Palliative Care : oso

Participatory Research in Palliative Care

Jo Hockley, Katherine Froggatt, and Katharina Heimerl — 2013-01-24

Author:: Jo Hockley, Katherine Froggatt, Katharina Heimerl
ISBN:: 9780199644155
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199644155.001.0001
Published in print:: 2012
Published Online:: 2013-01-24

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, this book 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.

The Nature of Healing

Eric J. Cassell — 2013-01-24

Author:: Eric J. Cassell
ISBN:: 9780195369052
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780195369052.001.0001
Published in print:: 2012
Published Online:: 2013-01-24

The healing tradition in Western medicine goes back to its Greek origins. What actually constitutes healing is poorly understood even in this first era of cure and advanced medical science. Sickness has usually been defined as the physical result of bodily disease. This is out of date in these times of chronic illness and when the problems of disability and aging are so common. This book uses a different definition: Persons are sick who cannot achieve their goals and purposes because of impairments of function from the molecular to the spiritual that they believe are in the province of medicine. Some impairment may be due to disease, but certainly not all. As the sick person has become the focus of medicine there have been repeated failed attempts to achieve both technologic and humanistic goals. This is wrong; there are not two goals there is only one ultimate goal, the well-being of the patient. All therapeutic interventions toward that end are exercises in healing. There are some impairments of function requiring high technology and others in which the personal actions of healers are most appropriate; proper balance is necessary. This book describes in depth what sickness is, what persons are, and how to understand function and its impairments. Healing skills and actions are explained and the nature of healing for sick and also suffering patients is detailed. The book concludes with a discussion of the moral basis of the patient-healer relationship and finally an understanding of goals.

The Edge of Medicine

David J. Bearison and Linda Granowetter — 2012-09-20

Author:: David J. Bearison, Linda Granowetter
ISBN:: 9780195389272
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine
DOI:: 10.1093/acprof:oso/9780195389272.001.0001
Published in print:: 2012
Published Online:: 2012-09-20

This book is a sequel to When treatment fails: How Medicine Cares for Dying Children (Oxford University Press, 2006). Its purpose was to systematically document persuasive issues that arise in pediatric end-of-life palliative care: when to withhold or withdraw curative treatments, how to manage pain and suffering, how to communicate bad news to patients and families, how the staff copes with patients dying and how they are able to move on, how best to train staff in pediatric end-of-life care, and how the staff understands the reactions of dying patients and their families. Similar in form (i.e., narrative analyses) and purpose, this book addresses these issues. It systematically analyzes and documents the challenges of pediatric end-of-life palliative care but does so from the special perspectives provided by narratives from children at the end of their lives and their families. It captures the frustrating and diverse voices among dying children and their parents. Together, these two books significantly advance ways to improve standards of care and promote transparency in ethically complicated deliberations concerning end-of-life care for children. Their findings will be used to develop pediatric palliative care policies and guidelines, teaching programs, advocacy resources, treatment protocols, and innovative service delivery models of national significance that improve the quality-of- life for children who are approaching the end of life and their families.

Supportive Care in Respiratory Disease

Sam H. Ahmedzai, David R. Baldwin, and David C. Currow — 2012-05-24

Author:: Sam H.AhmedzaiProfessor of Palliative Medicine, Academic Unit of Supportive Care, School of Medicine and Biomedical Sciences, University of Sheffield, UKDavid R.BaldwinConsultant Physician in General and Respiratory Medicine, Nottingham City Hospital, UKDavid C.CurrowProfessor of Palliative and Supportive Services, Flinders University; Flinders Centre for Clinical Change, Flinders University and Institute of Palliative and Supportive Care Research, Australia
ISBN:: 9780199591763
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199591763.001.0001
Published in print:: 2012
Published Online:: 2012-05-24

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.

A Public Health Perspective on End of Life Care

Joachim Cohen and Luc Deliens — 2012-05-24

Author:: JoachimCohenEnd-of-life Care Research Group, Vrije Universiteit Brussel, Brussels, BelgiumLucDeliensVU University Medical Center, Department of Public and Occupational Health, EMGO and Institute for Health and Care Research, Amsterdam, the Netherlands
ISBN:: 9780199599400
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199599400.001.0001
Published in print:: 2012
Published Online:: 2012-05-24

Worldwide, more than 50 million people die each year and it is estimated on the basis of the conditions leading to death that up to 60% of them could benefit from some form of palliative care. It is a public health challenge to ensure that these people can access good palliative or end-of-life care. Pursuing good population health essentially also implies striving for a ‘good enough death’ and a good quality of care at the end of life. Safeguarding a good quality of the end of life for patient populations for whom it is appropriate requires a public health approach. In most developed countries ageing populations that increasingly die from chronic diseases after a prolonged — often degenerative — dying trajectory make up the public health challenges for palliative care. The very large baby boom generation will soon reach old age and can be expected to pose strong demands regarding the circumstances and care at their end of life. Only by applying a public health approach to palliative care (instead of individual patient perspectives), can societies successfully help to organize and plan end-of-life care in accordance with these aspirations. This book presents a synthesis and overview of relevant research and empirical data on the end of life that can bear a basis for a more systematic ‘public health of the end of life’. The book focuses on population health, rather than clinical interventions or other aspects of individual health, and discusses studies using different methodologies (not only epidemiological research). The focus is on the quality of the end-of-life of populations, in particular from social sciences, environmental sciences, and humanities perspectives.

Palliative Medicine

Doreen Oneschuk, Neil Hagen, and Neil MacDonald — 2012-05-24

Author:: DoreenOneschukPalliative Medicine Physician, Associate Professor, Division of Palliative Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, CanadaNeilHagenProfessor, Division of Palliative Medicine, Department of Oncology, University of Calgary, Alberta, CanadaNeilMacDonaldFounding Director, Cancer Nutrition - Rehabilitation Program, McGill University, Montreal, Quebec, Canada and Professor of Oncology, McGill University
ISBN:: 9780199694143
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199694143.001.0001
Published in print:: 2012
Published Online:: 2012-05-24

Palliative care is now an integral part of the undergraduate medical curriculum. Medical education across the board is adopting a case-based approach. This book uses a series of cases to illustrate critical points in palliative medicine. The case-studies have been carefully chosen to reflect real life clinical practice. The chapters illustrate, through the case studies, the desired skills, attitudes, and knowledge required in this field of medicine. Since publication of the second edition, many approaches to palliative care have been further refined and developed. Ongoing research has led to the improved use of existing medications, and the development of several new treatments. More is known about the psychosocial existential distress experienced by patients and their families resulting in an improved understanding by health care providers of how best to approach and assist those affected by advanced illness, and more is known about methadone and other medications with emerging uses. The third edition of this book continues to offer a panoramic view of palliative care. It introduces a number of new topics including neurological disorders, the last days, and palliative sedation.

