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.

Over a period of almost 10 years, the work of the Project on Death in America (PDIA) played a formative role in the advancement of end of life care in the United States. The project concerned itself with adults and children, and with interests crossing boundaries between the clinical disciplines, the social sciences, arts and humanities. PDIA engaged with the problems of resources in poor communities and marginalized groups and settings, and it attempted to foster collaboration across a range of sectors and organizations. Authored by medical sociologist David Clark, whose research career has focused on mapping, archiving and analyzing the history and development of hospice, palliative care and related end of life issues, this book examines the broad, ambitious conception of PDIA - which sought to 'transform the culture of dying in America' - and assesses PDIA's contribution to the development of the palliative care field and to wider debates about end of life care within American society. Chapters consider key issues and topics tackled by PDIA grantees which include: explorations of the meanings of death in contemporary American culture; the varying experiences of care at the end of life (in different settings, among different social and ethnic groups); the innovations in service development and clinical practice that have occurred in the US in response to a growing awareness of and debate about end of life issues; the emerging evidence base for palliative and end of life care in the US; the maturation of a field of academic and clinical specialization; the policy and legal issues that have shaped development, including the ethical debate about assisted suicide and the Oregon experience; the opportunities and barriers that have been encountered; and the prospects for future development. A final chapter captures developments and milestones in the field since PDIA closed in 2003, and some of the challenges going forward.

Over the last thirty years, the concern of Pain Medicine practitioners about the potential for their patients to develop a dependence on opioids has left opioid therapy as a largely underutilized treatment. While there is no simple answer to chronic pain, opioids remain the only class of drugs capable of providing relief to patients experiencing serious pain. Opioid Therapy in the 21st Century, Second Edition fills a dearth of clinical knowledge about analgesics to aid practitioners in weighing the risks versus the benefits of opioid therapy for their chronic pain patients. Part of the Oxford American Pain Library, this concise guide serves as a practical, user-friendly reference for physicians across the range of primary care and medical specialties. It includes an overview of appropriate clinical applications of opioids, covering such topics as opioid pharmacology, route selection, and individualization of therapy, as well as strategies for managing and mitigating the risk of abuse, addiction, and diversion. There are also special sections dedicated to the unique needs of pediatric, geriatric, and palliative care patient populations. This second edition discusses opioids approved for use since publication of the first edition, such as Butrans (buprenorphine patch); fentanyl patch and nasal spray; abuse resistant version of Oxycontin; and Embeda (morphine sulfate). Approved indications for older opioids as well as clinical trial information have also been updated.

Participatory research is a relatively new method of researching practice especially within palliative care. It differs from other methodologies in that there is an expectation of action within the research process. The values that underpin participatory research are collaboration, empowerment, and reflection. In the current climate of collaboration and working with people in healthcare, participatory research methods are gaining increasing interest when there is a desire to bring about change. Organisational change is becoming an important focus as we look at ways of not only reducing costs but at the same time improving quality of care. While palliative care puts the patient and family at the centre, Participatory Research in Palliative Care discusses a new research methodology that puts practitioners at the heart of the research process as collaborators who work together with researchers to resolve problems in practice. Divided into three sections, it provides theoretical groundings of action research, a greater focus on exemplars from studies within palliative care, and discusses prominent issues when using such a methodology. All three sections are illustrated by an action research study undertaken by the author within a palliative care setting. Participatory Research in Palliative Care is written by international, multi-disciplinary authors who explore a collaborative approach to embark on research. It will appeal to health and social care professionals, academics undertaking research within palliative care, and the management of organisations where people with end of life care needs are cared for, including long-term care homes.

You're returning home from a conference at the other end of the county, switch on the answering machine at two in the morning and hear the words, "I'm dying." First, you know it just can't be true-she's been a hypochondriac all her life-but this time it may be. How do you literally drop a full life overnight to run a home hospice? This book is written by a younger sister, a psychotherapist and Psychosynthesis trainer. It's a story we all need to know as the population grows older, and most become caregivers in the home at some point. Included are many useful quotes, references from experts like James Pennebacker and Steven Levine, and the author's reflections. CYNTHIA PINCUS RUSSELL Russell, PhD, has published extensively in both general and academic periodicals. She teaches and supervises Psychosynthesis, collecting techniques from a variety of cultures for rapid recovery and growth. Dr. Russell has also been on the clinical faculty at Yale School of Medicine for years and served as Assistant Clinical Professor in Psychiatry (Psychology) as a supervisor. Her writing includes three books, dozens of articles, research on adult development and depression, poetry, non-fiction and fiction. Her book, "Double Duties," was a Woman Today Book Club selection, and Book of the Year of the New Haven Public Library. An essay, "Coming Home," was reprinted in seven languages. Recent publications include the poem "Memorial Day" in "Beyond Lament," an anthology of poems on the Holocaust, and poems in "Castalian Springs," "Orange Willow Review," "Red Oak" and many others. Articles have appeared in "The New York Times," "Parents," "Columbia," and other periodicals. Her "Patient as Teacher" program represents twelve years of research and interviews, and has been excerpted on line by the Yale School of Medicine.

