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?

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.

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.

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.

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.

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.

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.

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.

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.

The Clinical Pocket Guide to Advanced Practice Palliative Nursing is a companion guide to Advanced Practice Palliative Nursing, the first text devoted to advanced practice nursing care of the seriously ill and dying. Each chapter of this pocket guide presents point-of-care guidance on palliative care issues for quick reference in daily practice. Edited by leaders in the field, this handbook provides consistency in the nursing process from assessment to management and evaluation of symptoms and various clinical situations. The Clinical Pocket Guide to Advanced Practice Palliative Nursing contains clinical pearls developed from the textbook and practical tools on pain and symptom assessment, functional status, and communication, making it an ideal resource for practicing APNs.

Palliative care is an essential element of our health care system and is 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, and nurses are at the center of the palliative care team across settings and populations. The sixth volume in the HPNA Palliative Nursing Manuals series, Social Aspects of Care provides an overview of the financial and mental stress illness places, not just on the patient, but on the family as well. This volume contains information on how to support families in palliative care, cultural considerations important in end-of-life care, sexuality and the impact of illness, planning for the actual death, and bereavement. The content of the concise clinically focused volumes in the HPNA Palliative Nursing Manuals series is an ideal resource for nurses preparing for certification exams and provides a quick-reference in daily practice.

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.

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.

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.

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.

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.

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.

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

Amytrophic Lateral Sclerosis (ALS or motor neurone disease) is a progressive neurodegenerative disease that can cause profound suffering for both the patient and their family. Whilst new treatments for ALS are being developed, these are not curative and offer only the potential to slow its progression. Palliative care must therefore be integral to the clinical approach to the disease. Palliative Care in Amyotrophic Lateral Sclerosis: From diagnosis to bereavement reflects the wide scope of this care; it must cover not just the terminal phase, but support the patient and their family from the onset of the disease. Both the multidisciplinary palliative care team and the neurology team are essential in providing a high standard of care and allowing quality of life (both patient and carer) to be maintained. Clear guidelines are provided to address care throughout the disease process. Control of symptoms is covered alongside the psychosocial care of patients and their families. Case studies are used to emphasise the complexity of the care needs and involvement of the patient and family, culminating in discussion of bereavement. Different models of care are explored, and this new edition utilizes the increase in both the evidence-base and available literature on the subject. New topics discussed include complementary therapies, personal and family experiences of ALS, new genetics research, and updated guidelines for patient care, to ensure this new edition remains the essential guide to palliative care in ALS.

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.