Dignity Therapy

Harvey Max Chochinov — 2012-05-24

Author:: Harvey Max Chochinov
ISBN:: 9780195176216
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780195176216.001.0001
Published in print:: 2012
Published Online:: 2012-05-24

Maintaining dignity for patients approaching death is a core principle of palliative care. Turning that principle into ways of guiding care at the end-of-life, however, can be a complicated and daunting task. Dr. Harvey Max Chochinov, an international leader in palliative care, has conducted groundbreaking research on the issue of dignity and palliative care. His findings are beginning to change the way people think about and approach care for the terminally ill. Dignity Therapy is a novel, individualized, brief psychological intervention, designed specifically to address many of the psychological, existential and spiritual challenges that patients and their families face as they grapple with the reality of life drawing to a close. This therapeutic approach, based on years of Chochinov and his team's research, has been tested on patients with advanced illnesses in various countries worldwide. Many palliative care programs are starting to incorporate Dignity Therapy into the range of services offered dying patients and their families. This enthusiastic uptake of Dignity Therapy speaks to some universal aspects of being human; to be alive means to experience being vulnerable and being mortal. Dignity Therapy offers a way of preserving meaning, purpose and hope for patients approaching death. The benefits of this approach for patients and families have been demonstrated in various studies in diverse settings. Dignity Therapy: Final Words for Final Days introduces readers to this pioneering and innovative work, illustrating how Dignity Therapy can change end-of-life experience for those about to die and those who will grieve their passing.

Death, Dying, and Social Differences

David Oliviere, Barbara Monroe, and Sheila Payne — 2012-01-19

Author:: DavidOliviereDirector of Education and Training, St Christopher's Hospice, Sydenham, London; Visiting Professor, Middlesex University, London, UKBarbaraMonroeChief Executive, St Christopher's Hospice, Sydenham, London; Honorary Professor, International Observatory on End of Life Care, Lancaster University, Lancaster, UKSheilaPayneDirector of the International Observatory on End of Life Care, and Help the Hospices Chair in Hospice Studies, Lancaster University, Lancaster; Director of the Cancer Experiences Collaborative, UK
ISBN:: 9780199599295
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199599295.001.0001
Published in print:: 2011
Published Online:: 2012-01-19

Society has become increasingly diverse: multi-cultural, multi-faith, and wide ranging in family structures. The wealthier are healthier and social inequalities are more pronounced. Respecting and working with the range of ‘differences’ among service users, families, and communities in health and social care with ill, dying, and bereaved people is a neglected area in the literature. As the principles of palliative and end-of-life care increasingly permeate the mainstream of health and social care services, it is important that professionals are sensitive and respond to the differing needs of individuals from diverse socio-economic backgrounds, ethnicities, beliefs, abilities, and sexual orientations, as well as to the different contexts and social environments in which people live and die. This book explores what underpins inequality, disadvantage, and injustice in access to good end-of-life care. Increasingly clinicians, policy planners, and academics are concerned about inequity in service provision. Internationally, there is an increasing focus and sense of urgency both on delivering good care in all settings regardless of diagnosis, and on better meeting the needs of vulnerable and disadvantaged groups. National initiatives emphasize the importance of resolving disparities in care and harnessing empowered user voices to drive change.

When Treatment Fails

David J. Bearison — 2011-11-17

Author:: David J. Bearison
ISBN:: 9780195156126
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780195156126.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

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.

The Weeping Willow

Lynne Dale Halamish and Doron Hermoni — 2011-11-17

Author:: Lynne Dale Halamish, Doron Hermoni
ISBN:: 9780195325379
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
DOI:: 10.1093/acprof:oso/9780195325379.001.0001
Published in print:: 2007
Published Online:: 2011-11-17

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.

Volunteers in hospice and palliative care

Rosalind Scott, Steven Howlett, and Derek Doyle — 2011-11-17

Author:: RosalindScottDirector of Organisational Development, Children's Hospice Association, ScotlandStevenHowlettSenior Lecturer, Roehampton University, UKhttp://www.roehampton.ac.uk/staff/StevenHowlett/, Derek Doyle
ISBN:: 9780199545827
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199545827.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

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.

Venous Thromboembolism in Advanced Disease

Simon I R Noble, Miriam J Johnson, and Agnes Y Y Lee — 2011-11-17

Author:: Simon I RNobleClinical Senior Lecturer and Honorary Consultant in Palliative Medicine, Cardiff University and the Royal Gwent Hospital, Wales, UKMiriam JJohnsonSenior Lecturer in Palliative Medicine, Hull-York Medical School, and Honorary Consultant to St. Catherine's Hospice, North Yorkshire, UKhttp://www.hyms.ac.uk/research/palliative-medicine.aspxAgnes Y YLeeAssociate Professor, Division of Hematology and Thromboembolism, Department of Medicine, McMaster University; Acting Head, Thromboembolism Service, Hamilton Health Sciences Henderson Hospital, Hamilton, Ontario, Canadahttp://fhs.mcmaster.ca/medicine/hematology/faculty_member_lee.htm
ISBN:: 9780199232048
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199232048.001.0001
Published in print:: 2008
Published Online:: 2011-11-17

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.

A Time for Listening and Caring

Christina M. Puchalski — 2011-11-17

Author:: Christina M. Puchalski
ISBN:: 9780195146820
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
DOI:: 10.1093/acprof:oso/9780195146820.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

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.

Teamwork in Palliative Care

Peter Speck — 2011-11-17

Author:: PeterSpeckFormer Health Care Chaplain; Honorary Senior Research Fellow, King's College London, Department of Palliative Care and Policy, Guy's, King's and St Thomas' Medical School; Visiting Fellow, School of Psychology, Southampton University, UKhttp://www.csi.kcl.ac.uk/speck.html
ISBN:: 9780198567745
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780198567745.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

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?

Surgical Palliative Care

Geoffrey P Dunn and Alan G Johnson — 2011-11-17

Author:: Geoffrey PDunnAttending Surgeon, Department of Surgery, Hamot Medical Center and Medical Director, Great Lakes Hospice, Erie, PennsylvaniaAlan GJohnsonEmeritus Professor of Surgery, University of Sheffield
ISBN:: 9780198510000
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198510000.001.0001
Published in print:: 2004
Published Online:: 2011-11-17

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.

Supportive Care in Respiratory Disease

Sam H. Ahmedzai and Martin F. Muers — 2011-11-17

Author:: Sam H.AhmedzaiProfessor of Palliative Medicine, Royal Hallamshire Hospital, Sheffield, UKhttp://www.shef.ac.uk/oncology/staffprofiles/ahmedzaiMartin F.MuersRespiratory Physician, Leeds General Infirmary, and Senior Lecturer, University of Leeds, UK
ISBN:: 9780192631411
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192631411.001.0001
Published in print:: 2005
Published Online:: 2011-11-17

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.

