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Books > Medicine > Nursing & ancillary services > Nursing > Terminal care nursing
"Case Studies in Palliative and End-of-Life Care" uses a case-based approach to provide students and practitioners with an important learning tool to improve critical thinking skills and encourage discussion toward improving experiences for patients and their families. The book is organized into three sections covering subjects related to communication, symptom management, and family care. Each case is presented in a consistent, logical format for ease of use, highlighting key evidence-based concepts including the case history, care setting, diagnosis and prognosis, assessment, treatment considerations, and family support.A key reference, "Case Studies in Palliative and End-of-Life Care "is an invaluable resource for clinicians who provide palliative care to patients with life-limiting illnesses and those at the end of life along with their families.
When a patient has an advanced disease, considerable demands are placed on the whole family. Whilst coping with their own profound emotions, close relatives commonly have to support their loved ones through a range of treatments as the disease progresses through stages of remission and recurrence, until finally, a shift to a palliative mode of treatment must be faced. In such situations, family roles and relationships are likely to be disrupted and family members? coping resources can be stretched to the limit. It is clear from this that by the time the terminal stage of the patient's illness is reached, the family may have travelled a long and difficult road, and close relatives are likely to be emotionally vulnerable and in need of support.This study explores the needs of relatives of terminally ill patients and the concerns of nurses who provide care in the hospital. The research data is used to design, implement and evaluate clinical standards for improved family support.
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.
This insightful study examines the deeply personal and heart-wrenching tensions among financial considerations, emotional attachments, and moral arguments that motivate end-of-life decisions. America's health care system was built on the principle that life should be prolonged whenever possible, regardless of the costs. This commitment has often meant that patients spend their last days suffering from heroic interventions that extend their life by only weeks or months. Increasingly, this approach to end-of-life care is coming under scrutiny, from a moral as well as a financial perspective. Sociologist Roi Livne documents the rise and effectiveness of hospice and palliative care, and growing acceptance of the idea that a life consumed by suffering may not be worth living. Values at the End of Life combines an in-depth historical analysis with an extensive study conducted in three hospitals, where Livne observed terminally ill patients, their families, and caregivers negotiating treatment. Livne describes the ambivalent, conflicted moments when people articulate and act on their moral intuitions about dying. Interviews with medical staff allowed him to isolate the strategies clinicians use to help families understand their options. As Livne discovered, clinicians are advancing the idea that invasive, expensive hospital procedures often compound a patient's suffering. Affluent, educated families were more readily persuaded by this moral calculus than those of less means. Once defiant of death-or even in denial-many American families and professionals in the health care system are beginning to embrace the notion that less treatment in the end may be better treatment.
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.
As someone approaches the end of their life, it is vitally important that they receive quality care and support, that their wishes are met, and that they are treated with dignity and respect. Pathways through Care at the End of Life is a comprehensive guide to providing excellent, person-centred end of life care. Following a pathway from initial conversations about end of life to care in the last days of life and after death, it covers assessing need and planning care, co-ordinating care between different agencies, and ensuring quality in different settings, such as at home, in a hospice, or in hospital. Good practice guidance on communication, ensuring the person's needs are met, support for their family and how to facilitate a good death is given. Case studies illustrate real life practice, and questions throughout each chapter encourage reflective practice. This book will be essential reading for all those working with people at the end of life, such as nurses, social workers, GPs and home carers, as well as students in these fields.
At the end of life, our comfort lies mainly in relationships. In this book, Daniel Miller, one of the world's leading anthropologists, examines the social worlds of people suffering from terminal or long-term illness. Threading together a series of personal stories, based on interviews conducted with patients of an English hospice, Miller draws out the implications of these narratives for our understanding of community, friendship, and kinship, but also loneliness and isolation. This is a book about people's lives, not their deaths: about the hospice patients rather than the hospice. It focuses on the comfort given by friends, carers and relatives through both face-to-face relations and, increasingly, online communication. Miller asks whether the loneliness and isolation he uncovers is the result of a decline of English patterns of socialising, or their continuation. This moving and deeply humane book combines warmth and sharp observation with anthropological insight and practical suggestions for the use of media by the hospice. It will be of interest not only to students and scholars of anthropology, sociology, social policy and media and cultural studies, but also to healthcare professionals and, indeed, to anyone who would like to know more about the role of relationships in the final stage of our lives.
