Patient Care and End-of-Life Decision Making

Supportive Care in Respiratory Disease

Sam H. Ahmedzai, Martin F. Muers (eds)

Respiratory symptoms such as breathlessness and cough are common in patients with advancing and incurable disease. For example, cancer, chronic cardiac and pulmonary disease, progressive ... More

Respiratory symptoms such as breathlessness and cough are common in patients with advancing and incurable disease. For example, cancer, chronic cardiac and pulmonary disease, progressive neuromuscular disorders and degenerative disorders all give rise to varying degrees of respiratory distress, which adversely affects the patient's quality of life. In recent years, there has been significant growth in the palliation of respiratory symptoms, leading to practical ways of giving relief in hospices, hospitals, and at home. This book includes non-malignant respiratory diseases, such as tuberculosis in AIDS patients and cystic fibrosis, and focuses on aetiology and diagnosis and management, emphasising symptoms, quality of life, and psychosocial support. Its underlying theme is the application of modern research-based knowledge, in a humane way, for patients with advancing disease. Less

Supportive Care in Respiratory Disease

Sam H. Ahmedzai, David R. Baldwin, David C. Currow (eds)

Respiratory symptoms such as breathlessness and cough are common in patients with advancing and incurable disease. For example, cancer, chronic cardiac and pulmonary disease, progressive ... More

Respiratory symptoms such as breathlessness and cough are common in patients with advancing and incurable disease. For example, cancer, chronic cardiac and pulmonary disease, progressive neuromuscular disorders, and degenerative disorders all give rise to varying degrees of respiratory distress which adversely affects the patient's quality of life. In recent years, there has been significant growth into the palliation of respiratory symptoms leading to practical ways of giving relief in hospices, hospitals, and at home. The second edition of this title in the Supportive Care series includes non-malignant respiratory diseases such as tuberculosis in AIDS patients, cystic fibrosis and ventilator-dependent patients, and focuses on aetiology and diagnosis and management, emphasizing symptoms, quality of life, and psychosocial support. The underlying theme of the book is the application of modern research-based knowledge, in a humane way, for patients with advancing disease. Less

Surgical Palliative Care

Geoffrey P Dunn, Alan G Johnson (eds)

This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and ... More

This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, with increasingly minimal access to techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The text is divided into two sections: the first deals with general issues, varying from quality-of-life measurement to spirituality; and the second illustrates their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms. Less

Teamwork in Palliative Care: Fulfilling or Frustrating?

Peter Speck (ed.)

Teamwork is a complex but essential component of palliative care. The needs of people diagnosed with life threatening disease will vary greatly over time, and it is rarely possible for ... More

Teamwork is a complex but essential component of palliative care. The needs of people diagnosed with life threatening disease will vary greatly over time, and it is rarely possible for just one professional to be able to provide adequate care. In order to ensure an holistic approach, the whole multi-disciplinary team must be involved. Inevitable questions arise from such an approach, and this book seeks to address these. How does a team come into being? What different formats are there? How might the patient contribute to the effectiveness of their care and the way in which the team operates? What are the difficulties and frustrations encountered in developing and maintaining such teams? What models of working and styles of leadership have developed? How are power and authority handled within the team setting? The importance of team building, training, support, attention to group process, and stress management to protect the mental health of the team are explored. The ethical issues inherent in palliative care such as consent, autonomy, confidentiality, decision making within teams, and the legal implications of such are also discussed. The book concludes with one important question: Do we know if teams are the most effective way of providing care? Less

A Time for Listening and Caring: Spirituality and the Care of the Chronically Ill and Dying

Christina M. Puchalski

The connection between spirituality and health has received a lot of attention in both the scientific and lay presses. Is religion good for your health? Should doctors talk with their ... More

The connection between spirituality and health has received a lot of attention in both the scientific and lay presses. Is religion good for your health? Should doctors talk with their patients about their spiritual or religious beliefs? Should doctors pray with their patients? Through research and evidence, spirituality has been shown to be central to the care of the dying. It is therefore critical that healthcare providers know how to address a patient's spiritual needs. This book presents thinking on how spiritual care can be integrated into traditional caregiving in a practical and informed manner. Chapters that specifically address different religious and cultural perspectives are included. Patients' stories are used throughout to offer real-world experience. With a foreword by the Dalai Lama, the book is a guide for anyone involved in caring for the chronically ill or dying. Less

