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.

'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.

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.

Dame Cicely Saunders was the founder of the Hospice Movement, in which Britain leads the world. Her work transformed our approach to the care of the dying, and also the debate about euthanasia. She died in 2005 and her memorial service was held in Westminster Abbey in March 2006. Over 1600 people attended. This biography, by Shirley du Boulay, includes a 4-page plate section and new chapters by Marianne Rankin covering the years after 1984.

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.

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

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.

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.

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

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.

Helping your family and loved ones when they need you most

""""Caregiving"" has a big heart-on a much-needed topic. A rare book of spiritual and practical wisdom.""
--Sue Bender, author of ""Plain and Simple"" and ""Everyday Sacred""

""A poignant, wise, and in-the-trenches view of caregiving that is both practical and spiritual, especially of value to midlife adults.""
--Jean Shinoda Bolen, M.D., author of ""Goddesses in Everywoman"" and ""Close to the Bone""

""Lovely. . . . Beth McLeod's experience and wisdom shine through as she shares her heartfelt journey of loss, surrender, hope, and healing.""
--David Simon, M.D. medical director, the Chopra Center for Well Being, author of ""Vital Energy"" and ""Return to Wholeness""

Sooner or later it will touch us all: A family member or loved one becomes ill or disabled, and we step in to help. This is caregiving, and in this powerful, unique book, prizewinning writer and advocate Beth Witrogen McLeod leads us through the caregiving journey with unflinching authority and compassion. Framed by the author's personal odyssey as a caregiver and richly informed by the inspiring and poignant tales of others, ""Caregiving"" explores medical and financial problems, all aspects of spirituality, and such issues as depression, stress, housing, home care, and end-of-life concerns. A rare blend of powerful storytelling and practical information, ""Caregiving"" is a revelation.

Cancer: Palliative Care examines the nature of the care and support that can be provided to those in need of palliative care and their families. This covers not only the physical treatment, such as pain management, but also the psychological well-being of patients. Health workers, clinicians, specialist nurses and medical students will find a balanced and thoughtful overview of the subject which will be of value in managing patients and helping them to come to terms with their condition.

The Textbook of Palliative Care Communication is the authoritative text on communication in palliative care, providing a compilation of international and interdisciplinary perspectives. This volume was uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, and it unites clinicians with academic researchers interested in the study of communication. By featuring practical conversation and curriculum tools stemming from research, this text integrates scholarship and inquiry into translatable content that others can use to improve their practice, teach skills to others, and engage in patient-centered communication. The volume begins by defining communication, explicating debatable issues in research, and highlighting specific approaches to studying communication in a palliative care context. Chapters focus on health literacy and cultural communication, patient and family communication, barriers and approaches to discussing palliative care with specific patient populations, pain, life support, advance care planning, and quality of life topics such as sexuality, spirituality, hope, and grief. Team communication in various care settings is outlined, and current research and education for healthcare professionals are summarized. Unique to this volume are chapters on conducting communication research, both qualitatively and quantitatively, to promote further research in palliative care.

Rarely heard about in our society are caregivers' thoughts and feelings about life, death, and dying and how they act on those feelings. "For the Living: Coping, Caring and Communicating with the Terminally Ill" provides an in-depth, qualitative look at the experiences of oncology healthcare professionals as they work with terminally ill patients. Through a series of recorded and edited interviews, the author explores the social and cultural dynamics that affect physicians, nurses, and social workers routinely encountering mortality and loss. What death and the prospect of dying mean to these individuals should not be taken lightly.

Aimed at health care professionals and their colleagues, ministers of religion and funeral directors, this comprehensive work of reference describes the complex procedures required when someone dies. The information should be of value to all those who are concerned with the correct handling of situations as diverse as fatal mass disasters and the rites that are associated with those who hold unfamiliar religious beliefs. The guide is in three parts: legal and technical aspects; considerations for the living, care of the dying, and death with dignity; and religious, ethnic and cultural aspects of dying and death. The author combines medico-legal facts and practical, sensitive advice.