Heart failure occurs in almost epidemic proportions, placing a huge burden on both the healthcare system, and sufferers and their families. This can only rise over coming years as the ageing population, particularly in industrialized countries, increasingly suffers from heart failure and its related comorbidities. The care of this group of patients has evolved significantly over recent years as our knowledge and understanding of the pathophysiology of heart failure has developed. It has become evident that supportive care is integral to comprehensive heart failure care, and this book provides an evidence-based overview of heart failure aetiology, its management, and the supportive care required by patients throughout the course of their disease. Supportive Care in Heart Failure integrates the complexities of heart failure care, bridging knowledge bases from cardiology and cardiothoracic surgery, general medicine and palliative care. The book reviews essential information about epidemiology and pathophysiology of heart failure, and evidence-based medical, device, surgical and interdisciplinary management. It addresses the evaluation and management of quality of life, common symptoms and problems associated with heart failure, and the holistic approach to supportive care throughout the course of the illness through the end of life. Prognostication, communication, and ethical decision making are reviewed in detail. Heart failure has traditionally presented a challenge to physicians, as a generally progressive condition with significant symptoms, a poor quality of life, and high mortality. But by applying the principles of palliative medicine, it is possible to offer a supportive care approach that synthesizes the experience of both the heart failure specialist and the palliative care physician, and offers the best possible quality of care to this group of patients.

This moving and insightful handbook collects wisdom and experience from pactitioners and those who have lost a loved one on the role of spirituality in end of life care. It addresses the place of spirituality in our modern society and the challenge of life and death, best practice in end of life care, belief systems, how spirituality can play a part in care workers' roles, as well as creative interventions and leadership challenges. The handbook is divided into seven sections covering modern society, spirituality and the challenge of end of life care; end of life care in practice; user, carer and professional perspectives; death as a gateway: belief systems; looking ahead; conclusions.

Death comes for us all, and the desire to ease into that death is as ancient as humankind. The idea that sometimes it is better to die quickly and in control of that death--rather than linger in pain and misery once impending death is certain--has troubled yet comforted humankind. In Doctor, Please Help Me Die, author Tom Preston, MD, presents a thorough overview and discussion of end-of-life issues and physician-assisted death in America.

Doctor, Please Help Me Die traces the history of patients seeking relief from suffering at the end of life and discusses how cultural and professional customs have inhibited many doctors from helping their patients at the end. Preston shows how most doctors fail their patients by not discussing dying with them and by refusing to consider legal physician aid in dying--ultimately deceiving the public in their refusal to help patients die. He discusses the religious, political, and legal battles in this part of the culture war and gives advice to patients on how to gain peaceful dying.

Preston presents a strong argument for why every citizen who is dying ought to be extended an inalienable right to die peacefully, and why every physician has an ethical obligation to assist patients who want to exercise this right safely, securely, and painlessly.

A holistic view of the factors that impact the health of a patient beyond the illness itself, this book examines what it is like to be a patient. It espouses the view that terminal illness may not be a tragedy but, an opportunity for emotional growth. The inadequacies of medical care today are discussed, from the failure of health care professionals to see the person with the disease, to the many ways in which managed-care organizations jeopardize the doctor/patient relationship.

The work reviews concrete ways in which health care professionals can enhance the quality of their care, by remaining compassionate, continuing to offer patients hope (even if their condition is terminal), acknowledging and addressing patients' suffering, and counseling patients so that they can obtain the support needed. A new advocacy role for doctors is presented that enables patients to make advised decisions about their own treatment. This book encourages patients to take back their lives from the diseases that overwhelm them. It also discusses advance directives, living wills, cardiopulmonary resuscitation, and do not resuscitate orders. Information is provided to help patients assume self advocacy on end-of-life issues from an emotional perspective as well as a legal perspective.

How do doctors and nurses communicate with frightened patients who are dying, address the needs and concerns of the patients, and help the patients arrive at an acceptance of death? This work deals with the relationship that the health care team has with the dying and how well that team is prepared to address the fears of the dying. In addition, the health care team must learn to deal with their own emotions and ignorance concerning death. This work should be of interest to those professions that deal closely with dying people.