Supportive Care in Heart Failure

James Beattie and Sarah Goodlin — 2011-11-17

Author:: JamesBeattieConsultant Cardiologist, Heart of England NHS Foundation Trust, Birmingham; National Clinical Lead, NHS Heart Improvement Programme, UKSarahGoodlinPresident, Patient-centered Education and Research, Salt Lake City, USA
ISBN:: 9780198570288
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780198570288.001.0001
Published in print:: 2008
Published Online:: 2011-11-17

Heart failure occurs in almost epidemic proportions, placing a huge burden on both the healthcare system, and sufferers and their families. The care of this group of patients has evolved significantly over recent years as our knowledge and understanding of the pathophysiology of heart failure has developed. This book provides an evidence-based overview of heart failure aetiology, its management, and the supportive care required by patients throughout the course of their disease. It also integrates the complexities of heart failure care, bridging knowledge bases from cardiology and cardiothoracic surgery, general medicine and palliative care. It reviews essential information about the epidemiology and pathophysiology of heart failure, and evidence-based medical, device, surgical, and interdisciplinary management. It addresses the evaluation and management of quality of life, common symptoms and problems associated with heart failure, and the holistic approach to supportive care throughout the course of the illness through to the end of life. Prognostication, communication, and ethical decision making are outlined in detail. By applying the principles of palliative medicine, it is possible to offer a supportive care approach that synthesizes the experience of both the heart failure specialist and the palliative care physician, and offers the best possible quality of care to this group of patients.

Supportive Care for the Urology Patient

Richard W. Norman and David C. Currow — 2011-11-17

Author:: Richard W.NormanDavid C.Currow
ISBN:: 9780198529415
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780198529415.001.0001
Published in print:: 2005
Published Online:: 2011-11-17

This book provides a practical, evidence-based overview of the supportive care of patients with urological failure, focusing on chronic symptoms such as chronic prostatitis. It begins by looking at quality of life measurements, self-help strategies, the role of the interdisciplinary team, and psychological and social support. It then moves on to clinical chapters which cover issues such as patients who present with hematuria, urinary retention, urinary incontinence, neurological disease affecting the urinary tract, chronic prostatitis, and infertility; ending with a chapter on supportive care for the urology patient and family in the future. The book places a special emphasis on symptomatic interventions, particularly in the setting where the course of the illness cannot be modified.

Supportive Care for the Renal Patient

E. Joanna Chambers, Edwina Brown, and Michael Germain — 2011-11-17

Author:: E. JoannaChambersConsultant in Palliative Medicine, Richard Bright Renal Unit, Southmead Hospital, Bristol, UKhttp://psychiatry.medicine.iu.edu/faculty-listing/joanna-chambers/EdwinaBrownConsultant Nephrologist, Imperial College Kidney and Transplant Institute, Hammersmith Hospital, London, UKhttp://www1.imperial.ac.uk/medicine/people/e.a.brown/MichaelGermainProfessor of Medicine, Tufts University, Massachusetts, USA
ISBN:: 9780199560035
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199560035.001.0001
Published in print:: 2010
Published Online:: 2011-11-17

This book provides an evidence-based overview of supportive care for the nephrology patient. An international group of contributors emphasize 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 second 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.

Supportive care for the person with dementia

Julian Hughes, Mari Lloyd-Williams, and Greg Sachs — 2011-11-17

Author:: JulianHughesConsultant in Old Age Psychiatry and Honorary Professor of Philosophy of Ageing in Northumbria Healthcare NHS Foundation Trust and the Institute for Ageing and Health, Newcastle University, UKMariLloyd-WilliamsProfessor and Director of Academic Palliative and Supportive Care, University of Liverpool, UKhttp://tulip.liv.ac.uk/pls/new_portal/tulwwwmerge.mergepage?p_template=be&p_tulipproc=staff&p_params=%3Fp_func%3Dteldir%26p_hash%3DA992693%26p_url%3DBE%26p_template%3DbeGregSachsProfessor of Medicine and Chief, Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine and Scientist, IU Center for Aging Research and Regenstrief Institute, Inc., USAhttp://www.npcrc.org/grantees/grantees_show.htm?doc_id=676822
ISBN:: 9780199554133
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199554133.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

Supportive care can be thought of as an extension of palliative care so that the person with dementia receives good quality, holistic care that makes no distinctions between the dichotomies of care and cure from the time of diagnosis until, and beyond, death. It recognizes the need for an inter-disciplinary approach and for continuity of care. Supportive care in dementia must, therefore, be broad in its scope and application. This book provides such a perspective, drawing upon the experience and expertise of a wide range of internationally-based professionals to outline a model of supportive care that will provide good quality and holistic care for people with dementia. Making use of real-life reports from both patients and carers to help readers fully understand the reality of dementia, the book examines the key principles that guide the practice of supportive care. It looks at how supportive care can be used, and specific benefits a care model of this type can bring to the complex problems that are frequently encountered when treating this condition.

Resilience in Palliative Care

Barbara Monroe and David Oliviere — 2011-11-17

Author:: BarbaraMonroeChief Executive, St Christopher's Hospice, London, UKhttp://www.eolc-observatory.net/information/staff/bmonroe.phpDavidOliviereDirector of Education and Training, St Christopher's Hospice, London, UK
ISBN:: 9780199206414
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199206414.001.0001
Published in print:: 2007
Published Online:: 2011-11-17

This book offers an overview of key aspects of palliative care, presented through a resilience perspective. Why do some patients and families break down while others surmount the challenges facing them? What interventions strengthen individual, family and community coping? The book aims to facilitate change with people facing the crisis of death, dying, and bereavement. Much of the existing literature has focused on risk, problems, and vulnerability; the emerging concept of resilience focuses on strengths and possibilities. The ‘total pain’/‘total care’ approach pioneered by Dame Cicely Saunders and St Christopher's Hospice now needs reinterpreting in the light of changing contexts and challenges. The realities of demographic change and resource-constrained health and social care environments have generated an increasingly risk focused approach to service delivery. A narrowly medicalised approach has inevitable limitations: professional care alone will be unable to meet need and demand in the face of ageing populations, changing patterns of illness and the need for equity. The resilience approach offers a counterbalance that harnesses the strengths of individuals and the communities in which they live and in which most of their dying will take place. Resilience thinking emphasises the importance of public health and creates a partnership between patients, professionals, and community structures, seeking to build community capacity and to deliver a preventive health care that will leave future generations less afraid of the dying and bereavement that will confront all of us.

