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.

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.

"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.

Palliative and end of life care are an essential component of nursing practice. This book provides students with the key information they need to deliver effective and safe end of life care for patients and their families. Crucially, it also creates opportunities for them to reflect on their own perspectives on death and dying and explore the impact of this on their practice. Key features Fully mapped to the NMC standards of proficiency for registered nurses (2018) Helps you to develop a holistic understanding of the fundamental principles and practice of palliative and end of life care Activities encourage you reflect on your own perspectives of death and dying and to consider the impact this has on your practice Case studies bring the theory to life and illustrate the real world applicability

Fundamentals of Palliative Care for Student Nurses is a thorough yet accessible introduction and overview of a key area of the nursing programme. This textbook clearly explains the palliation of symptoms and the social context of death and dying. Engaging with the latest guidelines and curriculum, it highlights the practical and communicative skills required for induction programmes and continuing professional development. KEY FEATURES: * A full-colour, student-friendly, introduction to the essentials of palliative, or end of life care * A topical and timely subject area, explored clearly and concisely * Full of interactive pedagogy and features, including quizzes, multiple choice questions, vignettes/case studies and activities * Features a companion website with links to further reading, additional activities and resources, and self-testing interactive multiple choice questions Fundamentals of Palliative Care for Student Nurses focuses on this area with expert knowledge and compassion, preparing students in order to help them provide the best possible care for their patients and their families.

Christopher Kerr is a hospice doctor. All of his patients die. Yet he has tended thousands of patients who, in the face of death, speak of love, meaning and grace. They reveal that there is hope beyond cure as they transition to focus on personal meaning. In this extraordinary and beautiful book, Dr. Kerr shares his patients' stories and his own research pointing to death as not purely the end of life, but as a final passage of humanity and transcendence. Drawing on interviews with over 1,200 patients and more than a decade of quantified data , Dr. Kerr reveals why pre-death dreams and visions are remarkable events that bring comfort and exemplify human resilience. These are not regular dreams. Described as "more real than real," they frequently include loved ones long gone and mark the transition from distress to acceptance. These end-of-life experiences help patients restore meaning, make sense of the dying process and assist in reclaiming it as an experience in which they have a say. They also benefit the bereaved who get relief from seeing their loved ones pass with a sense of calm closure. Beautifully written with astonishing stories, this book, at its heart, celebrates the power to reclaim how we die, while soothing the bereaved who witness their loved ones go with unqualified grace.

Dame Cicely Saunders was the founder of the Hospice Movement, in which Britain leads the world. Her work transformed our approach to the care of the dying, and also the debate about euthanasia. She died in 2005 and her memorial service was held in Westminster Abbey in March 2006. Over 1600 people attended. This biography, by Shirley du Boulay, includes a 4-page plate section and new chapters by Marianne Rankin covering the years after 1984.

Medical futility is a controversial issue not only in its definition but also in its application. There are few books on the subject, and those in existence mostly focus on the situation in the United States. This title, however, provides extensive international perspectives on medical futility.This book will benefit healthcare professionals as well as health policy makers around the world. It allows them to see how different countries approach the issue of medical futility and their experiences in dealing with this issue. The complexity of the issue, and in particular how some countries innovatively address it in an ethically sound manner, is clearly presented.

It was a low-level panic at first, but very quickly there were big changes taking place. Day by day, wards were being cleared to make way for Covid-positive patients. Things were getting worse by the day. For the first time in my nursing career, I felt scared. As a palliative care nurse, it is Kelly Critcher's job to look death in the eye - to save a patient while the fight can still be won, and confront life's end with grace and kindness when it can't. In early 2020, everything changed for nurses on the NHS front line. Working on Covid wards and the High Dependency Unit, Kelly spent the height of the coronavirus crisis at Northwick Park hospital - perhaps the UK hospital most deeply ravaged by the illness. She, and many others like her, battled tirelessly in a critical care unit pushed to breaking point, delivering the bad news and fighting the good fight, day-in, day-out, throughout the gravest test our health service has faced since its inception. Kelly's story weaves together her raw, emotional diaries from the COVID frontline with a broader reflection on the truths about a life spent caught between battling for her patients' lives and helping them face down death with courage and compassion. Bringing together the enormity of the last twelve months - and the scars it will leave - this is a book for our times.

Help families of institutionalized elders with this compassionate and practical manual.

This volume reviews the state of the art in caring for patients dying in the ICU, focusing on both clinical aspects of managing pain and other symptoms, as well as ethical and societal issues that affect the standards of care recieved, The book also addresses the changing epidemiology of death in this setting related to managed care, practical skills needed to provide the highest quality of care to terminal patients, communicating with patients and families, the mechanics of withdrawing life supporting therapies, and the essential role of palliative care specialists in the ICU. The book briefly describes unique issues that arise when caring for patients with some of the more common diseases that preciptate death in the ICU. Contributors for the book were chosed because they have experience caring for patients in the ICU, and are also doing curent research to find ways to improve care for terminal patients in this setting.