In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the "right to die"-or to live. The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, informed by Foucault's genealogy of medicine and power as well as by a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion-people as, in effect, temporarily animated corpses with interchangeable parts-has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual "medicine." The result is a kind of nihilistic attitude toward the dying, and troubling contradictions and absurdities in our practices. Wide-ranging in its examples, from organ donation rules in the United States, to ICU medicine, to "spiritual surveys," to presidential bioethics commissions attempting to define death, and to high-profile cases such as Terri Schiavo's, The Anticipatory Corpse explores the historical, political, and philosophical underpinnings of our care of the dying and, finally, the possibilities of change. This book is a ground-breaking work in bioethics. It will provoke thought and argument for all those engaged in medicine, philosophy, theology, and health policy.

"Now I Lay Me Down...The Owner's Manual for the Dying Patient, Their Caregivers and Their Loved Ones" was written to help those with a terminal illness, and those who care for them, to improve the quality of their physical and spiritual life. It also gives guidance to the loved ones after death. During Mrs. Stringer's work as a hospice nurse she came to realize the importance of an open and honest relationship in the last months and days of a person's life. This is reflected in the book, as she has condensed an enormous amount of information in a straight-forward, easy to understand guide, while remaining sensitive and compassionate.

Intractable illnesses such as advanced cancer, AIDS, and chronic progressive neurological diseases present health-care professionals with an array of symptoms and ethical issues that demand extensive exploration and consideration. As the quest for advances in symptomatology continues, it is imperative to disseminate and integrate the knowledge currently available in palliative medicine. The International Symposium on Current Perspectives and Future Directions in Palliative Medicine was held in Tokyo in October 1997 to provide health-care professionals with a multidisciplinary approach for improving comprehensive palliative care. With invited speakers from North America, Europe, and Japan, the symposium focused on standard management and clinical trials of control of symptoms such as pain and cachexia, ethics in palliative medicine, the economics of health care, quality-of-life research, management of depression, and patient education.

Death strips away all of the superficial and mundane details of living and leaves behind life's bare essentials. Death is inevitable in life. It knows no boundaries. It knows no skin color, no financial or social standing. It knows nothing but itself. The paradox of Dying Declarations: Notes from a Hospice Volunteer is in its warm affirmation of life through the 'dying declarations' of patients who are peering into the cold face of death. The author reveals personal experiences about life, death, and the courage to strip away the unimportant aspects of life to make way for a clearer understanding on just what is truly important. Simple, moving stories invigorate and spark insightswhile discussing all aspects of hospice volunteering. By facing death on a regular basis, one can no longer maintain a tight grip on the masks, games, and trivialities that one uses to hide from truth. The person who looks death in the eye becomes more honest, grateful, compassionate, and humble. In Dying Declarations: Notes from a Hospice Volunteer, the author shares his experiences and the lessons he learned from the dying while working as a hospice volunteer. The stories, rather than being sad and depressing, present the author's hospice experience as being some of the most personally uplifting and enriching experiences of his life. In Dying Declarations: Notes from a Hospice Volunteer you will learn: about training for hospice work why hospice volunteers are at times more beneficial to the well-being of dying patients than family, clergy, or medical personnel the three basic tasks for a hospice volunteer how children and dogs can be beneficial for patients the impact that a dying patient can have on the life of a hospice volunteer words of wisdom about living life, directly from hospice patients Dying Declarations: Notes from a Hospice Volunteer will inspire and enlighten hospice volunteers, nurses, physicians, clergy, social workers or anyone who works for hospice or provides end-of-life care.

End-of-life decision making is often viewed from an academic perspective, which can obscure the debate's central human concerns. This guide introduces general readers to people with personal stakes in the right-to-die conundrum. Putnam provides practical assistance to readers and their loved ones, simultaneously incorporating the abstract and theoretical analysis essential to examining how we die in contemporary Western society. She also presents the backgrounds of the Hospice and Right-to-Die (Hemlock) Movements.

To elucidate the human side of the debate, Putnam profiles and interviews six important figures:

Dame Cicely Saunders, founder of the modern Hospice Movement

Derek Humphry, founder of The Hemlock Society in the U.S.

Herbert Cohen, an early leader in euthanasia circles in The Netherlands

Timothy Quill, whose assistance in a patient suicide resulted in a case before the U.S. Supreme Court

Joanne Lynn, founder of Americans for Better Care for the Dying

Jack Kevorkian (profiled, but unavailable for interview)

Another unique feature of this book is the application of philosopher Judith Jarvis Thomson's general theory of rights to the very specific right to die. Pointing to potential compatibilities between the two positions, she concludes that heroic compassion does not require a final choice between Hospice and Hemlock--there may be room enough for both.

