects of palliative care, this book is the ideal guide for palliative care specialists making the transfer from hospice to hospital, and for those setting up palliative care teams in the acute hospital setting.

Having a serious illness can be incredibly difficult, especially when there is no cure. As your disease progresses, not only your physical health, but your entire well-being may be affected. Unfortunately, most of your medical care may only treat your body. However, there are things that you and your health care team can do to help you feel better as a whole person.
This collaborative, skill-based program will teach you practical techniques to help you cope with your illness and the stress of everyday life. You will learn strategies to improve your mood and deal with feelings of anxiety, depression, or anger. Social support is key to successful coping and you may need to strengthen your relationships, especially with caregivers. It is also important to work with your medical team and develop more effective ways to manage your symptoms. You will set goals regarding your care as well as your quality of life. In addition, you may choose to explore your spirituality and practice tools that promote personal growth.
Your facilitator will work with you to tailor the program to your individual needs. This workbook includes user-friendly forms to help you apply the content of the sessions to your personal situation. At the end of this program, you will have a new set of hands-on skills to master as you continue to grow.

Improvements in health care in the 21st century mean people are living longer, but with the paradox that chronic illness is increasingly prevalent. Dementia, a term used to describe various different brain disorders that involve a loss of brain function that is usually progressive and eventually severe, is a condition associated with an ageing population and is becoming increasingly common. Worldwide there are approximately 24 million people with dementia, expected to rise to 81 million by 2040. Inevitably, people living with dementia will die, but their needs at the end of life are not well known. This book describes what might be achieved if the values and best practice of both dementia care and palliative care are brought together, to achieve quality end of life care for this specific group of patients. It explores what is known about the experience of dying with dementia, using a narrative approach, and develops a model that draws together a 'person-centred' approach to care. The book examines the possibilities and the challenges faced when trying to improve quality of life for people with dementia, and presents examples of good practice from across the world.

Health care professionals seeking to improve the quality of life for those living with serious illness and nearing the end of life will find exactly what their organization needs in the second edition of this acclaimed book by Dr. Joanne Lynn and her colleagues. Improving Care for the End of Life provides expert guidance on how to make significant improvements now, at all levels of the health care system from the bedside and the hospital to the health care policy and legislative arenas by using the rapid-cycle breakthrough approach to change. The ideas are proven, and the stories of teams that have put them to use will inspire and enlighten. New to the second edition: BL New chapters to address issues of growing interest such as continuity of care, and the special needs of dementia patients and their loved ones BL Details on trajectories of care and how these affect decisions at the end of life BL Updated and expanded information on pain management, advance care planning, ventilator withdrawal, depression and delirium, advanced heart and lung disease, and more BL Scores of new insights, measurement approaches, and tips based on the experiences of hundreds of improvement teams nationwide BL Thoroughly updated references The sourcebook speaks to all managers of health care systems serving people with serious illnesses, including doctors in offices, nurse managers on hospital units, social workers in long-term care facilities, administrators of home care and hospice agencies, hospital chaplains, directors of volunteer services, and others.

This is the fifth book in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In this volume the Editors bring together first-rate palliative care with oncological treatment for patients with head and neck cancer. Head and neck cancer is one of the most frightening and distressing cancers for patients and their families as it affects appearance, the ability to speak, and the ability to eat. Pain which is difficult to treat, infection, and disfiguring surgery with wounds that often do not heal, are common accompaniments of advanced disease. In addition, psychological distress, loneliness, and isolation are often experienced by patients. Head and neck cancer is not that common but, when it does occur, it very often needs specialist help from palliative care and hospice clinicians. There is little written on this subject and this book provides a comprehensive, practical guide that draws together all the information in an easily accessible format. It is an essential reference for on the ward, or before going to a home visit. The Palliative Care Consultations series is primarily aimed at those individuals working in an acute hospital cancer centre and/or tertiary referral centre. Books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common, but difficult. The volumes are site specific and each volume encompasses a review of the current oncological or haemato-oncological management of advanced disease with symptom control advice. These volumes give clinicians excellent advice on symptom control in the context of palliative care. The books are also of use and interest to other professions working in acute hospitals.

