Dieses Buch fasst den aktuellen Forschungsstand zum Thema Cannabis zusammen. Hierfur wurden alle bedeutsamen, in den letzten 10 Jahren in deutscher und englischer Sprache publizierten Forschungsarbeiten systematisch recherchiert und ausgewertet. Dargestellt werden: - psychische, organische und soziale Risiken des Konsums pflanzlicher und synthetischer Cannabisprodukte zu Rauschzwecken, - Wirksamkeit, Vertraglichkeit und Sicherheit von Cannabisarznei bei organischen und psychischen Erkrankungen, - Motive und Erwartungen eines nichtarztlich verordneten Gebrauchs von Cannabis im Sinne einer Selbstmedikation. Die Expertise liefert einen umfassenden UEberblick uber die aktuelle Literatur. Sie bewertet das therapeutische Potenzial und die Risiken von Cannabis entsprechend internationaler methodischer Vorgaben der evidenzbasierten Medizin. Die Expertise dient somit als solides Nachschlagewerk. Ihr Auftraggeber war das Bundesministerium fur Gesundheit.

In the 21st century, people in the developed world are living longer. They hope they will have a healthy longer life and then die relatively quickly and peacefully. But frequently that does not happen. While people are living healthy a little longer, they tend to live sick for a lot longer. And at the end of being sick before dying, they and their families are frequently faced with daunting decisions about whether to continue life prolonging medical treatments or whether to find meaningful and forthright ways to die more easily and quickly. In this context, some people are searching for more and better options to hasten death. They may be experiencing unacceptable suffering in the present or may fear it in the near future. But they do not know the full range of options legally available to them. Voluntary stopping eating and drinking (VSED), though relatively unknown and poorly understood, is a widely available option for hastening death. VSED is legally permitted in places where medical assistance in dying (MAID) is not. And unlike U.S. jurisdictions where MAID is legally permitted, VSED is not limited to terminal illness or to those with current decision-making capacity. VSED is a compassionate option that respects patient choice. Despite its strongly misleading image of starvation, death by VSED is typically peaceful and meaningful when accompanied by adequate clinician and/or caregiver support. Moreover, the practice is not limited to avoiding unbearable suffering, but may also be used by those who are determined to avoid living with unacceptable deterioration such as severe dementia. But VSED is "not for everyone." This volume provides a realistic, appropriately critical, yet supportive assessment of the practice. Eight illustrative, previously unpublished real cases are included, receiving pragmatic analysis in each chapter. The volume's integrated, multi-professional, multi-disciplinary character makes it useful for a wide range of readers: patients considering present or future end-of-life options and their families, clinicians of all kinds, ethicists, lawyers, and institutional administrators. Appendices include recommended elements of an advance directive for stopping eating and drinking in one's future if and when decision making capacity is lost, and what to record as cause of death on the death certificates of those who hasten death by VSED.

In this volume the personal journey of why a nurse chose to leave Acute Care nursing to be involved in Palliative Care nursing connect with a broader culture of Palliative Care nursing by interviewing those who chose palliative care nursing and examine the reasons for changes in careers from acute, curing based, nursing to Palliative Caring for those in end of life nursing. The longest section of the study travels the world of Palliative nursing with participant observers. It is about the actively working nurse and includes extensive analytical discussion of an attempt to understand the sense of professional change, and the significance of beliefs for the reasoning behind vocational transformation. The second section examines the interviews, the third addresses the heart of the research question and examines nursing moving from a curing model to a caring only approach when death of the patient is inevitable. The volume ends with a letter written by the author to her sons asking them to be there when her time comes at the end of life through a life limiting illness and requests her sons and the Palliative Care professionals observe her final wishes.