The first resource on end-of-life care for healthcare practitioners who work with the terminally ill and their families, "Living with Dying" begins with the narratives of five healthcare professionals, who, when faced with overwhelming personal losses altered their clinical practices and philosophies. The book provides ways to ensure a respectful death for individuals, families, groups, and communities and is organized around theoretical issues in loss, grief, and bereavement and around clinical practice with individuals, families, and groups. "Living with Dying" addresses practice with people who have specific illnesses such as AIDS, bone marrow disease, and cancer and pays special attention to patients who have been stigmatized by culture, ability, sexual orientation, age, race, or homelessness. The book includes content on trauma and developmental issues for children, adults, and the aging who are dying, and it addresses legal, ethical, spiritual, cultural, and social class issues as core factors in the assessment of and work with the dying. It explores interdisciplinary teamwork, supervision, and the organizational and financing contexts in which dying occurs. Current research in end-of-life care, ways to provide leadership in the field, and a call for compassion, insight, and respect for the dying makes this an indispensable resource for social workers, healthcare educators, administrators, consultants, advocates, and practitioners who work with the dying and their families.
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.
This is the only handbook for hospice and palliative care professionals looking to enhance their care delivery or their programs with LGBTQ-inclusive care. Anchored in the evidence, extensively referenced, and written in clear, easy-to-understand language, LGBTQ-Inclusive Hospice and Palliative Care provides clear, actionable strategies for hospice and palliative physicians, nurses, social workers, counselors, and chaplains.
Research literacy is now a requirement for Board-Certified chaplains in the US and a growing field in the UK. This reader gives an overview and introduction to the field of healthcare chaplaincy research. The 21 carefully chosen articles in this book illustrate techniques critical to chaplaincy research: case studies; qualitative research; cross-sectional and longitudinal quantitative research, and randomized clinical trials. The selected articles also address wide-ranging topics in chaplaincy research for a comprehensive overview of the field. To help readers engage with the research, each article includes a discussion guide highlighting crucial content, as well as important background information and implications for further research. This book is the perfect primary text for healthcare chaplaincy research courses, bringing together key articles from peer-reviewed journals in one student-friendly format.
Nearly half of people at the end of life will receive hospice care, but few psychologists, nurses, physicians, chaplains, and hospice workers have been trained specifically to recognize and address the psychological, social, and emotional issues that may arise in patients who are dying. Patients in the midst of advanced terminal illness may experience a variety of distressing emotions, and may feel anxious, frightened, regretful, or desperate. This guide was created specifically to guide helping professionals of all kinds through the process of working through patients' psychological issues to allow them peace and comfort in their final moments. The Helping Professional's Guide to End-of-Life Care clarifies the spiritual and emotional care that patients need and presents an evidence-based approach integrating cognitive behavioral therapy (CBT), transpersonal psychotherapy, hypnosis, mindfulness, and guided imagery to help patients manage emotional distress at the end of life. Through case conceptualizations and detailed treatment planning guidance, readers learn to formulate comprehensive assessment and treatment plans for patients and gain skills that will help them manage the emotional intensity of this work. This secular, professional treatment model can be applied to patients of any religious or spiritual background. The book also addresses integrating the patient's therapeutic team with the medical team, addressing the emotional needs of friends and family of the dying, crisis intervention for suicidal patients, working with clients on psychotropic medications, and how helping professionals can manage their own emotions to become more effective clinicians.
