Given our aging population, there will sadly be an increasing number of terminally-ill patients over the next ten to twenty years. A Patient-Centered Approach to Medicine for the Terminally-Ill explains that a more humane patient-centered approach is necessary to ensure that terminally-ill patients are cared for effectively at the end of life. It is a well-known fact that terminally-ill patients are very difficult to care for by their physicians and other medical specialists, and paternalism is no longer a viable way of caring for the terminally-ill. In this book, Switankowsky argues that there are five conditions for physicians to bring about patient-centered medicine. These are: effective physician-patient disclosure of treatments, successful decision-making, effective communication, development of effective physician-patient relationships, and advance directives. By following these five necessary conditions, physicians could ensure that all terminally-ill patients die with some degree of dignity and are given essential, humane care until the end of their days.

This educational workbook helps people who build compassionate relationships with dying people. Accompanied by its trainer's guide, it presents a comprehensive, sequential learning program for caregivers in non-medical capacities covering everything from self-understanding to spiritual issues, listening skills and expressive activities, developing the skills, awareness and resilience needed for this privileged and sensitive role. The program includes a variety of learning experiences, including large and small group activities, discussion, close reading, creative writing, self exploration, and skill development and practice. This is an invaluable resource for small groups of individuals who wish to volunteer in hospice or palliative care settings. A copy of the guide for trainers is included in each pack of workbooks, and is also freely available online. 'The best resource I have seen to guide teachers and learners in this complex training process. I predict that those of you who try it with your staffs and trainees will find that it bears fruit both for your patients and their families, but also for the sustenance and personal development of the staff members themselves.' Timothy Quill, M.D., in his Foreword

This enlightening volume provides first-hand perspectives and ethnographic research on communication at the end of life, a topic that has gone largely understudied in communication literature. Author Elissa Foster' s own experiences as a volunteer hospice caregiver form the basis of the book. "Communicating at the End of Life" recounts the stories of Foster and six other volunteers and their communicative experiences with dying patients, using communication theory and research findings to identify insights on the relationships they form throughout the process. What unfolds is a scholarly examination of a subject that is significant to every individual at some point in the life process.
Organized chronologically to follow the course of Foster' s involvement with hospice and the phases of the study, the book opens with Part 1, providing background and contextual information to help readers understand subsequent stories about communication between volunteers and patients. Part 2 of the volume emphasizes the adjustments required by the volunteers as they entered the world of hospice and the worlds of the patients. Part 3 underscores the importance of improvisation and finding balance within the role of volunteer-- in particular how to be fully present for patients as well as their family members. The volume concludes with Part 4, which addresses how volunteers coped with the death of their patients and what they learned from the experience of volunteering.
"Communicating at the End of Life "is appropriate for scholars and advanced students studying personal relationships, health communication, gerontology, interpersonal communication, lifespancommunication, and communication & aging. Its unique content offers precious and meaningful insights on the communication processes at a critical point in the life process.

The needs of critically ill children are unique and highly specialized. "Paediatric Intensive Care Nursing" is an essential manual of care and an invaluable resource to all those involved in the care of critically ill children and young people. Covering all the key aspects of pediatric intensive care, it is a fully comprehensive textbook which provides an evidence-based and up-to-date guide for all nurses who work with critically ill children.

"Paediatric Intensive Care Nursing" is divided into four user-friendly sections: The first section looks at the general background of paediatric intensive careSection two employs a systems approach, with each chapter focusing on a specific disease and following the same framework. This includes treating children with cardiac conditions, acute neurological dysfunction, musculoskeletal injuries and gastrointestinal and endocrine conditionsSection three looks at the essential care of managing pain relief, transportation needs and treating woundsThe final section explores the holistic aspects of nursing - nutrition and fluid management, infection control issues, safeguarding children and spirituality and bereavement

Written by a team of experts in the field, "Paediatric Intensive Care Nursing" is indispensable reading for nurses and health care professionals working with critically ill children.

This book provides a clear approach to establishing a user involvement system in a healthcare organisation and its potential impact on cancer services. Using a tool kit style approach drawing on examples of successful past projects and case studies to provide evidence of good practice it describes how to plan and implement different stages of user involvement enabling organisations to draw on user experience and expertise to evaluate develop and improve the quality of service that they provide. Members of regional cancer networks multidisciplinary cancer care teams and all those involved in the NHS cancer services will find this toolkit interesting reading.