Are you involved in caring for people at the end of their life? Do you have a role in supporting the families of those who are dying, or is this an area of your work you find personally difficult?This book is an accessible guide for all those working in health or social care and caring for people at the end of their lives. This will include people in roles such as healthcare assistant, hospice worker, volunteer, nurse or other carers.Written by experts with extensive experience in delivering high quality end of life care, this book is full of real life examples, reflection exercises and case studies. It also includes insights into what can help make a good death, and how to help support families at the end of life.The easy to read chapters emphasise treating people who are dying with dignity using a person centred approach.The book supports the delivery of quality care by recognising physical and non-physical symptoms, and thinking about various emotional and physical needs people might have. It is also important that care givers look after themselves and advice is given on how best to do this.An essential purchase for anyone looking for guidance or support in this area, and suitable for those working in the community, care homes, hospices, hospitals or other settings where people are cared for. With a Foreword from Dr. Ros Taylor, MBE, National Director for Hospice Care, Hospice UK."The book strikes a balance between the factual and the personal, and gives the reader detailed information and time to think through reflection exercises. It highlights essential elements of end of life care, including communication, symptom management and personal care during bereavement. It emphasises the importance of adopting a person-centred approach of people who are dying. The book supports the delivery of quality care by recognizing the physical and non-physical symptoms, and thinking about people's emotional and physical needs. It also makes clear that caregivers should look after themselves and how they should do so." Deborah Preshaw, doctoral nursing student, Queens University Belfast, UK "This is a beautifully presented learning tool to support the delivery of end of life care. I particularly like the 'signposts' which reinforce the intention of the book to enable 'carers' to apply what they read to their role in practice." Liz Bryan, Director of Education and Training, St Christopher's Hospice, UK "This book is a very welcome addition to the literature on end of life care, as it does exactly what it says - it is a practical guide. It is written by an inter-professional group of clinical experts who have managed to create a concise, accessible resource which would be perfect for carers, volunteers, Health Care Support Workers or health care student working in any clinical setting who wants to make a difference for individuals approaching the end of their lives. The book addresses all of the important aspects of care at this crucial time, including attitudes to death and dying, communication issues, common physical and psycho-social symptoms, and care in the last hours of life. The case studies of three individuals are threaded throughout the book and are an excellent way to illustrate theoretical content and demonstrate its clinical application. The glossary of terms is particularly useful for a non-specialist audience, as are the resources for further reading. I particularly welcome the use of 'signposts' to different activities at key points which encourage the reader to reflect and apply the knowledge to their own situation. I highly recommend this book to any individual who wants to develop their confidence and competence in this challenging, but critically important area of care." Mick Coughlan, Programme Leader, The Royal Marsden School, UK "I found the chapters easy to read and the link to a case study really brought the words 'to life'. The chapter on self-care was helpful - this is an area hospice managers are having to focus on in detail as our staff strive to maintain the high levels of quality care hospices are renowned for with compassion and dignity . Giving emotional support throughout a shift to patients, families and colleagues can lead to a feeling of 'exhaustion' and 'fatigue', which if not recognised and addressed leads to time off sick and a feeling of being 'powerless' for staff . Healthcare professionals must recognise this as well as their managers, who then need to provide different levels of interventions that staff can access - as described in the book. I think all palliative care libraries should have this book on their shelves and perhaps it could be a 'core' reading book for training. I also used it on the ward to discuss with nurses - it's not that what is written is necessarily new but it is well written, concise and relevant. I feel this book would be very useful for those new to palliative care as well as those studying the subject. Relating theory to practice is always powerful and for new nurses and other healthcare professionals this provides context and meaning." Clodagh Sowton, Director of Patient Services, Phyllis Tuckwell Hospice Care, UK "This is a welcome book to the field of end of life care. This practical guide is accessible and is an excellent bridge between the 'Lay Person' and those health care professionals caring for the individual as they approach the end of life. The authors present their subject areas in a most readable and engaging style. While reviewing the case studies (which are weaved throughout the whole book); you feel they have come from experienced carers who have had 'lived experiences' of end of life care. This therefore, makes the chapters much more relatable and applicable to practice and real world life. This is also a personable book and I would recommend it to health care professionals and lay persons alike- who need to address or who may require further insight into the realms of: Physical/psycho-social symptoms, communication challenges and differential perspectives on dying and death. Finally, I will also be directing students of healthcare towards this impressive, insightful book." Robert Murphy, Senior Lecturer - Adult Nursing, London South Bank University, UK "The material covered is very helpful and the range of authors has been well selected from individuals who are active in clinical practice. The book is practical and clear, and Clair deserves high praise for the contribution it will make to clinicians seeking to improve their palliative care knowledge and skills." Professor Max Watson, Medical Director Northern Ireland Hospice, Visiting Professor University of Ulster, UK

