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.

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.

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.

Dieses Buch thematisiert die arztlich geschuldete Leistung in der Palliativmedizin. Unter Einbeziehung der Definitionen u.a. der WHO und DGP erfolgt zunachst eine Begriffsklarung und Abgrenzung zur kurativen Medizin, dem Hospiz und der Sterbehilfe, sodann eine Auseinandersetzung mit dem medizinischen Standard i.S.d. 630a Abs. 2 Hs. 1 BGB. Dabei zeigt das Buch zum einen den Mangel an wissenschaftlicher Evidenz auf und fragt danach, ob und wie eine Standardbildung auch ohne diese moeglich ist. Weiter untersucht es die Frage, wie bei einer interdisziplinaren Kompetenz eine Standardbildung erfolgen kann. Die Ergebnisse sowie Loesungen tragen der besonderen Behandlungssituation vulnerabler Palliativmedizinpatienten Rechnung. Das Buch schliesst mit einer Aufarbeitung zweier besonderer Konstellationen der Palliativmedizin: den Entscheidungen unmittelbar am Lebensende sowie der Neugeboreneneuthanasie.

This book helps nursing and healthcare students to prepare for the challenges of working with the increasing number of patients requiring palliative care, so that they can work in partnership with patients and their carers, providing care that is compassionate, practical and backed up by the latest evidence. Delivering palliative care can be emotionally challenging and the book focuses on supporting healthcare staff, allowing them to provide the care that is needed. Key features include: * case studies in every chapter, helping students to practically work through difficult scenarios * reflective activities that assist readers in thinking critically about their care and how to improve it * a holistic approach to palliative care that includes family, carers and interprofessional work * up to date theory and policy. Palliative Care in Nursing and Healthcare is suitable for undergraduate nursing students and allied health students and practitioners. Michelle Brown is Senior Lecturer at the University of Derby.

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.

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.

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.

Palliative care is an essential element of our health care system and becoming increasingly significant amidst an aging society and organizations struggling to provide both compassionate and cost effective care. Palliative care is also characterized by a strong interdisciplinary approach. Nurses are at the center of the palliative care team across settings and populations. The second volume in the HPNA Palliative Nursing Series, Physical Aspects of Care: Pain, Nausea and Vomiting, Fatigue and Bowel Management, provides an overview of the principles of symptom assessment and management for symptoms including: pain, fatigue, nausea and vomiting, constipation, diarrhea, obstruction, and ascites. The content of the concise, clinically-focused volumes in the HPNA series prepares nurses for certification exams as well as quick-reference in daily practice. Plentiful tables, figures, and practical tools such as assessment instruments, pharmacology tables, and patient teaching points make these volumes useful resources for nurses.

Patients with advanced cancer may develop a number of clinical complications related to tumor progression or a variety of aggressive treatments. The majority of these patients are elderly, often with multiple co-morbidities that require appropriate assessment and management. In the palliative stage of their disease, patients undergo a progressive transition from active acute care to community-based hospice care. This transition requires modification in the diagnostic tests, monitoring procedures and pharmacological treatments to adjust them to the palliative and short-term nature of the care. Internal Medicine Issues in Palliative Cancer Care looks at internal medicine through a prognosis-based framework and provides a practical approach to maximizing comfort and quality of life while minimizing aggressive investigations and therapies for patients with life-limiting disease. Forty-six common internal medicine conditions are organized into nine clinical categories: pulmonary, cardiovascular, nephrologic and metabolic, gastrointestinal, hematologic, infectious, endocrine, rheumatologic, and neuro-psychiatric. This evidence-based resource is ideal for educating clinicians delivering palliative care to cancer patients in acute care facilities about complex internal medicine problems, decision-making regarding diagnostics and therapeutics which require a good understanding of state-of-the-art internal medicine and palliative care principles.