Teamwork is a complex but essential component of palliative care. The needs of people diagnosed with life threatening disease will vary greatly over time, and it is rarely possible for just one professional to be able to provide adequate care. In order to ensure an holistic approach, the whole multi-disciplinary team must be involved. Inevitable questions arise from such an approach, and this book seeks to address these. How does a team come into being? What different formats are there? How might the patient contribute to the effectiveness of their care and the way in which the team operates? What are the difficulties and frustrations encountered in developing and maintaining such teams? What models of working and styles of leadership have developed? How are power and authority handled within the team setting? The importance of team building, training, support, attention to group process, and stress management to protect the mental health of the team are explored. The ethical issues inherent in palliative care such as consent, autonomy, confidentiality, decision making within teams, and the legal implications of such are also discussed. The book concludes with one important question - do we know if teams are the most effective way of providing care? This book addresses key issues surrounding the role of the team in palliative care, and is an essential guide to reappraising the importance of collaborative teamwork, and enhancing understanding of existing team structures.

Over recent decades, tremendous advances in the prevention, medical treatment, and quality of life issues in children and adolescents surviving cancer have spawned a host of research on pediatric psychosocial oncology. This important volume fulfills the clear need for an up-to-date, comprehensive handbook for practitioners that delineates the most recent research in the field--the first of its kind in over a decade. Over 60 renowned authors have been assembled to provide a thorough presentation of the state-of-the art research and literature, with topics including:
-Neuropsychological effects of chemotherapy and radiation therapy
-Bone marrow transplantation
-Important issues about quality of life during and following treatment
-Collaborative research among child-focused psychologists
-Standards of psychological care for children and adolescents
-Stress and coping in the pediatric cancer experience
-The role of family and peer relationships
The Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease represents both multidisciplinary and international efforts, an alliance between physicians and parents, and a combination of research and service. With a wealth of information of great interest to patients and their families, this volume will also be a welcome resource to the psychologists, psychiatrists, pediatricians, oncologists, nurses, and social workers who confront these issues as they help children and their families through the treatment, recovery, and grieving processes.

Dyspnoea (breathlessness) is an uncomfortable awareness of breathing that occurs in approximately 30-75% of terminal cancer patients. It is one of the most distressing symptoms for both patients and family members and can seriously impact on quality of life. Typically, dyspnoea is associated with congestive heart failure, end-stage chronic obstructive pulmonary disease, or lung cancer. This book provides palliative care doctors and specialist nurses with practical guidelines to help manage and treat patients with breathlessness. It includes the science behind the symptom in an attempt to explain the pathology and physiology of this complex condition. The book has been organized to address generalized aspects of breathlessness in advanced illness and more specific aetiologies and managements relevant to particular underlying diseases. It summarizes the epidemiology and the pathophysiology of breathlessness, measurement, research approaches, rehabilitation and exercise, clinical approaches that can be taken at the bedside, pharmacological and non-pharmacological approaches, and surgical interventions. The care of patients with dyspnoea requires input from a variety of disciplines such as palliative care, physiotherapy, respiratory medicine and nursing, and this is reflected in the multidisciplinary list of contributors.

This book brings a fresh approach and conversation to the practice of professional supervision for human services by specifically articulating its often performed, but unnamed and under-explored therapeutic function. The discussion of the therapeutic function is timely given the rising complexities in our world, and the increasing awareness of emotional impacts of human service work. These impacts include stress, distress, emotional labour, indirect trauma, and direct trauma. Posing a challenge and invitation to supervisors to comfortably inhabit the therapeutic function of supervision to increase emotional support to workers, it places safe practice and worker wellbeing at the heart of supervision to enable high quality service delivery for often the most vulnerable in society. While underpinned by theory, it is written to be practically applied and is developed from a 'lived experience' perspective, offering a unique glimpse into actual practice. By modelling one of the main aims of professional supervision, which is to facilitate and enable the integration of experience into learning and knowledge, it will be of interest to all practitioners across a broad range of human services, particularly both new and experienced supervisors.