Taking as its focus a highly emotive area of study, The Dying Process draws on the experiences of daycare and hospice patients to provide a forceful new analysis of the period of decline prior to death.
Placing the bodily realities of dying very firmly centre stage and questioning the ideology central to the modern hospice movement of enabling patients to 'live until they die', Julia Lawton shows how our concept of a 'good death' is open to interpretation. Her study examines the non-negotiable effects of a patient's bodily deterioration on their sense of self and, in so doing, offers a powerful new perspective in embodiment and emotion in death and dying.
A detailed and subtle ethnographic study, The Dying Process engages with a range of deeply complex and ethically contentious issues surrounding the care of dying patients in hospices and elsewhere.

eBook available with sample pages: 0203130278

Taking as its focus a highly emotive area of study, The Dying Process draws on the experiences of daycare and hospice patients to provide a forceful new analysis of the period of decline prior to death.
Placing the bodily realities of dying very firmly centre stage and questioning the ideology central to the modern hospice movement of enabling patients to 'live until they die', Julia Lawton shows how our concept of a 'good death' is open to interpretation. Her study examines the non-negotiable effects of a patient's bodily deterioration on their sense of self and, in so doing, offers a powerful new perspective in embodiment and emotion in death and dying.
A detailed and subtle ethnographic study, The Dying Process engages with a range of deeply complex and ethically contentious issues surrounding the care of dying patients in hospices and elsewhere.

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America s project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients'rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

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.

"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.

Spirituality and Coping with Loss: End of Life Healthcare Practice describes a research study that reflects nurses' experience of the nature of loss encountered in end of life care settings as well as the ways in which spirituality is a resource in coping in these situations. Key findings indicate how nurses' spiritual development impacts their proficiency in spiritual care. These findings will be of interest to nurses and nurse educators as well as other healthcare professionals.

At the end of life, our comfort lies mainly in relationships. In this book, Daniel Miller, one of the world's leading anthropologists, examines the social worlds of people suffering from terminal or long-term illness. Threading together a series of personal stories, based on interviews conducted with patients of an English hospice, Miller draws out the implications of these narratives for our understanding of community, friendship, and kinship, but also loneliness and isolation. This is a book about people's lives, not their deaths: about the hospice patients rather than the hospice. It focuses on the comfort given by friends, carers and relatives through both face-to-face relations and, increasingly, online communication. Miller asks whether the loneliness and isolation he uncovers is the result of a decline of English patterns of socialising, or their continuation. This moving and deeply humane book combines warmth and sharp observation with anthropological insight and practical suggestions for the use of media by the hospice. It will be of interest not only to students and scholars of anthropology, sociology, social policy and media and cultural studies, but also to healthcare professionals and, indeed, to anyone who would like to know more about the role of relationships in the final stage of our lives.

When Professionals Weep speaks to the humbling and often transformational moments that clinicians experience in their careers as caregivers and healers-moments when it is often hard to separate the influence of our own emotional responses and worldviews from the patient's or family's. When ProfessionalsWeep addresses these poignant moments-when the professional's personal experiences with trauma, illness, death, and loss can subtly, often stealthily, surface and affect the helping process. This edition, like the first, both validates clinicians' experiences and also helps them process and productively address compassion fatigue, burnout, and secondary traumatic stress. New material in the second edition includes increased emphasis on the burgeoning fields of hospice and palliative care, organizational countertransference, mindfulness, and compassionate practice. It includes thought-provoking cases, self-assessments, and exercises that can be used on an individual, dyadic, or group basis. This volume is an invaluable handbook for practitioners in the fields of medicine, mental health, social work, nursing, chaplaincy, the allied health sciences, psychology, and psychiatry.

The fifth edition of this seminal reference and text in palliative care nursing helps the practitioner and student offer comprehensive, targeted interventions responsive to the needs of palliative and hospice patients and families. Based on the best level of evidence available, reference to clinical practice guidelines, and palliative care order sets to address critical symptoms, the knowledge presented in this edition supports compassionate, timely, appropriate and cost-effective care to achieve quality health outcomes for diverse palliative care populations across the illness trajectory. Noteworthy features of the new edition include broadening population health management by helping the reader to identify patterns and connections within and across population and utilize information to respond to the needs of populations. This strategy allows the reader to apply strategies that are consistent with IHI's Triple Aim that includes Improving the patient experience of care, Improving the health of populations and reducing the per capita cost of health care. Every Chapter in Sections 1, 2, and 3 includes an Evidence Based Box with a current study including a commentary written by someone from a discipline other than nursing or by an interdisciplinary team.

In this extraordinary book, Iona Heath draws on her experience as a general practitioner to select and comment on a collection of passages concerning death and dying, and to consider the essential nature of general practice. In Ways of Dying Heath illuminates the process for professionals and lay readers, and stimulates consideration of approaches to improved care at end of life. Her renowned work The Mystery of General Practice (which has been unavailable for some time), considers the complex character of this field, its core values and changing roles. The two extended essays cover important issues on the role of the healthcare professional in the care of the dying, the idea of life and death, and the essential nature of general practice. Matters of Life and Death offers inspiration for all doctors, especially those with an interest in medical humanities. It will also be of great interest to general readers interested in end of life matters, and the nature and art of medicine.