The growing geriatric population in the United States has created an increasing need for palliative medicine services across the range of medical and surgical specialties. Yet, palliative medicine lacks the resources to carry such a workload itself. Geriatric Palliative Care addresses this need by encouraging individual specialties to "own" the management of elderly with the same vigor as they "own" other key management competencies within their specialty. This clinically focused and highly practical handbook, which compliments the more comprehensive text Geriatric Palliative Care by Sean Morrison and Diane Meier (Oxford University Press, 2003), encourages this process of learning and ownership across many medical specialties. Designed to be readable and easily accessible to a range of health care providers, Geriatric Palliative Care outlines specific strategies for caring for specific palliative care issues common in elderly patients. The handbook also provides evidence based advice for helping patients, relatives, and staff cope with such issues as polypharmacy, dementia and consent, multiple pathologies, home care, elderly caregivers, and supporting the elderly in the place where they would like to be.

During a pandemic lockdown full of pyjama dance parties, life talks, and final goodbyes, a family helps a father die with dignity. In April 2020, journalist Mitchell Consky received bad news: his father was diagnosed with a rare and terminal cancer, with less than two months to live. Suddenly, he and his extended family -- many of them healthcare workers -- were tasked with reconciling the social distancing required by the Covid-19 pandemic with a family-based approach to end-of-life care. The result was a home hospice during the first lockdown. Suspended within the chaos of medication and treatments were dance parties, episodes of Tiger King, and his father's many deadpan jokes. Leaning into his journalistic intuitions, Mitchell interviewed his father daily, making audio recordings of final talks, emotional goodbyes, and the unexpected laughter that filled his father's final days. Serving as a catalyst for fatherly affection, these interviews became an opportunity for emotional confession during the slowed-down time of a shuttered world, and reflect how far a family went in making a dying loved one feel safe at home.

Hospice chaplains have traditionally played a unique part in palliative care, providing human compassion and support to help ease life's final chapter. This book thoughtfully tackles the question at the heart of modern hospice chaplaincy: do chaplains have a distinctive role in an increasingly secular society? A comprehensive look at why and how this work needs to be done, each chapter will be a rich resource for hospice chaplains and anyone working within a hospice multi-disciplinary team. Taking the form of reflections by chaplains and other professionals, they examine the tension between sacred and secular space, explore how spiritual care works in a changing society, and look at what voice a chaplain has within the hospice team. Essential reading for chaplains, this insightful book reflects on the important work undertaken by hospice chaplaincies and explains why they continue to be a vital resource for end-of-life care.

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.

A focus on intentional communication, team building, and relational maintenance.This text is designed to help form and maintain palliative care teams that survive and thrive. Whether you are starting a new team or hoping to help an existing team, this text addresses aspects of team players, leadership, meetings, organizational culture, and self- and team-care through a combination of empirical data and real voices from health care professionals in palliative care practice. By focusing on the individual professional in relation to team health and success, this text shows how to develop high quality, high-performing palliative care teams. Perfect for both students and the working professional, this text is useful at any time in your career or your team's development. It explores the types of providers involved in palliative care, their roles, possible conflicts, and the opportunity to amplify their work as a team while overcoming the stigma that may be attached to palliative care. This book focuses on the foundational role of communication in leadership, team building, and the delivery of patient care. Designed to provide workable solutions to challenges such as poor team design, siloing, and faulty communication, it provides suggestions that can be implemented immediately by your palliative care team. This focus allows health care professionals who are passionate about palliative care to grow into high functioning teams with a focus on excellent patient care. Key Features: Satisfactory and Unsatisfactory Palliative Care Experiences Stories from nurses, social workers, chaplains, physicians, pharmacists, executives, patients, and families Pearls from the Field: Provider and team takeaways Best practices of team leaders Tips for individuals and teams to communicate with other providers, departments, and senior leadership Discusses how to improve short-term and long-term functionality Outlines the predictors of burnout for palliative care professionals and teams Self-care and team-care suggestions Combines up-to-date research and theory in an accessible writing style

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.