When you or a loved one are diagnosed with a terminal illness, you wonder what can be done to make life easier and more meaningful during the remaining time on earth. In "A Hospice Guide Book, " author Dr. Curtis E. Smith shows how the concept of hospice, which emphasizes the important provisions of comfort care through the end-of-life journey, can help terminal patients die a comfortable, peaceful death with dignity.

A resource for families, patients, and health care providers, "A Hospice Guide Book" provides a thorough explanation of the hospice concept. It discusses
the definition of hospice care and its origins;
hospice fallacies, myths, and facts;
alternative care modalities;
the hospice team and its responsibilities;
levels of care and treatment;
pain and pain management;
hospice residences;
end of life care.

"A Hospice Guide Book" presents a plethora of information about hospice, enabling those who could become hospice patients the opportunity to receive the benefit of expert comfort care; pain control management; symptom control; and emotional, spiritual, and psychosocial support as they live with their terminal illness during the end-of-life journey and peacefully transition from this life to the next.

Caregivers. Beyond tired, beyond stressed, they hunger for a glimmer of hope. You can see it in their eyes and hear it in their voices. They are stretched way too thin and panic simmers just under the surface. What if the next thing to go wrong makes them snap? With Each Passing Moment, a devotional memoir, offers hope and encouragement for weary caregivers. The short chapters are arranged alphabetically by emotional, physical, and spiritual needs that caregivers face daily.

Grief is a very individual experience and it can impact all aspects of a person's life. Parents and Bereavement: A Personal and Professional Exploration of Grief brings together latest research and practice from the pioneering children and young adults' hospice - Helen and Douglas House, alongside the personal experience of a parent. The book includes information on a range of challenges faced by parents, including supporting surviving children, making challenging decisions about subsequent pregnancies, managing the impact of grief on relationships, and facing birthdays and anniversaries. It discusses both, the theories and the day-to-day experience of grief, and what might make a difference to how people manage it. This will be an invaluable resource for professionals involved in supporting families with end of life care and bereavement issues, including palliative care professionals, counsellors, and social workers. Parents and Bereavement will also help parents, family, and friends to understand and support each other through such loss.

This book is about the journey of dealing with ALS (Lou Gehrig's Disease). My wife Kenni Spencer, contacted this "evil disease" in 2009 and none of us even knew what it was nor what to expect. As with all terminal diseases, the print journey, is usually defined in words of hope, thankfulness, and new experiences. STOP...this book is about the "real face" of ALS. It charts the known's, the unknowns, the fears, the hopelessness, and the frustrations. This book shares the rawness and frankness of the ALS disease journey. It shares the whole dynamics that this disease manifests itself within the family structure. This book, the true face of ALS (Lou Gehrig's Disease), is not to enjoy, but to clarify and understand the reality of it's impact. There is this huge degree of hopelessness for ALS victims. I am hoping that by writing this book, and explaining the journey, some bits of hope can be realized for futures to come.

As a doctor at the end of a 24-hour shift in the intensive care unit, it's usually easy for me to fall asleep. Exhaustion hits me like a rock and it doesn't matter that the morning sun is pouring into my bedroom. After so many long hours of fighting for life and pushing back death, when I finally hit my bed and close my eyes, the next day arrives in an instant. Except for that one day when I couldn't sleep no matter what I tried. Saddened from seeing the familiar turmoil as my patients' families were caught unprepared, confused and distraught by an unexpected medical disaster, I tossed and turned in bed. In the ICU, every day is about people with devastating illness, the fragility of our bodies, and our mortality. There are lots of questions. Should we pursue aggressive, possibly painful interventions, or should we shift our focus and allow a natural and peaceful passing? In the end, it usually comes down one question: "What should we do?" It's an impossible question, for which there is only one, impossible answer. It's up to you. I decided to write Last Wish to help my patients and everyone who reads this book be better prepared to answer that question. My patients allowed me to share their stories as they struggled with life, death and somewhere in-between so that their victories and also their failures could help you think about your own wishes and those of your loved ones, and be better prepared if you're faced with an unexpected tragedy. In this book, just as with my patients, I'm not advocating any particular path, just showing you what the road might look like so you can consider the issues. I hope Last Wish will provide some insight for you and your family. At the very least, I hope it sparks discussion and helps you to consider planning for the inevitable mortality we all face. Lauren Van Scoy, M.D.