"Children's palliative care is an evolving specialty and as such our knowledge base cannot remain static. This book constantly challenges the reader to critically analyze their own practices and beliefs within an evidence-based framework and as such makes a valuable contribution to the growing body of knowledge on this important subject." - Susan Fowler-Kerry, in the Foreword. This book caters for readers from different working environments and levels of experience. It is ideal for paediatric nurses with no specialist palliative care knowledge, and also for palliative care nurses with no specialist paediatric experience. Other healthcare professionals and therapists working with children, young people and their families will also find this book invaluable. It will also be ideal for undergraduate and postgraduate health and social care students, and professionals involved in children's hospices, community services and charity groups. "This book captures not just the rapidly evolving evidence base, but also as many current developments as possible and applies them in a meaningful way to the care of infants, children, and young people living with life-limiting illness, and their families. It offers an overview of contemporary issues and helps to stimulate the type of dialogue that can bring about the actions that will make a real difference for the children, young people and families in our care." - Rita Pfund, in the Preface.

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.

'This book is a tribute to expert nursing. It should be seen as a celebration of all that is good in nursing. It also sets out the path for nursing that is centred on relationships - the essence of person-centred nursing is based on the quality of relationships both between nurse the client and others and also between nurses their colleagues and peers. Increasingly it is a challenge for nurses to hold on to humanistic care when we practice in a world of healthcare which is performance and fiscally driven. The concept of partnership and reciprocity runs through the book like a golden thread gleaming in a rich tapestry of person-centred practice expressed via the perspectives of the contributors. Expert practitioners working with people who have dementia have led the way in the development of person centred practice.' Pauline Ford Advisor in Gerontological Nursing Royal College of Nursing 'This book is a compendium of contemporary dementia care practice. It provides knowledge that is the foundation for a clear path to successful care outcomes. It clearly leaves no room for the ignorance that produced the uncertainty and inconsistency of past practices. If dementia can be likened to a journey of highs and lows this book shows us how to eliminate the negatives and accentuate the positives.' Bob Price Director Alzheimer Education Australia

This book explores the Care Trust concept promoted by central government for improving partnership working between health and social care. Using case studies and examples to raise current issues related to partnership working it explains how Care Trusts are bridging the gap between health and social care and considers how they are delivering more co-ordinated services and improved outcomes. All healthcare and social care professionals with responsibility for involved in or affected by the new partnership working arrangements will find this book useful reading.

Concerned with practices in palliative care, this text focuses on the psycho-social aspects of palliative care as opposed to the medical and nursing dimensions. Beginning with a framework of the interdependence of all aspects which is characteristic of the holistic nature of the subject, the book is intended to help readers identify the principles which underpin good practice in the non-medical dimensions in palliative care. The book caters for the professional reader and should be relevant to nurses, doctors, physiotherapists, occupational therapists and managers, as well as social workers undertaking professional training and working in palliative care.

Use of the arts in palliative care settings is a powerful and effective way of addressing the practical, psychological, social and spiritual issues faced by service users in end-of-life care. The Creative Arts in Palliative Care uncovers the possibilities for using the creative arts and provides guidance on how to implement arts projects successfully. Part 1 focuses on designing objectives for the creative arts in palliative care - such as self-fulfilment, social participation, diversion from pain and other common symptoms - and managing creative arts services. Part 2 demonstrates the theory and principles in practice, with detailed case studies: each chapter draws on a real-life project, the approaches it employed and the outcomes achieved. This book will be essential reading for healthcare professionals, arts practitioners and all those involved in providing palliative care services.

This book will be the first of its kind to offer intensive conversation analysis on patient-clinician interactions in the context of palliative medicine. The book focuses on a series of individual case studies of conversations that revolve, in each case, around one key critical term that is often evoked or understood differently by clinicians and patients.

Communication is at the heart of any complete understanding of the end of life. While it is true that individuals physically die as a single entity, the process of ending an individual life is located within a complex system of relationships and roles connected and constructed through communicative processes. In this volume, top scholars from numerous disciplines showcase the latest empirical investigations and theoretical advances that focus on communication at the end of life. This multi-contextual approach serves to integrate current findings, expand our theoretical understanding of the end of life, prioritize the significance of competent communication for scholars and practitioners, and provide a solid foundation upon which to build pragmatic interventions to assist individuals at the end of life as well as those who care for and grieve for those who are dying. This book is suitable for undergraduate and graduate courses in Death and Dying, Communication and Aging, Health Communication, Life Span Development, Life Span Communication, Long term care, Palliative care and Social Work.