Supportive Care for the Renal Patient Second Edition provides a comprehensive, evidence-based overview of supportive care for the nephrology patient. An international group of contributors emphasise the continuum of palliative care from the time of diagnosis through to end-of-life care and the issues surrounding withdrawal of dialysis. The book addresses the psychological impact of the disease, the importance of involving the patient in making decisions about their care, ethical considerations, the role of the family and the multidisciplinary team. This new edition includes two new chapters on conservative management of advanced kidney disease (AKD) and dialysis in the very elderly. The chapters covering non pain symptoms, advance care planning, quality of life, psychological and psychiatric consideration and end-of-life care have also be completely revised to include new evidence and current thinking. This book will be of particular interest to palliative care practitioners; nephrologists, who increasingly need to know more about palliative care; nurse practitioners, dialysis nurses, social workers, dieticians, and psychiatric consultants. ABOUT THE SUPPORTIVE CARE SERIES Supportive care is the multidisciplinary holistic care of patients with chronic and life-limiting illnesses and their families - from the time around diagnosis, through treatments aimed at cure or prolonging life, and into the phase currently acknowledged as palliative care. It involves recognising and caring for the side-effects of active therapies as well as patients' symptoms, co-morbidities, psychological, social and spiritual concerns. It also values the role of family carers and helps them in supporting the patient, as well as attending to their own special needs. Unlike traditional palliative care, which grew from the terminal care of cancer patients, supportive care is not restricted to dying patients nor to cancer. This series covers the support of patients with a variety of long-term conditions, who are currently largely managed by specialist medical teams in hospital and by primary care teams in community settings. Each volume therefore provides a practical guide to the supportive care of patients at all stages of illness. Series Editor: Sam H. Ahmedzai

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.

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.

Practical, emotional, and spiritual guidance
The time may come when you or a loved one has to face a life-threatening illness; when you realize that you or your loved one may be dying. It's never easy to think about the last years of life, but being prepared can help you have your hopes and wishes realized. By taking the time now to plan for the future, you can maintain control of your life even at the very end.
Staying in Charge is a supportive guide to opening up the lines of communication and making life more fulfilling from the first day of diagnosis of a serious illness. This reassuring handbook helps you to focus on important matters such as:
* Handling a living will or a do-not-resuscitate order
* Deciding upon medical power of attorney
* Gathering support from friends and family
* And, most significantly, learning to live in the midst of dying

Based on the wisdom of many experts and caregivers in the field, Staying in Charge offers everything you need to know to make the last years of life more fruitful, less isolating, and more comfortable and peaceful-whenever and wherever the journey occurs.
""Few of us think of our own death with an open heart or a clear mind. Kaplan and Lukas courageously and compassionately demystify this unknown part of life with practical and spiritual guidance. With Staying in Charge, the secret is out: You can plan for death and, in so doing, learn how to live more fully.""
-Beth Witrogen McLeod, author of Caregiving: The Spiritual Journey of Love, Loss, and Renewal
""Staying in Charge: Practical Plans for the End of Your Life means what it says. When it comes time to manage a serious illness, we all want to be in control. There isn't a person alive who shouldn't read and absorb the counsel of this valorous-and unexpectedly cheering-work.""
-Stefan Kanfer, former editor, Time magazine author of Ball of Fire and A Summer World

Winner of the Michael Ramsay Prize 2016 Dementia is one of the most feared diseases in Western society today. Some have even gone so far as to suggest euthanasia as a solution to the perceived indignity of memory loss and the disorientation that accompanies it. In this book John Swinton develops a practical theology of dementia for caregivers, people with dementia, ministers, hospital chaplains, and medical practitioners as he explores two primary questions: * Who am I when I've forgotten who I am? * What does it mean to love God and be loved by God when I have forgotten who God is? Offering compassionate and carefully considered theological and pastoral responses to dementia and forgetfulness, Swinton's Dementia: Living in the Memories of God redefines dementia in light of the transformative counter story that is the gospel.

Many hospice social workers must address spiritual issues with their clients, but do not feel competent to do so effectively. This targeted volume draws upon multidisciplinary theory and research to advance a relational model of spiritually sensitive hospice care. The book will help readers elevate their spiritual competence and foster a relationship with their clients that will enrich the experience for all involved. Spirituality and Hospice Social Work helps practitioners understand various forms of spiritual assessment for use with their clients. The book teaches practitioners to recognize a client's spiritual needs and resources, as well as signs of spiritual suffering. It also discusses religious and spiritual practices that clients may use to enhance their spiritual coping. Spirituality and Hospice Social Work stresses the need for interdisciplinary collaboration with other members of the hospice team, along with the value of maintaining professional ethical standards when addressing spiritual issues. Throughout, the importance of spiritual sensitivity and its effect upon client well-being is emphasized.