Research Methods in Palliative Care

Julia M Addington-Hall, Eduardo Bruera, Irene J Higginson, and Sheila Payne — 2011-11-17

Author:: Julia MAddington-HallChair in End of Life Care, School of Nursing and Midwifery, University of Southampton, UKhttp://www.npcrc.org/about/about_show.htm?doc_id=495334EduardoBrueraProfessor and Chair, Department of Palliative Care and Rehabilitation Medicine, The University of Texas M D Anderson Cancer Center, Houston, TX, USAIrene JHigginsonProfessor of Palliative Care and Policy, Department of Palliative Care, Policy and Rehabilitation, King's College London, UKhttp://www.csi.kcl.ac.uk/higginson.htmlSheilaPayneHelp the Hospices Chair in Hospice Studies, International Observatory on End of Life Care, Institute of Health Research, Lancaster University, Lancaster, UKhttp://www.lancs.ac.uk/shm/dhr/profiles/Sheila-Payne/
ISBN:: 9780198530251
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198530251.001.0001
Published in print:: 2007
Published Online:: 2011-11-17

Palliative and end-of-life care are concerned with the physical, social, psychological, and spiritual care of people with advanced disease. It currently has a poorly developed research base, but the need to improve this is increasingly recognized. One of the reasons for the lack of research — and the variable quality of the research that is undertaken — is the difficulty of conducting research with very ill and bereaved people. Standard and well-established research methods may need to be adapted to work in this context. This means that existing research methods' books may be of limited use to palliative care practitioners seeking to do research for the first time, or to more experienced researchers wanting to apply their knowledge in palliative care settings. This book encompasses methods used in both clinical and health services' research in palliative care, with sections on clinical, epidemiological, survey and qualitative research, as well as a section covering skills needed in any research project. Each chapter provides an up-to-date overview of the research method in question, an understanding of its applicability to palliative care and of the particular challenges of using it in this setting.

Recognizing Spiritual Needs in People who are Dying

Rachel Stanworth — 2011-11-17

Author:: Rachel Stanworth
ISBN:: 9780198525110
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780198525110.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

Listening carefully to patients at the end of life is at the heart of good palliative care and this book provides a means of recognizing and talking about spiritual needs even when religious language is not used. The author refers to this as a ‘language of spirit’. The book is based on interviews with patients who are dying and the language that they use to describe their experiences. It deals with death, dying, the experiences of patients, and the relief of spiritual pain by looking closely at patient stories, drawings, and behaviour. The book explains why it is often easier to recognize than to explain spiritual issues. Part One explores the psychological, spiritual, and theological interpretations of human experience. A detailed account is given of how the patients' own stories were collected. Drawing on a broad literature that is grounded in patients' words and deeds, Part Two introduces a non-religious ‘language of spirit’. Illuminated by patient art, Part Three shows what patients use this language to ‘say’ about their situation and how it is mediated through various metaphors. Part Four suggests ways of responding positively to patients' spiritual needs.

Psychosocial Issues in Palliative Care

Mari Lloyd-Williams — 2011-11-17

Author:: MariLloyd-WilliamsProfessor/Director, Academic Palliative and Supportive Care Studies Group, University of Liverpool, UKhttp://tulip.liv.ac.uk/pls/new_portal/tulwwwmerge.mergepage?p_template=be&p_tulipproc=staff&p_params=%3Fp_func%3Dteldir%26p_hash%3DA992693%26p_url%3DBE%26p_template%3Dbe
ISBN:: 9780199216420
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199216420.001.0001
Published in print:: 2008
Published Online:: 2011-11-17

Caring for patients with a terminal illness and their families requires the skills of many professionals working together as a team. It is often the psychosocial issues surrounding patients and families that cause professionals even greater difficulty than the physical symptoms. The issues of psychosocial assessment, treatment, care, and support of palliative care patients differs from the care of patients with early, treatable cancer — time is short and the emphasis different both from a patient and carer perspective. This second edition examines current practice and provision of psychosocial support as applied to palliative care patients. It is a practical text, reviewing the current literature and evidence in order to demonstrate good, and better, practice in psychosocial care. The text covers a number of areas including the nature of services required to provide effective psychosocial care; cultural issues of psychosocial care and adaptation; the importance of communication, including patients with communication difficulties; and socio-economic issues affecting the patient with advanced metastatic disease. Specific disorders such as anxiety and depression are included, as is the integration of service provision. The book also explores the evidence of specific psychotherapeutic interventions and includes guidelines on techniques that can be used in clinical practice. Complementary therapies are widely sought by patients and families and the evidence base is slowly growing — a review of such therapies including herbal and homeopathic medicines is included. Whilst spiritual support and staff support are an integral part of all aspects of psychosocial care, and are incorporated throughout, these areas are also discussed in-depth in individual chapters.

Pruritus in Advanced Disease

Zbigniew Zylicz, Robert Twycross, and E. Anthony Jones — 2011-11-17

Author:: ZbigniewZyliczConsultant, Comprehensive Cancer Centre, Nijmegen, The Netherlands and Chair of Palliative Care, The Ludwik Rydigier University of Medical Sciences, Bydgoszcz, PolandRobertTwycrossEmeritus Clinical Reader in Palliative Medicine, Oxford University and Head, WHO Collaborating Centre for Palliative Care, Oxford, UKE. AnthonyJonesChief of Hepatology, Department of Gastrointestinal and Liver Diseases, Academic Medical Center, Amsterdam, The Netherlands
ISBN:: 9780198525103
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198525103.001.0001
Published in print:: 2004
Published Online:: 2011-11-17

Pruritus is a prevalent symptom in many skin conditions. However, much less is known about pruritus unassociated with primary skin disease. This latter problem is of major relevance to most medical specialties, notably palliative care, haematology, oncology, internal medicine, hepatology, nephrology, anaesthesiology, immunology, and psychiatry. Specialists in these non-dermatological disciplines each see a few patients with severe pruritus and, therefore have only limited possibilities to learn from their personal experience. In response to the need for information on pruritus in non-dermatological disciplines, this book aims to build a bridge of relevant knowledge and evidence between the various non-dermatological specialties. Pruritus can cause considerable discomfort in patients with cancer, patients receiving treatment for cancer, and patients with non-malignant terminal illnesses. Some knowledge about the pathophysiology of certain types of pruritus exists in different clinical specialties. This book brings this information together. An international group of contributors cover the neurophysiology and clinical assessment of pruritus, the measurement of scratching activity as well as opioid-induced pruritus, pruritus in haematological disorders, neuropathic pruritus and psychogenic pruritus, and the treatment of pruritus in these different clinical settings.

Providing a palliative care service: towards an evidence base

Nick Bosanquet and Chris Salisbury — 2011-11-17

Author:: Nick Bosanquet, Chris Salisbury
ISBN:: 9780192629913
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780192629913.001.0001
Published in print:: 1999
Published Online:: 2011-11-17

This book addresses key questions about the need for palliative care, the current provision of services, and the evidence for the effectiveness of a range of alternative models of organisation in palliative care. A broad approach is taken to include the needs of both cancer patients and patients with other terminal diseases, and the relationship between palliative care and other aspects of health care services. The book is based on a comprehensive and detailed review of the international scientific literature on evaluation of palliative care, providing an essential evidence base for policy decisions.