Monitoring the Critically Ill Patient is an invaluable, accessible guide to caring for critically ill patients on the general ward. Now fully updated and improved throughout, this well-established and handy reference guide text assumes no prior knowledge and equips students and newly-qualified staff with the clinical skills and knowledge they need to confidently monitor patients at risk, identify key priorities, and provide prompt and effective care. This new edition includes the following five new chapters: * Monitoring the critically ill child * Monitoring the critically ill pregnant patient * Monitoring the patient with infection and related systemic inflammatory response * Monitoring a patient receiving a blood transfusion * Monitoring pain

This book introduces a process-based, patient-centered approach to palliative care that substantiates an indication-oriented treatment and radical reconsideration of our transition to death. Drawing on decades of work with terminally ill cancer patients and a trove of research on near-death experiences, Monika Renz encourages practitioners to not only safeguard patients' dignity as they die but also take stock of their verbal, nonverbal, and metaphorical cues as they progress, helping to personalize treatment and realize a more peaceful death. Renz divides dying into three parts: pre-transition, transition, and post-transition. As we die, all egoism and ego-centered perception fall away, bringing us to another state of consciousness, a different register of sensitivity, and an alternative dimension of spiritual connectedness. As patients pass through these stages, they offer nonverbal signals that indicate their gradual withdrawal from everyday consciousness. This transformation explains why emotional and spiritual issues become enhanced during the dying process. Relatives and practitioners are often deeply impressed and feel a sense of awe. Fear and struggle shift to trust and peace; denial melts into acceptance. At first, family problems and the need for reconciliation are urgent, but gradually these concerns fade. By delineating these processes, Renz helps practitioners grow more cognizant of the changing emotions and symptoms of the patients under their care, enabling them to respond with the utmost respect for their patients' dignity.

With the number of people requiring palliative and end of life care steadily increasing, it is the responsibility of every nurse, regardless of specialism, to know how to provide high quality care to this group of people. Yet caring for those nearing the end of life can throw up complex issues, including handling bereavement, cultural and ethical issues, delivering care in a wide variety of settings, symptom management and also ensuring your own emotional resilience. This book is specifically designed to equip nursing students and non-specialists with the essential knowledge in relation to the care and management of people nearing the end of life.

When a patient has an advanced disease, considerable demands are placed on the whole family. Whilst coping with their own profound emotions, close relatives commonly have to support their loved ones through a range of treatments as the disease progresses through stages of remission and recurrence, until finally, a shift to a palliative mode of treatment must be faced. In such situations, family roles and relationships are likely to be disrupted and family members? coping resources can be stretched to the limit. It is clear from this that by the time the terminal stage of the patient's illness is reached, the family may have travelled a long and difficult road, and close relatives are likely to be emotionally vulnerable and in need of support.This study explores the needs of relatives of terminally ill patients and the concerns of nurses who provide care in the hospital. The research data is used to design, implement and evaluate clinical standards for improved family support.

Eine beginnende Demenz wird oft verdrangt. Die Frage ist immer wieder: Ist das schon dement oder doch nur tudelig? Die Menschen wollen diese Krankheit nicht wahrhaben und doch nimmt sie ihren weiteren Verlauf. Es fehlt dabei oft die Zeit und die Musse sich umfassend uber Hilfsmoeglichkeiten und Erleichterungen zu informieren. Dieses Buch ist ein Leitfaden fur Angehoerige und Betreuende und will Mut machen fur einen wurdevollen Umgang mit den Betroffenen. Es werden Moeglichkeiten aufgezeigt, dieser Krankheit durch eine gezielte und begleitende Unterstutzung im eigenen Zuhause oder einer Pflegeeinrichtung zu begegnen. Unterschiedliche Stationen werden anhand von Fallerzahlungen anschaulich dargestellt und durch aktuelle medizinische und psychologische Informationen erganzt. Praktische Tipps und Hilfsangebote fur Angehoerige und Betreuende runden diesen Leitfaden ab.