This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author's research-based CARES Tool, a reference that synthesizes five key elements demonstrated to enable a peaceful death as free from suffering as possible: Comfort, Airway Management, Management of Restlessness and Delirium, Emotional and Spiritual Support, and Self-Care for Nurses. The book describes step-by-step how nurses can easily implement the basic tenets of the CARES Tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible. The book identifies the most common symptom management needs in dying patients and describes in detail the five components of the CARES paradigm and how to implement them to enable a peaceful death and minimize suffering. It includes palliative care prompts founded on 29 evidence-based recommendations and the National Consensus Project for Palliative Care Clinical Practice Guidelines. The resource also addresses the importance of the nurse to act as a patient advocate, how to achieve compassionate communication with patient and family, and barriers and challenges to compassionate care. Additionally, the book discusses how to translate current research into effective practice, and how to practice self-care. Case studies emphasize the importance of compassionate nursing care of the dying and how it can be effectively achieved. Key Features: Provides nurses with clear understanding of the most common needs of the dying Supplies practical, evidence-based applications to facilitate and improve care of the dying Clarified the current and often complex literature on care of the dying Includes case studies illustrating the most common needs of dying patients and how these are addressed effectively by the CARES tool Based on extensive evidence as well as the National Consensus Project for Palliative Care Clinical Practice Guidelines.

The concept of a "good death" has been hotly debated in medical circles for decades. This volume delves into the possibility and desirability of a "good death" by presenting the psychosocial measures of care as a crucial component, such as religion, existentialism, hope and meaning-making. The volume also focuses on oncologic psychiatry and the influence of technology as a means to alleviate pain and suffering, and potentially provide relief to those at the end of life. Such initiatives are aimed at diminishing pain and are socially bolstering and emotionally comforting to ensure a peaceful closure with life as opposed to a battle waged. Utilizing the most recent information from medical journals and books to present the latest on healthcare and dying today, this volume crosses the boundaries of thanatology, psychology, religion, spirituality, medical ethics and public health.

Intensive care units (ICUs) provide comprehensive, advanced care to patients with serious or life-threatening conditions and consequently, a significant amount of end-of-life care (EOLC). Indeed, approximately 20% of deaths in the U.S. are associated with an ICU stay, and nearly half of U.S. patients who die in hospitals experience an ICU stay during the last 3 days of life. Despite the commonality of the ICU experience, ICU patients typically suffer from a range of distressing symptoms such as pain, fatigue, anxiety, and dyspnea, causing families significant distress on their behalf. Thus, there is a growing imperative for better provision of palliative care (PC) in the ICU, which may prevent and relieve suffering for patients with life threatening illnesses. Effective palliative care is accomplished through aggressive symptom management, communication about the patient and family's physical, psychosocial and spiritual concerns, and aligning treatments with each patient's goals, values, and preferences. PC is also patient-centered and uses a multidisciplinary, team-based approach that can be provided in conjunction with other life-sustaining treatments, or as a primary treatment approach. Failure to align treatment goals with individual and family preferences can create distress for patients, families, and providers. If implemented appropriately, palliative care may significantly reduce the health care costs associated with intensive hospital care, and help patients avoid the common, non-person centered treatment that is wasteful, distressing, and potentially harmful. Due to the success of many PC programs, administrators, providers, and accrediting bodies are beginning to understand that palliative care in the ICU is vital to optimal patient outcomes.

There are few enough studies of the needs of dying people in the Western world, but no accessible studies of the needs of dying people in Asian cultures. Now, in this pioneering work, Dr Mui Hing June Mak shows us how a Good Death expresses itself in Hong Kong, and also how this ideal varies and is modified in other Asian societies as this is observed in their own, often inaccessible literature. The author offers a comprehensive review of the literature on dying conduct and needs from several Asian perspectives, and also provides a perceptive analysis of the lessons to be learnt from her qualitative study which employed a 'Grounded Theory' methodology to understand the experiences and end-of-life needs of cancer patients in hospice care in Hong Kong. A relation-based theory, Harmonious Death, is developed. She also makes several suggestions to translate these theoretical concepts into practice. Dr Mak brings to her words not only the disciplined eye of a hospice clinician and academic but also a compassionate insight derived from her direct personal experiences. Close, personal relationship with three dying people were formative of her current research and professional interests, and also the driving concern in ensuring that the voices of all the participants in her study are heard clearly, sympathetically, and poignantly. Audience: The book will be of interest to teachers, students and professionals across the whole range of health and social care and social work, particularly those in palliative or hospice settings, as well as well as those with an interest in behavioural and social sciences, anthropology, philosophy, thanatology, not to mention the humanities. Contents: Foreword by Professor Allan Kellehear . literature review . Western and Chinese perspectives on death and dying . the research study . elements of a Good Death in Chinese culture: awareness of death; maintaining hope; freedom from pain and suffering; maintaining social relations; experiencing personal control; preparation and bidding farewell; accepting the timing of one's death A Harmonious Death, The Good Death models . Conclusions and recommendations for hospice philosophy, education, research and health policy

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.

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.

This is a comprehensive account of the psychology of death and bereavement, which places the subject within the contexts of the major world religions and their associated mourning and funeral customs. Clearly written, well referenced and carefully organized, the book examines the thinking of Freud and Jung and of modern psychiatrists, and also discusses those aspects of death - bereavement visions, euthanasia, grief for a pet and suicide - which are not covered elsewhere.The second edition has enabled the contents to be updated and enlarged. There are five new chapters, including one dealing with the scientific assessment of death: another looks at the psychological insights provided by Shakespeare, whilst a third deals with the beliefs and customs of minority groups - the Bahais, Jehovah's Witnesses, Mormons, Quakers, Spiritualists and Seventh-day Adventists. The text is highly accessible and uses case histories to bridge the gap between theory and experience in an novel and creative way.

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