Are you involved in caring for people at the end of their life? Do you have a role in supporting the families of those who are dying, or is this an area of your work you find personally difficult?This book is an accessible guide for all those working in health or social care and caring for people at the end of their lives. This will include people in roles such as healthcare assistant, hospice worker, volunteer, nurse or other carers.Written by experts with extensive experience in delivering high quality end of life care, this book is full of real life examples, reflection exercises and case studies. It also includes insights into what can help make a good death, and how to help support families at the end of life.The easy to read chapters emphasise treating people who are dying with dignity using a person centred approach.The book supports the delivery of quality care by recognising physical and non-physical symptoms, and thinking about various emotional and physical needs people might have. It is also important that care givers look after themselves and advice is given on how best to do this.An essential purchase for anyone looking for guidance or support in this area, and suitable for those working in the community, care homes, hospices, hospitals or other settings where people are cared for. With a Foreword from Dr. Ros Taylor, MBE, National Director for Hospice Care, Hospice UK."The book strikes a balance between the factual and the personal, and gives the reader detailed information and time to think through reflection exercises. It highlights essential elements of end of life care, including communication, symptom management and personal care during bereavement. It emphasises the importance of adopting a person-centred approach of people who are dying. The book supports the delivery of quality care by recognizing the physical and non-physical symptoms, and thinking about people's emotional and physical needs. It also makes clear that caregivers should look after themselves and how they should do so." Deborah Preshaw, doctoral nursing student, Queens University Belfast, UK "This is a beautifully presented learning tool to support the delivery of end of life care. I particularly like the 'signposts' which reinforce the intention of the book to enable 'carers' to apply what they read to their role in practice." Liz Bryan, Director of Education and Training, St Christopher's Hospice, UK "This book is a very welcome addition to the literature on end of life care, as it does exactly what it says - it is a practical guide. It is written by an inter-professional group of clinical experts who have managed to create a concise, accessible resource which would be perfect for carers, volunteers, Health Care Support Workers or health care student working in any clinical setting who wants to make a difference for individuals approaching the end of their lives. The book addresses all of the important aspects of care at this crucial time, including attitudes to death and dying, communication issues, common physical and psycho-social symptoms, and care in the last hours of life. The case studies of three individuals are threaded throughout the book and are an excellent way to illustrate theoretical content and demonstrate its clinical application. The glossary of terms is particularly useful for a non-specialist audience, as are the resources for further reading. I particularly welcome the use of 'signposts' to different activities at key points which encourage the reader to reflect and apply the knowledge to their own situation. I highly recommend this book to any individual who wants to develop their confidence and competence in this challenging, but critically important area of care." Mick Coughlan, Programme Leader, The Royal Marsden School, UK "I found the chapters easy to read and the link to a case study really brought the words 'to life'. The chapter on self-care was helpful - this is an area hospice managers are having to focus on in detail as our staff strive to maintain the high levels of quality care hospices are renowned for with compassion and dignity . Giving emotional support throughout a shift to patients, families and colleagues can lead to a feeling of 'exhaustion' and 'fatigue', which if not recognised and addressed leads to time off sick and a feeling of being 'powerless' for staff . Healthcare professionals must recognise this as well as their managers, who then need to provide different levels of interventions that staff can access - as described in the book. I think all palliative care libraries should have this book on their shelves and perhaps it could be a 'core' reading book for training. I also used it on the ward to discuss with nurses - it's not that what is written is necessarily new but it is well written, concise and relevant. I feel this book would be very useful for those new to palliative care as well as those studying the subject. Relating theory to practice is always powerful and for new nurses and other healthcare professionals this provides context and meaning." Clodagh Sowton, Director of Patient Services, Phyllis Tuckwell Hospice Care, UK "This is a welcome book to the field of end of life care. This practical guide is accessible and is an excellent bridge between the 'Lay Person' and those health care professionals caring for the individual as they approach the end of life. The authors present their subject areas in a most readable and engaging style. While reviewing the case studies (which are weaved throughout the whole book); you feel they have come from experienced carers who have had 'lived experiences' of end of life care. This therefore, makes the chapters much more relatable and applicable to practice and real world life. This is also a personable book and I would recommend it to health care professionals and lay persons alike- who need to address or who may require further insight into the realms of: Physical/psycho-social symptoms, communication challenges and differential perspectives on dying and death. Finally, I will also be directing students of healthcare towards this impressive, insightful book." Robert Murphy, Senior Lecturer - Adult Nursing, London South Bank University, UK "The material covered is very helpful and the range of authors has been well selected from individuals who are active in clinical practice. The book is practical and clear, and Clair deserves high praise for the contribution it will make to clinicians seeking to improve their palliative care knowledge and skills." Professor Max Watson, Medical Director Northern Ireland Hospice, Visiting Professor University of Ulster, UK
Talking openly with sick and dying children about their illness is always difficult and often agonizing. It is honesty, however, that these children deserve and need. Dietrich Niethammer, a prominent pediatric oncologist, explains why it is so important to speak frankly and respectfully to young patients about their disease. The question at the heart of this book is how children and adolescents feel and think about death and dying. Dr. Niethammer thoroughly examines the literature on the topic, arguing that children and adolescents not only are capable of discussing their illness but benefit from doing so. Puzzled why it took medical practitioners so long to accept truth-telling in their care of dying children, Niethammer traces the development of this notion from the early twentieth-century work of Sigmund Freud to the discomfort surrounding it still today. Severely sick children and adolescents think about the consequences of their disease, whether adults discuss it with them or not. When adults remain silent, they do a disservice to the children. Dr. Niethammer urges doctors to practice not in silence and denial but in open communication with ill children, giving the children an opportunity to express their fears and anxieties and to cope with their disease on their own terms. Dr. Niethammer's compelling personal experiences combined with the latest research make this a compassionate and invaluable resource for physicians, nurses, social workers, teachers, parents--for all who care for sick and dying children and adolescents.