The Philosophy of Palliative Care

Fiona Randall and R S Downie — 2011-11-17

Author:: Fiona Randall, R S Downie
ISBN:: 9780198567363
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780198567363.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

The idea of a philosophy of palliative care emerged with Cicely Saunders' vision for ‘a good death’, and was developed further with the World Health Organization (WHO) definition of palliative care. It is now being applied not only to cancer patients, but to all patients in end-of-life situations. As this palliative care approach advances, it is important to pause and comment on its effectiveness. It is a philosophy of patient care, and is therefore open to critique and evaluation. Using the Oxford Textbook of Palliative Medicine, 3rd edition as their basic reference, the authors present their argument that the palliative care approach has become too busy and over-professionalised, and that it therefore has significant weaknesses. They examine the framework of the specialty – quality of life, autonomy, dignity, patient-centredness, and the priority assigned to relatives in the remit of care – and the moral problems associated with implementing such a philosophy. The resource implications of various healthcare policies are also discussed in relation to the WHO definition. Whilst the authors defend the achievements of palliative care and those who work in the profession, they present suggestions for an alternative philosophy that prompts many ethical and philosophical questions about the future of palliative care.

Pediatric Psychooncology

David J. Bearison and Raymond K. Mulhern — 2011-11-17

Author:: David J.BearisonThe Graduate School of the City University of New YorkRaymond K.MulhernUniversity of Tennessee College of Medicine
ISBN:: 9780195079319
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780195079319.001.0001
Published in print:: 1994
Published Online:: 2011-11-17

As the practice of pediatric oncology continues to advance and prognoses continue to improve, the course of treatment for children with poor prognoses becomes more biologically aggressive, more stressful, and more uncertain. Even for children who cannot be cured, new treatments have prolonged the survival of those with active disease and, consequently, medical interventions have complicated the dying process. For those who are cured, there are the lingering uncertainties of having undergone medical regimens whose adverse late effects are not yet fully understood. Consequently the field of pediatric oncology now encompasses more than strictly medical concerns. The conditions of treatment, survival, and dying have become the concerns of all health-care practitioners, including psychiatrists. This volume addresses a range of psychological issues—coping with pediatric cancer, pain and symptom management, medication compliance, sibling and family relations, care of the dying child, among others—pertaining to the practice of pediatric oncology. Each topic encompasses a substantial body of research that has theoretical and applied significance. Each chapter contextually defines the research area, discusses its theoretical and methodological concerns, critically reviews and integrates research findings in the area, discusses unresolved research issues, and suggests future research. The topics included are currently supported by sufficient empirical research to allow useful generalization of findings in the clinical setting.

Patient Participation in Palliative Care

Barbara Monroe and David Oliviere — 2011-11-17

Author:: BarbaraMonroeChief Executive, St Christopher's Hospice, Sydenham, London, UKhttp://www.eolc-observatory.net/information/staff/bmonroe.phpDavidOliviereDirector of Education and Training, St Christopher's Hospice, Sydenham, London, UK
ISBN:: 9780198515814
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780198515814.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

Patient participation and user involvement are central to current thinking about the effective delivery of desired healthcare outcomes. Working with the person who lies behind every patient is core to palliative care. A voice can only become significant when it is listened to and acted upon. With palliative care increasingly addressing the needs of people with a variety of conditions in a range of settings, as well as with advances in research, technology, and information, the challenge to be ‘a voice for the voiceless’ is greater than ever. This book addresses key aspects in the provision of patient-centered palliative care and tracks significant developments in user involvement. It sets the philosophy within the cultural, social, and political context of modern healthcare, particularly addressing issues of quality, standards, education, and bereavement. A key component in the delivery of high-quality palliative care is the multi-professional team. Following a discussion of teamwork, five core professions present a critical analysis of their working practices. The book concludes with a commentary from a palliative care user and a bereaved carer. It is often somewhat glibly asserted that the patient is, or should be, at the centre of care. There have been few attempts to examine how to keep him or her there without professional needs and protocols crowding him or her out. This book asks how we listen and why we listen, and focuses on the challenges of how professionals can keep the needs of the patient central in clinical care.

Palliative Day Care in Practice

Julie Hearn and Kathryn Myers — 2011-11-17

Author:: JulieHearnSenior Executive, National Cancer Research Institute (NCRI) Clinical Studies GroupsKathrynMyersLocum Consultant in Palliative Medicine, The Peace Hospice, Watford, UK
ISBN:: 9780192631831
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192631831.001.0001
Published in print:: 2001
Published Online:: 2011-11-17

Day care for people with advanced diseases is one of the most rapidly expanding components of palliative care in the UK, and is increasingly a focus of new-service development throughout the world. Many benefits, in terms of quality of life, holistic care for the patient and family and increased time at home are claimed by day care. This book provides a comprehensive overview of the current philosophy, patterns, and policies of palliative day care. It places emphasis on the need to evaluate performance in palliative day care and describes in detail aspects such as audit, health economics, and research, and their associated problems and pitfalls. For readers new to the field it aims to survey the broad concepts and components of palliative day care and the philosophies and practical issues that relate to them. For those more experienced in the field, it seeks to highlight some of the questions, challenges, and dilemmas that palliative day care services face and which will need to be addressed in the years ahead.

Palliative Care Perspectives

James L. Hallenbeck — 2011-11-17

Author:: James L. Hallenbeck
ISBN:: 9780195165784
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780195165784.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview of death and dying to specific approaches to symptom management. As an introduction to both the art and science of palliative care, the book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. It links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.

Palliative Care in the Home

Derek Doyle and David Jeffrey — 2011-11-17

Author:: Derek Doyle, David Jeffrey
ISBN:: 9780192632272
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192632272.001.0001
Published in print:: 2000
Published Online:: 2011-11-17

Most people with far-advanced illness wish to be cared for at home for as long as possible. The challenge of providing good palliative care at home is therefore of major importance for family doctors, nurses, and all those committed to maintaining the highest possible quality of life for the dying person. As modern specialist palliative care has raised both standards of care and also public expectations of family doctors and community nurses, this book helps to place specialist care in context. As palliative care is a major responsibility for teams providing care at home, the book provides a definitive guide on how to provide effective care for people with far-advanced disease. It has been written by two palliative specialists, both of whom have been family doctors. The book deals with all the physical, emotional, spiritual, and social problems that will be encountered by family doctors and community nurses caring for patients and relatives in a home setting. It deals in detail with emergencies, communications, and ethical issues, and emphasises throughout the importance of team work.

Palliative care in the acute hospital setting

Sara Booth, Polly Edmonds, and Margaret Kendall — 2011-11-17

Author:: Sara Booth, Polly Edmonds, Margaret Kendall
ISBN:: 9780199238927
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199238927.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

Hospital palliative care teams have been established in rapidly increasing numbers over the last twenty, as it has been recognised that hospices can never transfer the philosophy and practice of palliative care into the acute sector by simply existing; they often work as ‘stand alone units’ and remain outside mainstream medicine. However it has become apparent that improving access to palliative care for patients in acute hospitals is not as easy as employing external palliative care specialists as consultants. Even setting up a team of professionals who work solely in a hospital will often not improve the care of the great majority of patients being treated there. Based on the experience and knowledge of three clinicians in the area who have developed palliative care services in acute settings, this book provides those facing the same challenges with guidance and advice on a range of problems they might encounter. Using a problem focused and practical approach, this guide is filled with case-based problems to help with the identification of realistic, usable, everyday solutions. It also covers the skills and knowledge needed to help teams make progress in the hospital as well as outlining the best training to help professionals continue to flourish.

