The editors undertook this project to promote the International
Conference on Death, Grief, and Bereavement in La Crosse,
Wisconsin, USA. Throughout its history, the conference has
attracted internationally known speakers. This book illustrates the
quality of their presentations. Section One, "Professional
Applications in End of Life Care," begins with Currier, Hammer, and
Neimeyer's examination of the importance of the social network,
including both religion and family, not just the individual, in
working with those at the end of their lives. The authors analyse
the impact of social support and its health implications. In
Chapter 2, Parkes looks at the influence of child development on
adult life and bereavement. Rather than simply showing how insecure
child development affects loss as adults, he examines how insecure
attachments in childhood can lead to extreme attachments to God,
homes, territories, political leaders, and symbols and discusses
interventions for these extreme attachments. Papadatou (Chapter 3)
develops a model for professionals and caregivers who work with the
dying. She suggests that those who give care to the dying also have
multiple needs and also face suffering, examines the private world
of professionals and what is healthy and what is unavoidable, and
describes both functional and dysfunctional coping patterns used by
professionals. Kobler (Chapter 4) uses case studies to explain how
to develop and maintain relationships with children and their
families in paediatric palliative care. She offers strategies for
using rituals and ways to initiate and maintain relationships with
children and their families. Thompson (Chapter 5) focuses on the
effects of working in situations involving high levels of emotion
and the stress that may result. He makes a strong case that such
stress can do harm to individuals, groups, and whole organisations
and offers a model for a more holistic approach that incorporates
social and organisational strategies and practical ways to prevent
and manage stress. Eves-Baine and colleagues (Chapter 6) examine
the application of paediatric and adult-based principles to the
newborn period. They discuss how to create the best situations for
families when life-sustaining medical therapy has been withdrawn,
how to support the family, and the ethical challenges that
perinatal palliative care presents. The authors offer models for
care through the journey of palliative and bereavement care.
Section Two, "Facing End of Life and Its Care," begins with
Gilbert's chapter presenting a strong argument that caregivers need
to honour the multiple tracks that come with dying while
maintaining a focus on the wishes of the dying person. He offers
ways for the team to better meet the needs of the dying person.
Koppleman (Chapter 8) follows the journey of a friend who faced
death. It is a powerful story, told from the point of view of the
dying in a scholarly fashion. Smith and Potter (Chapter 9) suggest
that palliative care for the dying can be defined as offering
"comfort care," both for those who are dying and for their loved
ones. The authors present a model of the psycho-spiritual side of
palliative care as a way of offering comfort to all those involved.
Adams (Chapter 10) examines different methods of working with
patients and families. It looks at the ways in which such work can
be complicated by factors of geographic distance, differences in
family reactions, differences in treatment plan concepts, and in
meaning making. All of these factors may become stumbling blocks
and may prevent the delivery of positive support. Pizzini (Chapter
11) looks at the experience of dying in prison from the perspective
of inmates who are terminally ill, prison medical staff, and prison
security staff. She discusses how to maintain dignity of the dying
and a "good death" while in prison. McCord (Chapter 12) discusses
attempts by hospice patients and others diagnosed with terminal
illnesses to die either by their own hand or with physician
assistance. She presents common risk factors, strategies to assess
the degree of risk and possible plans for suicide and suicide
postvention in the context of hospice. Section Three, "Cultural
Considerations in End-of-Life Care" begins with The End of Life:
Two Perspectives in which Robert G. Stevenson looks at two
perspectives on the end of life that are not often examined in
terms of their impact on the individual and his/her attitude toward
this time. The two perspectives are that of adolescents, and that
are shown in a military ceremony used in the 18th and 19th
centuries, the Feu de Joie or Fire of Joy. In Chapter Fourteen,
Janet McCord discusses suicide attempts by hospice patients and
others diagnosed with terminal illnesses to die either by their own
hand or with physician assistance. Connor's description of the need
for hospice and palliative care around the world and the challenges
of developing palliative care globally, and offers models that can
be used around the world. Cox and Cox (Chapter 15) suggest ways to
offer end-of-life care to Roman Catholics who do not fit the
traditional model of hospice care and examine special needs,
theology, and rituals. Cox and Sullivan (Chapter 16) offer
suggestions on end-of-life care for American Indians, explaining
cultural differences among American Indians and suggesting ways to
improve care to a group that is generally neglected in hospice
care. Smith (Chapter 17) looks at the cultural differences and
understandings of Fundamentalist Christian views of a "good death"
and the afterlife, ways to negotiate faith understandings that
complicate end-of-life care, and ways to comfort individuals who
may be marginalised because they do not share the theological views
of the dying individual or key family members.
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