The Oxford Handbook of Palliative Care covers all aspects of palliative care in a concise and succinct format suited to busy professionals who need to access key information in their daily care of patients.
This new edition is revised throughout, with an additional emphasis on the nursing aspects of Palliative Care. The authors have included new sections on international palliative care, self care and liaison palliative care in acute hospitals. There is also extended material on the use of antibiotics, palliative care research and quality of life issues.
The second edition of the Oxford Handbook of Palliative Care continues to be an invaluable resource for all health professionals working with adults, children and families with palliative care needs.

John Chuchman, Pastoral Bereavement Educator and Companion shares his Grief and Caregiving workshop and seminar materials and background information hoping to help anyone experiencing a loss in life and anyone wishing to improve his/her basic caregiving skills.

A clinical case-based handbook has a role in general clinicians' practice of caring for patients with serious or life-limiting illness. The explosion of the field of Hospice and Palliative Medicine impacts all physicians and healthcare providers. Fellowship trained s- cialists graduate in greater numbers annually. These and more seasoned specialists are now certified by the American Board of Medical Specialties as subspecialists. Research in this field is expanding in scope and quantity, and peer reviewed journals devoted to this work are multiplying. Moreover, peer reviewed journals in primary care and other subspecialties of medicine regularly include papers that focus on end-of-life care, quality of life issues, and symptom management. Overall then, access to clinical information necessary to care for patients with life-limiting illness is not only essential, but also increasingly available. This case-based clinical book aims to help with the actual practice of caring for patients with life-limiting illness. Numerous texts and journals exist to provide the data to inform care, yet there remains a need to find practical points and information about the practical application of the principles of palliative care. Thus, we hope that the cases, key points, and practical tips will help health care providers who are not experts already in palliative care in the care of patients with serious illness and challenging problems. Some chapters follow one patient through the course of an illness to highlight the applicability of palliative care throughout the disease process.

Author Tom Preston, MD, and his terminally ill patients and their families often face the controversial predicament of how to die when suffering has been medically extended. Through their conversations, they demonstrate how dying is a process, how physicians alter when and how we die, and why "natural" death is a misnomer after medical interventions prolong the process. Their cases also explain why patients-not physicians or others-should be able to make their own decisions about when and how to die.

Dr. Preston gives compelling reasons as to why aid-in-dying is not suicide when used by terminally ill patients, and why physicians who help them die are not assisting suicide. He shows us the ethical aspects of aid-in-dying and how they are consistent with other current and legal medical practices that help patients end their suffering. He debunks claims that legalized aid-in-dying would be abused for financial, social, or political reasons. Dr. Preston also shows how outdated cultural attitudes impede society's understanding of how we die, why many physicians withdraw from their dying patients, and how the sanctity-of-life principle has become distorted to obstruct physician assisted deaths.

"Patient-Directed Dying" is a powerful manifesto calling for mercy and reason in helping terminally ill patients die a peaceful death.

Riveting in their emotional clarity and utterly jargon free, these 30 stories from real life penetrate how we grieve and how we can help those who grieve- whether the griever is oneself, someone we care about, or a client or patient. Lynne Dale Halamish, an internationally respected grief counsellor with more than 20 years' experience, and Doron Hermoni, a family physician, researcher, and educator, present vignettes from practice that show how death- lingering, unexpected, violent, or self-inflicted- and the loss of a relationship- to oneself or with a child, sibling, parent, mate, grandparent, or friend- give life to grief, together with the process by which each person fully encounters his or her grief. Each story is no more than two or three pages, and the authors follow each one with a short summary of its teachings and a selection of annotated recent references for those who wish to read more about a topic. Looked at in relief, the stories reveal a master grief counsellor at work.

Improving care for the patients who are in the last phase of their lives has been a field that most health care providers have struggled with during last few years. Having worked with hundreds of providers throughout the country, these experienced authors know what providers need when it comes to implementing a quality improvement project. This guide will provide user-friendly, step-by-step instructions on how to implement a quality improvement project in the full range of care settings. The instructions will be brought to life with specific examples from actual successful projects and key information on the best practices in the industry. Readers will also be pointed to resources available online and elsewhere, with information on how to access them. The guide will be written in an informal, maximally helpful style, with checklists, tables, and boxed information. Answering 80% of the questions in less than half the space, The Common Sense Guide is the perfect portable companion to Dr. Lynn's desk reference, Improving Care for the End of Life. The book will be of great interest to all health care professionals involved in the care of those with serious chronic illness -- doctors, nurses, social workers, chaplains, clinic administrators, quality improvement experts, and so forth.