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. This book includes a selection of Cicely Saunders' most important writings throughout a period of over forty years.
Full articles, chapters, editiorials, reviews, and commentaries include important clinical themes relating to the care of dying people such as pain and symptom management, issues of communication and truth telling, and the needs of particular patient groups, such as those with cancer and other diseases. The book includes pieces that reflect on the wider development of the palliative care field and on policy and organizational issues. Some of the papers take up the theme of spiritual care at the end of life, as well as the question of euthanasia, raising in turn issues of a wider theological and philosophical nature.
The articles are written for a multi-disciplinary audience and will be of enormous interest to many professionals now working in palliative care. The collection will become a key work of reference for those interested in the evolution of hospice and palliative care and will serveas an important sourcebook of many currently hard to obtain publications by the acknowledged founder of the modern hospice movement. This book will also stand as a remarkable testimony to the personal contribution of Cicely Saunders and the influence she has had upon the modern field of palliative and end of life care.

This book offers healthcare professionals, academics and anyone affected by cancer a fresh and original approach to the supportive care of people with cancer. It looks at the underlying reasons why cancer so often leads to high levels of distress and, more importantly, it suggests many practical ways distress can be minimised and prevented. The actual experiences of cancer patients, as recorded in their personal diaries, are combined with theory, research and practical clinical advice. In each of its seven chapters Cancer in Context takes a different perspective towards supportive care in cancer. It begins by considering how people in general manage and adjust to massive changes in their lives and, in particular, how they react to the threat of cancer. It goes on to examine the "lived experience" of people with cancer as they negotiate the many changes and challenges that follow their diagnosis. Of course cancer doesn't only affect the person who has the disease, it also impacts on families, partners and carers. One chapter explores these and other issues, such as sexual difficulties, the needs of older people, single people, and gay and lesbian couples. Chapter 4 shows that the social and cultural context of a person's life is critical to understanding their resources, the way the are treated, and the responses the make to serious illness. However, it is in the clinical context that professionals have an opportunity to minimise disruption to their patients' quality of life as they endure the notorious demands of oncology treatments. The book offers practical clinical advice on psychosocial aspects of conventional cancer treatments, common treatment difficulties, cancer rehabilitation and palliative care. Chapter 6 provides a summary of the burgeoning area of information and communication skills within healthcare and, finally, the book ends by considering how doctors, nurses, radiographers and other healthcare professionals can maintain their supportive care in light of such high levels of stress and burnout among these staff groups.

Patients with degenerative neurological disorders are among the most handicapped patients in medicine. Many of these diseases are incurable. Expert palliative care is the duty of every neurologist: however, to date, this has not been a standard feature of neurological practice or training. This book helps define a new field, namely palliative care in neurology. It brings together all necessary information for neurologists caring for a patient with advance disease. Palliative care is an approach to the management of patients with life-threatening illness that attempts to enhance comfort, relieve psychosocial and spiritual distress, assure respect for decision making, provide support for the family, and prepare the patient and family for the end of life. This unique book covers each of the many dimensions of palliative care as they relate to patients with advanced neurological disorders. Basic principles of palliative care and specific ethical issues (such as euthanasia, food and hydration and advance directives) are covered. The needs of populations with specific neurological disorders are described and the management of symptoms that are common to all is explored in detail. Each chapter introduces its topic using a case report which may be used directly for teaching purposes. The authors have put together an invaluable resource, which lays the foundation for further research in the field.

Pruritus is a prevalent symptom in many skin conditions. However, much less is known about pruritus without primary skin disease. This problem affects most medical specialties, notably palliative care, haematology, oncology, internal medicine, hepatology, nephrology, anaesthesiology,
immunology and psychiatry. Specialists from these disciplines each see few patients with severe pruritus and therefore have only limited possibility to learn from their experience. In response, this book aims to build a bridge of knowledge and evidence between the various different specialties.
Pruritus can cause extreme discomfort in chronic cancer patients or in people who are receiving cancer treatment, as well as patients with non-malignant terminal illnesses. Knowledge about the pathophysiology of pruritus is scattered through many clinical specialties and this book brings this
information together in a readily accessible compendium of knowledge which will be of value to physicians of any specialty. An international group of contributors cover the neurophysiology, clinical assessment, and measurement of scratching activity as well as opiod-induced pruritus, pruritus in
haematological disorders, neuropathic pruritus, psychogenic pruritus and therapies and treatment.
Aimed primarily at palliative care physicians, oncologists and nurses, the book will also prove valuable to all health care professionals who require guidelines to assist with effective symptom control thereby ensuring best quality of life for their patients.