Die Logopadie als therapeutischer Baustein findet nur langsam ihren Platz im interdisziplinaren Team des Palliative Care Settings. Dabei gehoert zu den Aufgaben von Logopad*innen und Sprachtherapeut*innen auch die Versorgung von schwerstkranken und sterbenden Menschen auf der Palliativstation, im Hospiz oder zu Hause. Bei neuro-palliativen Patienten stehen dabei die Behandlung von Schluck-, Sprach-, Sprech- und Stimmstoerungen im Fokus. Dieser Band 3 der dreibandigen Reihe geht auf das Umfeld von Angehoerigen und deren gezielten und professionellen Unterstutzung ein. Sie lernen Instrumente fur das Erkennen von Belastungsfaktoren kennen, wie Umfeldanalyse, Belastungswaage und SUD-Skala und koennen so gezielt auf eine Entlastung reagieren. In Band 1 erfahren Sie, welche Zielsetzungen, Massnahmen und Methoden der Bereich der palliativen Logopadie als neuer Fachbereich innerhalb der Logopadie einnehmen kann. Band 2 legt den Schwerpunkt auf Ethik, Beratung und Selbstfursorge.

Die Logopadie als therapeutischer Baustein findet nur langsam ihren Platz im interdisziplinaren Team des Palliative Care Settings. Dabei gehoert zu den Aufgaben von Logopad*innen und Sprachtherapeut*innen auch die Versorgung von schwerstkranken und sterbenden Menschen auf der Palliativstation, im Hospiz oder zu Hause. Bei neuro-palliativen Patienten stehen dabei die Behandlung von Schluck-, Sprach-, Sprech- und Stimmstoerungen im Fokus. In diesem Essential erfahren Sie, welche Zielsetzungen, Massnahmen und Methoden die palliative Logopadie als neuer Fachbereich innerhalb der Logopadie einnehmen kann. Dieser Band 1 beschreibt die Entstehungsgeschichte, Moeglichkeiten der Qualitatssicherung und Assessments im therapeutischen Alltag. Fallbeispiele geben wertvolle Tipps fur die Mundpflege und zum Thema Spiritualitat. Anamnese-, Beobachtungsboegen und ein Essensprotokoll unterstutzen die Verlaufskontrolle bei Schluckstoerungen. Band 2 beinhaltet die Themen Ethik, Beratung und Selbstfursorge, Band 3 das Thema Angehoerigenarbeit.

Die Logopadie als therapeutischer Baustein findet nur langsam ihren Platz im interdisziplinaren Team des Palliative Care Settings. Dabei gehoert zu den Aufgaben von Logopad*innen und Sprachtherapeut*innen auch die Versorgung von schwerstkranken und sterbenden Menschen auf der Palliativstation, im Hospiz oder zu Hause. Bei neuro-palliativen Patienten stehen dabei die Behandlung von Schluck-, Sprach-, Sprech- und Stimmstoerungen im Fokus. Die Foerderung von Ressourcen in der Kommunikation, beim Essen und Trinken und der Atmung sind fur Betroffene von grosser Bedeutung. Umso wichtiger ist es, Betroffene und Angehoerige fundiert zu beraten und zu begleiten. Ethische UEberlegungen fordern Therapeut*innen dabei heraus.In Band 1 erfahren Sie, welche Zielsetzungen, Massnahmen und Methoden der Bereich der palliativen Logopadie als neuer Fachbereich innerhalb der Logopadie einnehmen kann. Dieser Band 2 legt den Schwerpunkt auf Ethik, Beratung und Selbstfursorge, Band 3 auf eine praxisnahe Angehoerigenberatung.