"The Oxford Handbook of Oncology" is a practical guide to the clinical consultation in oncology. Covering the scientific basis, as well as diagnosis, it includes investigations, management and palliative care issues in cancer. It has been extensively revised and updated for the new edition to reflect recent advances in oncology with particular emphasis on new therapies. It includes new approaches to diagnosis and treatment and there is an expanded section on oncological emergencies with practical advice for immediate patient management. The first part covers the general principles of cancer aetiology, the key treatment modalities, namely, surgery, radiotherapy, chemotherapy, and hormone therapy, and the development of novel therapies through clinical trials. This is followed by a systematic account of the current management of individual cancers according to their site of origin. Each chapter includes epidemiology, pathology, staging, treatment, and prognosis. This part also contains an outline of current areas of research and appropriate references to guide the reader to more detailed oncology publications. The third part of the book provides information to aid in the day-to-day management of cancer patients, including practical advice on symptom control and the assessment and treatment of oncological emergencies. This handbook is the essential guide to practical management of everyday clinical situations and will be invaluable to junior doctors in oncology, palliative care and general medicine, as well as specialist nurses, general practitioners, medical students, pharmacists and professions allied to medicine.

This book tells the story of a caregiver for a person who is seriously ill of cancer. It is of help to both the caregiver and the person suffering from illness. It offers physical, mental, emotional, and spiritual suggestions to help with the process of the disease, and, if it comes to that, dying. The book's information is valuable as a guide for any caregiver helping another with any serious, debilitating illness, not solely cancer. The large paperback is printed in a large font which allows for comfortable and fast reading. Caregivers, I know, are always pressed for time. Book Published March 25, 2005.

Palliative care supports patients suffering from life-limiting illnesses by providing relief from physical, emotional and spiritual suffering, improving the quality of life for them and their families. It is an important component of good patient care, an integral part of the continuum of support for patients suffering with advanced cancer and end stage organ diseases. Providing good palliative care requires both sound clinical knowledge and compassion.With new chapters on end stage organ diseases, spiritual care and medical ethics, all healthcare professionals will find wisdom and practical advice in this book by the patient's bedside. The editors and contributors of the 2nd Edition of The Bedside Palliative Medicine Handbook have taken great care to provide readers with an evidence-based, updated guide to the practice of palliative medicine.

The prospect of dying can be overwhelming, whether it's happening to you, a family member, or a friend. In "Good End," Dr. Michael Appleton addresses questions about hospice care and end-of-life issues with compassion and honesty. This is a must read for patients and families who are on hospice or considering hospice care.

"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.

Taking a multidisciplinary approach, End of Life Nursing Care flows smoothly from historical perspectives to caring for the caregiver; and includes theories, holistic models, the grief process and responses to loss, ethical and legal considerations, patient centered care, communication, management of specific terminal illnesses, and issues across the lifespan. The text covers the encircling meaningful parameters of history, sociology, psychology, pathophysiology, philosophy, and the law.

Hospice is the primary system to provide care for the terminally ill and their families. Warm, compassionate, and absolutely practical, this definitive resource from the National Hospice Organization will answer all your questions about hospice care and will show you how to make this comprehensive and flexible system work for you and your family.

The Hospice Choice illustrates the gamut of situations dying people and their families may face and suggests ways to manage them. Throughout is information on the broad range of services hospice can provide:

• Physicians and Nursing Services: to help with care specifically designed to keep the patient comfortable and at home
• Counseling Services: to help families and patients sort out their needs and responses
• Respite Services: to allow caregivers needed breaks
• Bereavement Counseling: to provide support for surviving family members and significant others for as much as a full year after loss

The Hospice Choicealso addresses sensitive issues like methods of payment, issues of ethnicity, the special problems raised by sudden death, and the realities of caregiver exhaustion. It will give you the concrete information, support, and encouragement that will help you make wise, compassionate decisions for yourself and for your loved ones.

In this meditative, heartbreaking, and unexpectedly comforting book, artist and essayist Judith Margolis tells the story of her mother's illness, decline, and death through thoughtfully written vignettes, poignant drawings, and poetic, prayerful affirmations. As her mother fights a series of health crises and faces the end of her life, Margolis documents her anxious concern and her father's turmoil while juggling responsibilities and her own distress. The resulting narrative, told with quiet intensity and candor, bears witness to contentious deliberations over medical decisions, the difficulties of patient care, and the complicated dynamics of family. In this book, designed to imitate a traditional Jewish prayer book, Margolis reminds herself and others caring for a dying parent to "pray"-pray for clarity, pray to stay centered, pray to forgive oneself-as a way of acknowledging and embodying the turbulent emotions involved. Both the form of the book and Margolis's rendering of the traditions involved in a family death ground Life Support firmly in the Jewish experience, providing a spiritual layer to this honest, realistic narrative that all readers will find inspiring and relevant. Life Support: Invitation to Prayer is a unique testimony to the power of creative response to infirmity and careful documentation during times of personal loss, as well as a loving tribute to family, spirituality, and grief.