Surgical Palliative Care describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, with increasingly minimal access techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The text is divided into two sections; the first dealing with general issues, varying from quality of life measurement to spirituality, and the second illustrating their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms. Aimed primarily at palliative medicine and pain consultants, this book will also appeal to surgeons who increasingly need to know more about palliative care.

Fatigue in Cancer provides a comprehensive review of the key issues involved in the research and practical application of current evidence and best practice guidelines for addressing cancer-related fatigue. An international group of contributors draw together core topics relating to this complex area of cancer management, focusing on issues of definition, patho-physiology, treatment related variables and the psychological, social and emotional impact on patients, families and carers. Critical reviews of practical management strategies for both adults and children are included, as are the current approaches to the measurement of cancer-related fatigue in clinical and research contexts. The book contributes a multi-disciplinary overview of a problem increasingly overlooked by cancer scientists, researchers, and clinicians.
This book demonstrates the considerable capacity of cancer-related fatigue to impact on quality of life. Its multi-disciplinary focus and consideration of prioritised areas of future research will ensure that it will prove invaluable for all health professionals and researchers in oncology and palliative care.

A focus throughout on lifespan perspectives and a consideration of palliative care across all ages. Consideration of different cultural perspectives, beliefs, thoughts and practices outside Western societies and dominant paradigms. Integrates primary research throughout, including a focus on contemporary research from social media. Complements mainstream psychological approaches to life-limiting illness by exploring death, dying and palliative care with a critical health psychology lens.

This book gives readers an understanding of the theoretical foundations of social support communication along with practical tools to ethically and justly connect with and support others in daily life. Incorporating research, real-world examples, and autoethnographic methods, this book examines how social hierarchies, personal power dynamics, and relational and social histories can be better understood to create stronger social support messages across all our relationships, including family, friend, workplace, and health provider-patient relationships. The book translates theories of social support communication into practical application, examining how support messaging goes wrong and how to do it right. Intended as a supplementary text in interpersonal communication, psychology, and social work undergraduate courses, the book is also ideal for professionals who engage in caretaking and support tasks and wish to enhance their knowledge of social support theory.

In the tradition of Atul Gwande's Being Mortal, this compassionate work helps individuals develop a more accepting view of dying while teaching them what to expect and how to navigate the healthcare system at end of life. The health care system has a narrow view of how to care for patients in elderhood. That view focuses on extending life with machines and procedures, not caring holistically for the patient. As such, patients will likely spend the last years of their lives in long-term care facilities and their final weeks in an ICU. Our fear of death contributes to this model for health. Dying at home, peacefully, and surrounded by family is almost impossible in our world. Fittingly, the central idea of this book is that in old age, or when facing a terminal diagnosis, it is more important to understand your life rather than to extend it. While this may seem simple, its implications are profound. A natural death means accepting that, at some point, we are old enough or sick enough to die without trying to interrupt that natural process beyond being kept comfortable. In our cynical and overly clinical age, it is difficult to reflect on the meaning of one's life, but that kind of honest introspection is exactly what we need. Accordingly, The Journey's End seeks to help people manage their healthcare, their expectations, and their decisions in the final phase of life.

This comprehensive revision of the invaluable reference presents a rigorous survey of pain and palliative care phenomena across the lifespan and across disciplines. Grounded in the biopsychosocial viewpoint of its predecessor, it offers up-to-date understanding of assessments and interventions for pain, the communication of pain, common pain conditions and their mechanisms, and research and policy issues. In keeping with the current public attention to painkiller use and misuse, contributors discuss a full range of pharmacological and non-pharmacological approaches to pain relief and management. And palliative care is given expanded coverage, with chapters on interventive, ethical, and spiritual concerns. * Pain, intercultural communication, and narrative medicine. * Assessment of pain: tools, challenges, and special populations. * Persistent pain in the older adult: practical considerations for evaluation and management. * Acute to chronic pain: transition in the post-surgical patient. * Evidence-based pharmacotherapy of chronic pain. * Complementary and integrative health in chronic pain and palliative care. * The patient's perspective of chronic pain.* Disparities in pain and pain care. This mix of evolving and emerging topics makes the Second Edition of the Handbook of Pain and Palliative Care a necessity for health practitioners specializing in pain management or palliative care, clinical and health psychologists, public health professionals, and clinicians and administrators in long-term care and hospice.