Palliative care is an essential element of our health care system and is becoming increasingly significant amidst an aging society and organizations struggling to provide both compassionate and cost-effective care. Palliative care is also characterized by a strong interdisciplinary approach, and nurses are at the center of the palliative care team across settings and populations. The sixth volume in the HPNA Palliative Nursing Manuals series, Social Aspects of Care provides an overview of the financial and mental stress illness places, not just on the patient, but on the family as well. This volume contains information on how to support families in palliative care, cultural considerations important in end-of-life care, sexuality and the impact of illness, planning for the actual death, and bereavement. The content of the concise clinically focused volumes in the HPNA Palliative Nursing Manuals series is an ideal resource for nurses preparing for certification exams and provides a quick-reference in daily practice.

Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. 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.

Wish to die statements are becoming a frequent phenomenon in terminally ill patients. Those confronted by these statments need to understand the complexity of such wishes, so they can respond competently and compassionately to the requests. If misunderstood, the statements can be taken at face-value and the practitioner may not recognise that a patient is in fact experiencing ambivalent feelings at the end of life, or they may misinterpret the expressed wish to die as a sign of clinical depression. Public debate about the morality and ethics of various end-of-life care options has exploded in recent years. However, it has never been sensitive to the finer aspects of clinical reality or the experiences of patients. The Patient's Wish to Die: Research, Ethics, and Palliative Care brings together that reality and the patient's voice, combining them with different research approaches. It presents the best available knowledge and research methodologies about patients' wishes at the end-of-life, together with a series of ethical views and a discussion about the clinical implications for palliative care. The book presents material in an open and unbiased manner whilst remaining sensitive to the spiritual and existential dimensions of dying, and to the different cultural views that provide meaning to the individual. Written by the best specialists and ethics scholars from around the world, including palliative care practitioners and end-of-life scholars from countries where assisted dying practices are legalized and from those where it isn't, The The Patient's Wish to Die: Research, Ethics, and Palliative Care will prove essential reading for all those working or studying in the field of palliative care.

The care of patients with advanced and terminal illness can be extremely rewarding but often causes professionals a considerable amount of discomfort. This is especially so when you feel under confident in your abilities to provide a high quality of symptom management and relief from distress and to communicate appropriately with patients. Patients with advanced disease present some of the most challenging ethical, physical, psychological and social issues to clinicians and indeed to society. Patients need us to be knowledgeable, skilful and understanding. The fully revised and updated new edition of Palliative Care outlines the fundamental principles and facts which will enable you to make a very real difference to your patients and their families. Information is provided in an accessible, user-friendly way and covers a wide range of physical and non-physical symptom management. Multi-professional team work is addressed, as is the role and support of families. There is also a consideration of the dilemmas and decisions that may be encountered by doctors around the end of a patient's life. This practical resource, designed to provoke contemplative professional development, and enhance learning will be essential reading for nursing and medical practitioners, and other professionals who support patients in their homes, in care homes, and in hospital.

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.

From the internationally acclaimed author of the groundbreaking and award-winning book Dementia Beyond Drugs comes another eye-opening exploration of how to improve the lives of people with dementia and those who care for them. In this revised edition-including updated facts, studies, and terminology-Dr. G. Allen Power demonstrates how to achieve sustainable success in dementia care by changing the caregiving lens to focus on well-being and the ways in which it can be enhanced in people living with dementia. Revealing how drug-based interventions as well as completely holistic approaches consistently fall short of addressing and meeting the needs of people with dementia, this book offers a proactive approach-one that challenges widely accepted dementia care practices and provides a compelling new framework for developing more effective dementia services. Through in-depth examinations of seven domains of well-being, readers will discover how current care practices erode them, and the transformative approaches that can restore them, plus: how to apply a well-being approach to the everyday care of people living with dementia a highly adaptable framework that can be adopted in any living environment valuable insight on overcoming physical and operational barriers to well-being a wealth of person-centered, strengths-based approaches to care Filled with true stories that demonstrate the power of a well-being approach to greatly improve the lives of people with dementia as well as those who care for them, this book presents methods that promise a new and hopeful vision for achieving the best possible outcomes for every person living with cognitive changes. Readers will be challenged, motivated, and profoundly inspired.