Palliative Care in Amyotrophic Lateral Sclerosis

David Oliver, Gian Domenico Borasio, and Declan Walsh — 2011-11-17

Author:: DavidOliverConsultant Physician in Palliative Medicine, Wisdom Hospice; Honorary Senior Lecturer at the Kent Institute of Medicine and Health Sciences, University of Kent, UKGian DomenicoBorasioProfessor and Acting Chairman, Interdisciplinary Center for Palliative Medicine; Head, Motor Neurone Disease Research Group, Department of Neurology, University of Munich, Germanyhttp://www.klinikum.uni-muenchen.de/Projekt-Neuroethik/en/research_team/GDB/index.htmlDeclanWalshProfessor and Director, The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic, USA
ISBN:: 9780199212934
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199212934.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

Amyotrophic lateral sclerosis (or motor neurone disease) is a rare disease but one 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. This book 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, culminating in discussion of bereavement. The experience of patients and families is considered and case studies are provided to show the practical application of the theoretical knowledge. Different models of care are explored, and this second edition of the text utilises the increase in both the evidence-base and available literature on the subject. Additional chapters on nursing, spiritual care, decision making, and ethical issues surrounding end of life care are included in this edition.

Palliative Care for Non-cancer Patients

Julia Addington-Hall and Irene Higginson — 2011-11-17

Author:: JuliaAddington-Hallhttp://www.npcrc.org/about/about_show.htm?doc_id=495334IreneHigginsonhttp://www.csi.kcl.ac.uk/higginson.html
ISBN:: 9780192629609
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780192629609.001.0001
Published in print:: 2001
Published Online:: 2011-11-17

The specialty of palliative care has traditionally grown out of oncology and there has been little research into the needs of patients dying from causes other than cancer. Few non-cancer patients receive hospice in-patient, home care, or day care although a good proportion of hospices say that their services are available to non-cancer patients. As a result, the importance of palliative care for non-cancer patients is now being increasingly recognized internationally, and in the UK a committee reporting to the Department of Health recommended that palliative care should be accessible to all patients who need such care. This book considers the needs and experiences of patients dying from, for example, stroke, heart disease, or dementia by drawing on a range of disciplines and specialties in medicine. The provision of palliative care for patients dying from causes other than cancer raises a number of important questions for policy makers and purchasers. This book summarizes what is known about the needs of and appropriate service provision for people dying of causes other than cancer and begins to set a research agenda.

Palliative Care Ethics

Fiona Randall and Robin Downie — 2011-11-17

Author:: Fiona Randall, Robin Downie
ISBN:: 9780192630681
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780192630681.001.0001
Published in print:: 1999
Published Online:: 2011-11-17

A book for nurses, doctors, and all who provide end-of-life care, this volume guides readers through the ethical complexities of such care, including policy initiatives, and encourages debate and discussion on their controversial aspects. Divided into two parts, it introduces and explains clinical decision-making processes about which there is broad consensus, in line with guidance documents issued by the WHO, the BMA, the GMC, and similar bodies. The changing political and social context, where ‘patient choice’ has become a central idea, and the broadened scope of patients' best interests have added to the complexity of decision making in end-of-life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians, which include patient choice; consent; life-prolonging treatment; and symptom relief, including sedation. Part Two explores the more controversial current end-of-life care initiatives, such as advance care planning, preferred place of care and death, euthanasia and assisted suicide, extended ideas of ‘best interests’, and the view that there are therapeutic duties to the relatives of patients. Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of consumerist choice, they reject its place in the health service, proposing a realistic, fair, humane and widely adoptable system of end-of-life care.

Palliative Care Consultations in Primary and Metastatic Brain Tumours

Sara Booth, Eduardo Bruera, and David Oliver — 2011-11-17

Author:: SaraBoothMacmillan Consultant in Palliative Medicine, Addenbrooke's Palliative Care Team, Cambridge, UKEduardoBrueraProfessor of Palliative Medicine, University of Texas, M.D. Anderson Cancer Center, USA, David Oliver
ISBN:: 9780198528074
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198528074.001.0001
Published in print:: 2004
Published Online:: 2011-11-17

This is the third book in an international, multi-contributed series aimed at providing practical clinical guidance on how to deal with difficult symptoms related to specific cancer sites. There are few more distressing problems for patients and families than the development of a primary or secondary brain tumour. Treatment is often palliative, though intensive, from the start. Little firm evidence exists to guide the physician in caring for patients with seizures refractory to standard treatment. Most of the work is based on case reports or personal experience. The book draws the information together in an accessible form so that it can be read and referred to on the ward, or before a domiciliary visit. Specialists in palliative care and oncology settings, working in the acute sector and in hospices, will find this book useful. It will also appeal to consultants as well as specialist registrars, clinical nurse specialists, and nurse practitioners in palliative care, oncology, and neurology.

Palliative Care Consultations in Head and Neck Cancer

Sara Booth and Andrew Davies — 2011-11-17

Author:: SaraBoothMacmillan Consultant in Palliative Care and Director of Palliative Care Service, Addenbrooke's Palliative Care Team, Cambridge, UKAndrewDaviesConsultant in Palliative Medicine, Royal Marsden Hospital, NHS Foundation Trust, Sutton, UK
ISBN:: 9780198530749
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198530749.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

This is the fifth book in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In it, the editors bring together palliative care and oncological treatment for patients with head and neck cancer. Head and neck cancer is one of the most frightening and distressing cancers for patients and their families as it affects appearance, the ability to speak, and the ability to eat. Pain, which is difficult to treat, infection, and disfiguring surgery with wounds that often do not heal, are common accompaniments of advanced disease. In addition, psychological distress, loneliness, and isolation are often experienced by patients. Head and neck cancer is not that common but, when it does occur, it very often needs specialist help from palliative care and hospice clinicians. There is little written on this subject and this book provides a practical guide that draws together all the information in an easily accessible format. The Palliative Care Consultations series is primarily aimed at those individuals working in an acute hospital cancer centre and/or tertiary referral centre. The books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common but difficult.

Palliative Care Consultations in Haemato-oncology

Sara Booth, Eduardo Bruera, and Jenny Craig — 2011-11-17

Author:: SaraBoothMacmillan Consultant in Palliative Medicine, Addenbrooke's Palliative Care Service, Cambridge, UKEduardoBrueraProfessor and Chair, Department of Palliative Care and Rehabilitation Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, USA, Jenny Craig
ISBN:: 9780198528081
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198528081.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

This book is the first volume in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. Patients with haematological malignancy often undergo the most rigorous treatments, usually requiring long inpatient stays at tertiary referral centres far removed from friends, families, and everyday life. The treatment for some malignancies is palliative, although aggressive, from diagnosis, and there can be a number of difficult symptom-control problems, all of which are covered here. The book draws on the expertise of the haematologist, who is vital if the patient is to have optimal care, and provides practical advice in an easily accessible form so that it can be read and referred to on the ward, or before a domiciliary visit.