None of the literature in the field of terminal care provides a full treatment of the laws, documents, and policies relating to the difficult issues arising at the end of life. When Life Ends was written to fill this gap by an attorney who serves on the bioethics committee of a large public hospital. It is an invaluable resource and practical tool for physicians, nurses, medical staffs, legal professionals, hospital administrators, and hospital bioethics committees because it provides: 1) in-depth legal commentaries on the refusal of life-sustaining treatment, advance directives, surrogate decision making, and the Patient Self-Determination Act; 2) more than 70 medical and legal documents to be used in connection with end of life decisions; and 3) hospital policies and procedures to suggest guidelines to hospital bioethics committees as they carry out their functions of developing policies and procedures to address end of life legal and ethical issues.

Presents a view of hospice care through the eyes of a long-term hospice nurse. This title includes stories which are accompanied by discussion of end-of-life issues that arise among the families hospice nurse has served. It is useful for health care and social worker and layperson alike.

"I just wish I had armfuls of time." These are the words of a four year old facing a life-threatening illness. This text portrays the psychological experience of such children, who are irreversibly changed from the moment of diagnosis. Barbara Sourkes is a psychologist who specializes in psychotherapy with children who have cancer and other serious diseases. In the account, she describes how she works with these children, using drawings, soft toys and dolls, stories and real medical instruments to allow them to communicate their experience of the illness, the treatment they undergo, their relationship with their families, and their feelings of grief and loss in coming to terms with the prospect of death. Making use of the words of children, offering interpretations and practical advice, this is a book that should be useful reading for those concerned with the care of terminally ill children.

Hospice Care and Cultural Diversity captures the richness and differences that make up the United States and its culture. This book shows you the complex issues arising from work with patients of a different culture and encourages research in hospices which support culturally innovative programs. Many people are individually knowledgeable and culturally sensitive, but few hospices have systematically planned for service to culturally diverse groups. This volume identifies who is implementing organizational programs of cultural sensitivity and acknowledges the efforts of those individuals working to make hospice accessible to everyone.Hospice Care and Cultural Diversity contains original research, personal insights, and overviews to help you understand what is being done in the field. Specifically, chapters discuss: National Hospice Organization activities, goals, and recommended actions death and dying from a Native American perspective breaking barriers to hospice for African Americans a case study of the development of a culturally sensitive treatment plan in pre-hospice south Texas caregiving norms surrounding dying and use of hospice services among Hispanic American elderly cultural considerations surrounding childhood bereavement among Cambodians in the U.S. one hospice's experience in identifying and meeting the needs of ethnic minority patientsPeople from many different cultures are eager to share their customs, practices, and beliefs. They want hospice providers to understand their culture, and they want their community served by hospice. The only book of its kind, Hospice Care and Cultural Diversity is a valuable reference and source of ideas for anyone interested in the delivery of hospice services. From students to experts, you will find much information to help make hospice care accessible and comfortable for all groups of people.

This thoughtful new book presents strategies for helping end-stage renal disease patients and their families deal with the psychosocial aspects of the chronic long-term illness. Technological advances in the treatment of this disease have offered much hope for improved quality in living which has led caregivers to have a greater concern for preserving the quality of life of their patients. In Psychosocial Aspects of End-Stage Renal Disease leaders in the field of many disciplines share knowledge and reveal problems that are still evident to them in the confrontation with this potentially fatal illness.Five comprehensive sections devote special attention to the different areas of concern for the psychosocial well-being of end-stage renal disease patients. The impact of renal disease on family relationships is covered by examining issues of family responses and coping measures such as marital and family reactions to home and hospital dialysis treatment. Ethical issues in treatment are explored, including the ethics of treatment refusal and a Jewish perspective on kidney transplants. Relations between staff and patients and a timely section on renal disease and special populations, particularly the elderly and AIDS patients, make up the final two sections of this informative volume. Professionals in all allied health disciplines will benefit from this important volume as it demonstrates a model approach, if not the definitive one, for the treatment of the psychosocial aspects of end-stage renal disease as well as other chronic illnesses.