The family are intimately involved in the care of the dying and themselves require support through their experience of both palliative care and bereavement. This volume describes a comprehensive model of family care and how to go about it - an approach which is new, preventive, cost effective and with proven benefits to the bereaved.;The book has been designed rather like a therapy manual, providing a step-by-step approach to assessment and intervention. Its rich illustration through many clinical examples brings the process of therapy alive for the reader, anticipating the common challenges that arise and describing how the therapist might respond. Families are recognised throughout as a central social unit, pivotal to the success of palliative care. This title should be of use to doctors, nurses, psychologists, social workers, pastoral care workers, psychiatrists and other allied health professionals who work in caring for the dying and for their bereaved relatives. Based soundly on a decade of internationally regarded research, this book will alter the direction of future medical practice and is destined to become a classic in its field.
This beautifully illustrated and sensitive storybook is designed to be used therapeutically by professionals and caregivers supporting children with an untreatable illness. With engaging, gentle and colourful illustrations that can be used to prompt conversation, it tells the story of the final journey made by a Boy with a Bear, as the Boy says his goodbyes and comes to terms with his life-ending illness. This book is also available to buy as part of the Therapeutic Fairy Tales pack. Therapeutic Fairy Tales is a series of short modern tales dedicated to exploring challenging life situations that might be faced by young children. Each short story is designed to be used by professionals and caregivers as they use stories therapeutically to support children's mental and emotional health. Other books in the series include: Storybook Manual: Introduction To Working With Storybooks Therapeutically And Creatively The Night Crossing: A Lullaby For Children On Life's Last Journey The Island: For Children With A Parent Living With Depression Designed to be used with children aged 7+, each story has an accompanying online resource, offering therapeutic prompts and creative exercises to support the practitioner. These resources can also be adapted for wider use with siblings and other family members. The Night Crossing - from the Therapeutic Fairy Tales series - is born out of a creative collaboration between Pia Jones and Sarah Pimenta
'Death is inevitable-none of us will escape it. Ending life with a terminal illness is a slow and rather lonely process. I am interested in the question of why some nurses choose to work in the field of palliative care. I am one who willingly stepped into the role of being with patients at their most vulnerable time -when death became inevitable. My nursing history has spanned fifty years, of which the last twenty were in palliative care of terminally ill and dying patients. What was it that influenced me to move from a curing model to comfort caring only? My work is an account of how I discovered palliative care nursing after thirty years in the acute-care setting. I migrated to Australia at the age of seventeen after the violence of World War II and the death of my father in a refugee camp. It seemed that taking on nursing was the best way to settle into a new life. I was happy with general nursing but had a feeling that there was more I could contribute to my patient care. My mother's unexpected death with cancer was responsible for showing the way. She died in the hospice unit of the hospital where I was employed. Sitting by her side showed me another aspect of nursing that attracted me to a career change. I transferred to the Hospice after mother died and remained there for twenty years. Naturally I wondered why this change of direction happened.' - Susan Bardy
Within the last decade music therapists have developed their work with people who have life-threatening illnesses and with those who are dying. This book presents some of that work from music therapists working in different approaches, in different countries, showing how valuable the inclusion of music therapy in palliative care has already proved to be. It is important for the dying, or those with terminal illness, that approaches are used which integrate the physical, psychological, social and spiritual dimensions of their being. The contributors to this book emphasize the importance of working not only with the patient but with the ward situation, friends and family members. By offering patients the chance to be creative they become something other than patients - they become expressive beings, and there is an intimacy in music therapy that is important for those who are suffering. Many of the contributors write in their own personal voice, providing a particular insight which will be valuable not only to other music therapists seeking to enrich their own ways of working, but to all those involved in caring for the sick and the dying. Contributors describe their work with both children and adults living with HIV/AIDS, cancer and other chronic degenerative diseases.
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. |
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