Palliative Care Consultations in Gynaeoncology

Sara Booth, Eduardo Bruera, and Teresa Tate — 2011-11-17

Author:: SaraBoothMacmillan Consultant in Palliative Medicine, Addenbrooke's Palliative Care Service, Cambridge, UKEduardoBrueraProfessor and Chair, Department of Palliative Care and Rehabilitation Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA, Teresa Tate
ISBN:: 9780198528067
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198528067.001.0001
Published in print:: 2004
Published Online:: 2011-11-17

This is the second book in an international, multi-contributed series aimed at providing practical clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In gynaeoncology there are a number of symptoms that cause great distress to the individual and their families, and perplexity to the physicians and nurses caring for them. This book covers the management of incurable disease for each of the most common cancers, and also includes a review of the most difficult symptoms that are encountered in this tumour group. Contributors provide a scientific background to symptom-control chapters, with an indication of the sources and evidence for their advice.

Palliative Care Consultations in Advanced Breast Cancer

Sara Booth and Helena Earl — 2011-11-17

Author:: SaraBoothMacmillan Consultant in Palliative Medicine and Lead Clinician in Palliative Care, Cambridge University Hospitals NHS Foundation Trust, UK; Honorary Senior Lecturer, Department of Palliative Care and Policy, King's College, London, UK, Helena Earl
ISBN:: 9780198530756
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198530756.001.0001
Published in print:: 2005
Published Online:: 2011-11-17

This is the fourth volume in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In it, the editors bring together palliative care with oncological treatment for patients with advanced breast cancer. The book is presented in a user-friendly handbook format, with the use of tables and algorithms to ensure that it is portable, accessible, and can be read and referred to on, or before going to, the ward, or before a domiciliary visit. Specialists in palliative care and oncology settings, working in the acute sector and in hospices, will find the book useful. It will also appeal to consultants as well as specialist registrars, clinical nurse specialists, and nurse practitioners in palliative care and oncology. The Palliative Care Consultations series is primarily aimed at individuals working in an acute hospital cancer centre and/or tertiary referral centre. The books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common but difficult. The volumes are site-specific and each encompasses a review of oncological or haemato-oncological management of advanced disease with symptom-control advice.

Oral Care in Advanced Disease

Andrew Davies and Ilora Finlay — 2011-11-17

Author:: AndrewDaviesConsultant in Palliative Medicine, Royal Marsden Hospital, Sutton, UKIloraFinlayBaroness Finlay of Llandaff; Vice Dean, School of Medicine, Section of Palliative Medicine, University of Wales College of Medicine
ISBN:: 9780192632432
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192632432.001.0001
Published in print:: 2005
Published Online:: 2011-11-17

Lesions of the oral cavity have an enormous impact on the quality of life of patients with advanced disease. They cause considerable morbidity and diminish a patient's physical and psychological well being. Oral complications impair oral nutrition and can cause a variety of problems including malnutrition, anorexia, and cachexia. Psychological problems relate to the role that the oral cavity plays in communication and social life. This book provides comprehensive, clinically relevant, evidence-based guidelines on oral problems to ensure first-rate care. The scientific foundations and research base for their management underpin the discussion throughout. A multi-disciplinary group of contributors provide authoritative guidelines on clinical features, investigations, and pharmacological and non-pharmacological treatment, as well as complementary therapies. Chapters cover oral assessment, hygiene, domiciliary dental care, infections, taste disturbance, pain, HIV infection and AIDS, neurological diseases, and paediatric problems.

Oncology for Palliative Medicine

Peter Hoskin and Wendy Makin — 2011-11-17

Author:: Peter Hoskin, Wendy Makin
ISBN:: 9780192628114
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192628114.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

Consultants and nurses in palliative medicine who do not have a background in oncology need to know about the different types of cancer to be able to deal with palliation in these patients. The new edition of this book continues to provide comprehensive coverage of cancer management aimed at palliative care professionals. To aid understanding in the specialty, the format of the book has been thoroughly revised to include numerous tables, figures, algorithms, case histories, and key points to ensure that it will prove an invaluable, practical guide to oncology for all health care professionals involved in the care of patients with malignant disease. It provides a comprehensive overview of the management of malignant disease from the perspective of palliative medicine. The pathology, diagnosis, and management of individual tumour sites are described, with an emphasis on the symptoms produced in advanced disease and the place of oncological treatment in their management. Introductory chapters present the principles of oncological management, and later chapters address specific symptoms from the viewpoint of their pathophysiology and management. Each chapter is enhanced by typical case histories and patient journeys.

Nerve Blocks in Palliative Care

Fiona Hicks and Karen H Simpson — 2011-11-17

Author:: Fiona Hicks, Karen H Simpson
ISBN:: 9780198527039
Publisher:: Oxford University Press
Subjects:: Palliative Care, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780198527039.001.0001
Published in print:: 2004
Published Online:: 2011-11-17

In most patients, pain medication, along with physical therapy and supportive counselling, adequately controls the pain of terminal disease, but in some cases pain medication fails or produces unacceptable side effects, and other more invasive interventions may be used. This book provides guidelines on nerve blocking and neuromodulation techniques to help patients and professionals make choices in pain management. Patient selection and appropriate referral are discussed as well as ethical issues and consent. The book outlines the full range of techniques considered to provide excellent care for patients with pain that is difficult to manage and will be a source of information for a variety of professionals working with patients with advanced disease, including palliative care doctors and specialist nurses.

The Nature of Suffering and the Goals of Nursing

Betty R. Ferrell and Nessa Coyle — 2011-11-17

Author:: Betty R. Ferrell, Nessa Coyle
ISBN:: 9780195333121
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780195333121.001.0001
Published in print:: 2008
Published Online:: 2011-11-17

The essence of nursing care continually exposes nurses to suffering. Although they bear witness to the suffering of others, their own suffering is less frequently exposed. This book attempts to give voice to the suffering that nurses witness in patients, families, colleagues, and themselves. By making this suffering visible, the book aims both to honor and help solve the problem. The book offers nurses' colleagues in other professions — social workers, psychologists, chaplains, ethicists, and physicians — a window onto what it means to practice nursing.