Venous Thromboembolism in Advanced Disease: A clinical guide

Simon I R Noble, Miriam J Johnson, Agnes Y Y Lee (eds)

There is increasing recognition of the burden of venous thromboembolism (VTE) in patients with advanced incurable disease and the clinical, ethical, and philosophical challenges they may ... More

There is increasing recognition of the burden of venous thromboembolism (VTE) in patients with advanced incurable disease and the clinical, ethical, and philosophical challenges they may pose. With a growing elderly population and oncological therapies helping patients live longer with malignant disease, VTE is likely to be an ongoing problem. Whilst presentation, diagnosis, and treatment of VTE in general medicine are well established, its management within the palliative care setting is less clear-cut. Clinical presentation is often masked by other palliative symptoms, and symptoms can be consistent with those of other conditions; diagnosis is therefore underappreciated, and the condition can be difficult to manage. Bringing together international contributions from the field of VTE and palliative care, this book explores the increasing challenges faced by healthcare professionals when managing VTE in advanced disease. Topics such as the epidemiology and pathogenesis of the condition are discussed. It appraises the current evidence informing the prevention, diagnosis, and treatment of VTE, with particular emphasis on its application to patients with incurable malignancy and non-malignant disease. Chapters are illustrated with key learning points and, where appropriate, case studies are presented to illustrate the decision-making processes that may occur when balancing the evidence with its impact on patient quality of life. Less

Volunteers in hospice and palliative care: A resource for voluntary service managers

Derek Doyle

Rosalind Scott, Steven Howlett (eds)

This book provides practical guidelines on the responsibilities of those who lead, co-ordinate, and manage volunteers in small hospices, large specialist palliative care units, and in ... More

This book provides practical guidelines on the responsibilities of those who lead, co-ordinate, and manage volunteers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams. Volunteers are key workers, who often perform difficult and important work. In the United Kingdom alone there are thousands of volunteers in hospice work, a small proportion doing work with patients, and the vast majority doing equally valuable work such as driving, sitting with relatives, and manning charity shops and telephones. As a result, Europe, Australia, the United States and Canada are very interested in the United Kingdom's use of volunteers. Aimed primarily at Voluntary Services Managers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams, this updated second edition covers volunteer selection, training, supervision and support, and legal and ethical considerations. Less

The Weeping Willow: Encounters with Grief

Lynne Dale Halamish, Doron Hermoni

This book is a practical and direct handbook for grieving. It presents 30 stories from real life that examine how we grieve and how we can help those who grieve—whether the griever is ... More

This book is a practical and direct handbook for grieving. It presents 30 stories from real life that examine 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. The authors 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. Less

When Treatment Fails: How medicine cares for dying children

David J. Bearison

Over 50,000 children die of medical causes each year in the U.S., and 85% of them do so in hospitals. While great strides have been made in palliative care, many of these children still ... More

Over 50,000 children die of medical causes each year in the U.S., and 85% of them do so in hospitals. While great strides have been made in palliative care, many of these children still suffer considerably in the last months of life. Studies have found that pediatricians, who often do not expect to confront death on a frequent basis, and other hospital staff typically feel inadequately trained to manage the situation and are emotionally unprepared for the death. All of the feelings associated with caring for a chronically ill child – guilt, anger, frustration, ambivalence, exhaustion – are magnified when a child's life can no longer be prolonged. This book is based directly on the voices of those who care for children at the end of their lives: the doctors, nurses, social workers, pastoral counselors, and psychologists. Centered on seven cases, the author has elicited and recorded the stories of these professionals about their experiences of caring for patients. The narratives illustrate how clinicians from different professional roles speak about the biological, psychological, spiritual, and social dimensions of caring for terminally ill patients. The author analyzes their ways of making sense of and giving meaning to their difficult experiences, unearthing common and distinct themes and issues across disciplines. Less