The effective management of pain from cancer is a top priority for patients, carers and healthcare professionals, and has been the subject of extensive research. Approximately two-thirds of cancer patients will experience severe pain, and many of them will have more than one pain. However, because of the increasing number of available treatments for cancer, patients are surviving for longer periods, and are developing complex consequences of their cancer and its treatment, such as central and peripheral neuropathic pain syndromes. Approximately 8 - 10% of cancer pain remains unrelieved by conventional means.
Interventional cancer pain management implies the use of invasive techniques, such as neuraxial (epidural, intrathecal and intracerebroventricular) drug administration, brachial and lumbar plexus blocks, autonomic blockade, neurolytic blocks and cordotomy. It can also include TENS, acupuncture and complementary therapies. This book describes specifically the difficult pain problems that are now faced in palliative care and highlights the need for greater collaboration between the disciplines of pain medicine and palliative care. It refers to the psychological and spiritual needs of patients, and provides patient experience data on specialist techniques. The book is an invaluable resource for all healthcare professionals working in palliative care, pain management, and primary care to inform them about the range of interventional techniques available, with evidence of efficacy, side effects and management advice.

The need for renewal and support for those who care for seriously ill, dying, and bereaved people has been acknowledged from the very beginning of the hospice and palliative care movement. While often referring to the rewards and satisfactions of the work, Dame Cicely Saunders was the -first to acknowledge that helping encounters with dying patients and distressed relatives could be a source of anguish and grief for dedicated and compassionate carers. Caregiver Stress and Staff Support in Illness, Dying, and Bereavement discusses the challenge of finding a balance between the support needs of patients, families, and staff and the resources available. With contributions from practitioners and researchers from around the world, this book recognizes that palliative care today is being provided in many different settings and that there may be wide variations in the way individuals and organizations identify and manage the stressors that arise through the work. This unique collection of international perspectives on the complexities and management of caregiver stress and staff support builds on the firm foundation Mary Vachon built over thirty years ago in her studies, yet broadens the scope to include significant social, political, and cultural variations on the theme.

This is a practical, accessible guide for nurses on the management and care of the dying and deceased patient. It outlines the practicalities and legal issues associated with death, the principles of caring for a patient who is dying, and the principles of dealing with death, both expected and unexpected.

"Care of the Dying & Deceased Patient" explores all the practical issues surrounding death, including symptom control, resuscitation, organ donation, how to break bad news, the last offices, cultural issues, post mortems and documentation issues. It also explores both the legal and ethical issues involved- including withholding/withdrawing treatment, assisted euthanasia, patient's property, wills etc.

SPECIAL FEATURESA practical guide to the management of the dying and deceased patientOf use to all nurses and nursing studentsAccessible and user-friendlyWritten by an expert in the field

. Brings together a diversity of experience and perspectives of the use of narrative and stories, from leading international scholars and practitioners in the social sciences and palliative care
. Considers the value, use and impact of narrative approaches in the delivery of palliative and end of life care including narrative medicine, research, education, therapy, rehabilitation, patient particiption, spiritual care, family
and bereavement care
. Identifies methods of working more effectively with narrative in everyday clinical practice
. Engages with theoretical ideas and concepts from a range of disciplines
The use of narrative methods has a long history in palliative care, pioneered by Dame Cicely Saunders, founder of the modern hospice movement. Narrative and Stories in Health Care provides a vibrant, multidisciplinary examination of work with narrative and stories in contemporary health and social care, with a focus on the care of people who are ill and dying. It animates the academic literature with provocative 'real-world' examples from international contributors, including palliative care service users and those working in the social and human sciences, medicine, theology, and the creative arts.
Narrative and Stories in Health Care addresses and discusses key questions: What is a narrative? What is a story? What are some of the main methods and models that can be used and for what purposes? What practical and ethical dilemmas can the methods entail in work with illness, death and dying? As well as highlighting the power of stories to create new possibilities, the book also acknowledges the conceptual, methodological and ethical problems and challenges inherent in narrative work.
As the hospice and palliative care movement evolves to meet the challenges of 21st century health care, this fascinating book highlights how narratives and stories can be attended to in ways that are productive, ethical, and caring."