- features research that is uniquely existential and spiritual - there's not yet a lot available on the topic of reconciliation and forgiveness (aspects of the aging process that need to be explored)

Anyone suffering from a terminal illness faces huge challenges, not only emotionally and physically, but also in the range of practical decisions they need to make. In your own time guides the patient through the choices that exist in the current system of medical care, helping them decide on the kind of care they want, and where they receive it - in the hospice or the home. It includes chapters on coming to terms with their situation, the help available to them at home, how to choose between a hospice and home, and advice on coping with the inevitable feelings and emotions of both patient and carer. Written by a GP with extensive experience in this area, the book is unique in presenting both a compassionate and practical guide for anyone affected by serious illness, one that will empower them with the information they need to maintain the highest possible quality of life in their final days.

Focussing on end-of-life care for people who use, or have used, substances, this book explores their social and health care needs and the multiple disadvantages they have often experienced, discussing the complexities around access to care that result. Presenting models of good practice, case studies and empirically based evidence, Substance Use, End-of-Life Care is informative, rigorous and useful for policy and practice development. The first section foregrounds the personal experiences of people living with substance use, their families and friends, and the health and social care professionals who work with them. The second section looks at how health inequalities can impact people in need of palliative care, including chapters on health literacy, mental health and learning disabilities. The final section explores social challenges that may be experienced, including homelessness, sex work, racism and incarceration. This interdisciplinary volume is essential for researchers, practitioners, students and educators working around substance use, mental health and palliative and end-of-life care, who are looking for guidance and a reference for their work in supporting people at the end of their lives who have multiple and often complex needs.

Cancer related pain can be successfully managed in the majority of patients by the use of medication. Some patients, however, have pain that does not respond to opioids, and require more specialised pain management techniques. Examples of such treatments are nerve blocks, radiotherapy, acupuncture and physiotherapy. This is the first book to provide detailed information on these and other methods of pain management. The Editors are experienced clinicians who have brought together an international, multi-professional team of pain specialists, palliative medicine practitioners and oncologists to provide a practical, comprehensive guide to the overall management of cancer pain. By effectively covering many different aspects of care, this book will appeal to all health care professionals involved with the frontline of cancer related pain.

Bladder cancer represents a significant cause of morbidity and mortality worldwide and presents major problems in detection and management. This book will review comprehensively the current understanding of the biology, pathophysiology and urological oncology of the disease, looking at the
problems and potential solutions. Fully illustrated including a colour plate section, it will include chapters on both the scientific and clinical principles, emphasizing molecular biology, pathogenesis, detection and experimental therapeutics, and focusing on new developments in clinical research.
The contributors are international and well known in the area.

Fear and Primordial Trust explores fear as an existential phenomenon and how it can be overcome. Illustrated by clinical examples from the author's practice as a psychotherapist and spiritual caregiver working with the severely ill and dying, the book outline theoretical insights into how primordial trust and archaic fear unconsciously shape our personality and behaviour. This book discusses in detail how in our everyday world, we lack primordial trust. Nevertheless, all of us have internalized it: as experiences of another non-dual world, of being unconditionally accepted, then sheltered and nurtured. The book outlines how from a spiritual viewpoint, we come from the non-dual world and experience a transition by becoming an ego, thereby experiencing archaic fear. This book explains fear in terms of two challenges encountered in this transition: firstly, leaving the non-world world when everything changes and we feel forlorn. Secondly, on awakening in the ego when we feel dependent and overwhelmed by otherness. The book also helps readers to understand trust as the emotional and spiritual foundation of the human soul, as well as how fear shapes us and how it can be outgrown. The book makes the case that understanding fear and primordial trust improves care and helps us to better understand dying. It will be of interest to academics, scholars and students in the fields of psychiatry, counselling, psychotherapy and palliative care and to all those interested in understanding fear, trust and the healing potential of spiritual experiences. Chapters 1 and 3 of this book are freely available as a downloadable Open Access PDF under a Creative Commons Attribution 4.0 license available at https://www.taylorfrancis.com/books/mono/10.4324/9781003176572