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.

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.

"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.

Palliative medicine is the medical care provided for people who have a life limiting illness or condition. It encompasses both the physical symptoms a person may experience but also the psychosocial, emotional, and ethical issues that may arise. Now in its fourth edition, Palliative Medicine: A Case-Based Manual walks clinicians through the management of the most common situations found in palliative medicine, from diagnosis and managing symptoms through to grief and bereavement. Using real patient case scenarios and an easy-to-read question and answer format, it gives students and medical professionals an accessible, evidence-based entryway to gain the skills and knowledge needed to provide high quality palliative and end of life care to patients and their families. This new edition has been fully updated to cover the latest guidance, including new chapters dedicated to medical cannabis, opioids, grief and bereavement, and wider issues including palliative care in the community, structurally vulnerable populations, and public health. Written by over 50 experienced palliative care clinicians and educators, this book will be a welcome guide for palliative care workers, medical and nursing students, and medical professionals of any specialty where palliative needs might arise.

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.

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.

"A profound exploration of what it means for all of us to live-and to die-with dignity and purpose." -People "Visceral and lyrical." -The Atlantic As the American born daughter of immigrants, Dr. Sunita Puri knew from a young age that the gulf between her parents' experiences and her own was impossible to bridge, save for two elements: medicine and spirituality. Between days spent waiting for her mother, an anesthesiologist, to exit the OR, and evenings spent in conversation with her parents about their faith, Puri witnessed the tension between medicine's impulse to preserve life at all costs and a spiritual embrace of life's temporality. And it was that tension that eventually drew Puri, a passionate but unsatisfied medical student, to palliative medicine--a new specialty attempting to translate the border between medical intervention and quality-of-life care. Interweaving evocative stories of Puri's family and the patients she cares for, That Good Night is a stunning meditation on impermanence and the role of medicine in helping us to live and die well, arming readers with information that will transform how we communicate with our doctors about what matters most to us.

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.

Behavioral Intervention Research in Hospice and Palliative Care: Building an Evidence Base sets forth research considerations and guidelines to build evidence-based interventions to improve end-of-life care. It is an in-depth introduction to implementation research and showcases how a clinical need is identified to inform an intervention. The book extensively examines the various phases of intervention research, including design, implementation, evaluation, dissemination and translation. The book focuses on methodological, ethical and practical issues. The science behind the quality of hospice and palliative care lags behind that of traditional medical practice, despite the continuous growth of palliative care interdisciplinary teams. Researching, developing and testing strategies is essential to advancing the effectiveness and value of this care.

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.

'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 work deals with the pressures experienced by nurses caring for patients with a wide range of problems and needs. Two particular situations that nurses face are covered - the terminally ill patient and the acute patient, where the first will die and the second will eventually recover. The book poses the question Are there differences in the way that nurses care for the living and the dying? and Do the disparate needs of these two groups result in role conflict for the nurses who care for them?

Jennifer Worth's bestselling memoirs of her time as a midwife have inspired and moved readers of all ages. Now, in In the Midst of Life she documents her experiences as a nurse and ward sister, treating patients who were nearing the end of their lives. Interspersed with these stories from Jennifer's post-midwife career are the histories of her patients, from the family divided by a decision nobody could bear to make, to the mother who comes to her son's adopted country and joins his family without being able to speak a word of English. In the Midst of Life also gives moving insights not just into Jennifer's life and career, but also of a period of time which seems very different to today's, fast-paced world.

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.

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.

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.

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.

Individuals and families face challenges at the end of life that can vary significantly depending on social and cultural contexts, yet more than ever is now known about the needs that cut across the great diversity of experiences in the face of dying and death. A number of behavioural interventions and clinical approaches to addressing these needs have been developed and are available to help providers care for clients and assist them in achieving their goals. Perspectives on Palliative and End-of-Life Care: Disease, Social and Cultural Contexts explores how these interventions can be used to address a range of issues across social and cultural contexts for those in need of end of life care. With perspectives from experienced clinicians, providers, and caregivers from around the world, the book offers a strong foundation in contemporary evidence-based practice alongside seasoned practice insights from the field and explores interventions for people as diverse as HIV caregivers in Africa and individuals dying with dementia. In addition, readers will learn about the process of caring for individuals with chronic illnesses including severe mental illness; weigh the impact of policy regulations on the availability of and access to palliative care and interventions; and be able to compare the different issues experienced by family caregivers and formal caregivers. As the companion volume to Perspectives on Behavioural Interventions in Palliative and End-of-Life Care, this book will be of interest to a wide variety of individuals, such as academics, researchers and postgraduates in the fields of mental health, medicine, psychology and social work. It will also be essential reading for healthcare providers and trainees from psychosocial and palliative medicine, social work and nursing.

'Warm, wise and practical' Cressida Cowell, MBE An invaluable reference for parents of sick or hospitalised children by an experienced and eminent psychologist. To many parents, it is hard to imagine a more upsetting reality than one where their child is hospitalised, severely sick, or terminally ill. In When Your Child is Sick, psychologist Joanna Breyer distils decades of experience working with sick children and their families into a comprehensive guide for navigating the uncharted and frightening terrain. She provides expert advice to guide them through the hospital setting, at-home care, and long-term outcomes. Breyer's actionable techniques and direct advice will help parents feel more in-control of a circumstance that has upended their life. She alerts parents to key personnel in the hospital, gives dialogue prompts to help parents ask for the help they need, addresses the needs of their other children at home, offers advice on how to best utilise friends and family who want to help, includes stories from other families who have been there, and teaches coping techniques to help both parents and children weather the stress of prolonged illness and even death. When Your Child is Sick is a valuable guide to managing the myriad practical and emotional complications of an impossible situation.

This book provides an up-to-date description of cross-cultural aspects of end-of-life decision-making. The work places this discussion in the context of developments in the United States such as the emphasis on patient informed consent, "right to die" legal cases, and the federal Patient Self-Determination Act. With the globalization of health care and increased immigration from developing to developed countries, health care professionals are experiencing unique challenges in communicating with seriously ill patients and their families about treatment options as well as counselling all patients about advance medical care planning. While many Western countries emphasize individual autonomy and patient-centered decision-making, cultures with a greater collectivist orientation have, historically, often protected patients from negative health information and emphasized family-centered decision-making. In order to place these issues in context, the history of informed consent in medicine is reviewed. Additionally, cross-cultural issues in health care decision-making are analysed from the perspective of multiple philosophical theories including deontology, utilitarianism, virtues, principlism, and communitarian ethics. This book is a valuable addition to courses on end-of-life care, death and dying, cross-cultural health, medical anthropology, and medical ethics and an indispensable guide for healthcare workers dealing with patients coming from various cultural backgrounds.