The Nature of Suffering and the Goals of Medicine

Eric J. Cassell — 2011-11-17

Author:: Eric J. Cassell
ISBN:: 9780195156164
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
DOI:: 10.1093/acprof:oso/9780195156164.001.0001
Published in print:: 2004
Published Online:: 2011-11-17

This is a revised and expanded edition of a classic in palliative medicine, originally published in 1991, with three added chapters and a new preface summarizing our progress in the area of pain management. The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly, is suffering? One patient with cancer of the stomach, from which he knew he would shortly die, said he was not suffering. Another, someone who had been operated on for a minor problem—in little pain and not seemingly distressed—said that even coming into the hospital had been a source of pain and suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine? According to the author of this book, these are crucial questions, but ones that have unfortunately remained only queries void of adequate solutions. It is time for the sick person, the author believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, he argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with the methods and training techniques firmly rooted in the doctor's relationship with the patient.

Narrative and Stories in Health Care

Yasmin Gunaratnam and David Oliviere — 2011-11-17

Author:: YasminGunaratnamLecturer, Goldsmiths College, University of London, UKhttp://www.gold.ac.uk/sociology/staff/gunaratnam/DavidOliviereDirector of Education and Training, St Christopher's Hospice; Visiting Professor, School of Health and Social Sciences, Middlesex University, UK
ISBN:: 9780199546695
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199546695.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

The use of narrative methods has a long history in palliative care, pioneered by Dame Cicely Saunders, founder of the modern hospice movement. This book provides a multidisciplinary examination of work with narrative and stories in contemporary health and social care, with a focus on the care of people who are ill and dying. It animates the academic literature with ‘real-world’ examples from international contributors, including palliative care service users and those working in the social and human sciences, medicine, theology, and the creative arts. The book addresses and clarifies core issues: What is a narrative? What is a story? What are some of the main methods and models that can be used and for what purposes? What practical and ethical dilemmas can the methods entail in work with illness, death, and dying? As well as highlighting the power of stories to create new possibilities, the book also acknowledges the conceptual, methodological, and ethnical problems and challenges inherent in narrative work. As the hospice and palliative care movement evolves to meet the challenges of 21st century health care, this book highlights how narratives and stories can be attended to in ways that are productive, ethical, and caring.

Medicine and Care of the Dying

Milton J. Lewis — 2011-11-17

Author:: Milton J. Lewis
ISBN:: 9780195175486
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780195175486.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

There is a growing conflict in medicine between the research imperative, with its implicit goal of overcoming death itself, and the re-emergent clinical imperative to treat death as a part of life and to make the process of dying as tolerable as possible. Central to this conflict is the rise of scientific medicine and the decline of religious and associated discourses. Many Anglo Saxon countries are marked by a moral and religious pluralism that breeds controversy over bioethical issues such as euthanasia. Some scholars argue that modern medicine has put the cure of bodies before the care of persons. Some scholars attribute this to a metaphysical heritage of dualism and reductionism. This heritage has become problematic in the modern age, where waning belief in a divine order leaves the individual self as the bearer of meaning. At the same time, knowledge about nature and society has been increasing at such an accelerated pace that it has become difficult to develop a unified secular worldview. Chapters One and Two address these larger issues. Chapter Three focuses on medicine's approach to cancer as an example of the strengths and weaknesses of the research imperative. Chapter Four looks at the diffusion of the theory and practice of palliative care throughout the Anglo Saxon world. The fifth chapter discusses the development of effective pain control. The sixth chapter addresses the changing meaning of euthanasia in Western history in the past century as it has transitioned from a philosophical position to a widely debated policy proposal.

Living with Dying

Cicely Saunders, Mary Baines, and Robert Dunlop — 2011-11-17

Author:: Cicely Saunders, Mary Baines, Robert Dunlop
ISBN:: 9780192625144
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192625144.001.0001
Published in print:: 1995
Published Online:: 2011-11-17

The new edition of this book has been updated to incorporate recent advances in both the approach to, and treatment of, the terminally ill. Based on many years of monitoring clinical practice and research at St Christopher's Hospice, the author presents practical, balanced advice on the general ethical and medical principles of caring for dying patients. This will continue to be an invaluable handbook for all hospice physicians and nurses as a compassionate source of factual information.

Living and Dying with Dementia

Neil Small, Katherine Froggatt, and Murna Downs — 2011-11-17

Author:: Neil Small, Katherine Froggatt, Murna Downs
ISBN:: 9780198566878
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780198566878.001.0001
Published in print:: 2007
Published Online:: 2011-11-17

Improvements in health care in the 21st century mean people are living longer, but with the paradox that chronic illness is increasingly prevalent. Dementia, a term used to describe various different brain disorders that involve a loss of brain function which is usually progressive and eventually severe, is a condition associated with an ageing population and is becoming increasingly common. Worldwide, there are approximately 24 million people with dementia, expected to rise to 81 million by 2040. Inevitably, people living with dementia will die, but their needs at the end of life are not well known. This book describes what might be achieved if the values and best practice of both dementia care and palliative care are brought together, to achieve quality end-of-life care for this specific group of patients. It explores what is known about the experience of dying with dementia, using a narrative approach, and develops a model that draws together a ‘person-centred’ approach to care. The book examines the possibilities and the challenges faced when trying to improve quality of life for people with dementia, and presents examples of good practice from across the world.

Issues in Palliative Care Research

Russell K. Portenoy and Eduardo Bruera — 2011-11-17

Author:: Russell K.PortenoyBeth Israel Medical Center, New York, USAEduardoBrueraUniversity of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA
ISBN:: 9780195130652
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780195130652.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

Palliative care is rapidly evolving as a multidimensional therapeutic model devoted to improving the quality of life of all patients with life-threatening illness. Symptom control, management of psychosocial and spiritual concerns, decision making consistent with values and goals, and care of the imminently dying that is appropriate and sensitive to the unique needs of the individual and the family — these are among the critical issues addressed through palliative care. As this discipline has evolved, the need for research in all these areas has become widely acknowledged. This book describes both the progress that has already been made in the investigation of these issues and the methodologic elements that must be addressed in future studies. The perspective is broad and the overriding goal is to inform about the state of the art in these rapidly evolving areas of research.

A House Called Helen

Jacqueline Worswick — 2011-11-17

Author:: Jacqueline Worswick
ISBN:: 9780192632357
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780192632357.001.0001
Published in print:: 2000
Published Online:: 2011-11-17

The concept of a children's hospice, seen as innovative when the first, Helen House, opened in Oxford in 1982, is now well established, and the growth in the number of children's hospices has seen corresponding important developments in the field of paediatric palliative care. This book provides an account of how Helen House came into being. It records the events surrounding the foundation of the hospice and how it stemmed directly from what was learnt from the events following the sudden illness of the author's eldest daughter Helen, after whom the hospice was named. The book sets out the philosophy that underpinned the hospice, which was taken up as the guiding philosophy of children's hospice care. It describes the hospice's operational framework and details the service provided by Helen House. The book provides valuable insight into the needs of the families who use hospice services and touches both on the difficulties they face caring, often over a long period of time, for a child with a life-limiting illness, and on the role and attitudes of professionals and indeed of the public at large. In this new edition, an additional chapter reviews the growth of children's hospices and reflects on the challenges they face in their maturity. It considers the development of children's hospice care in relation to wider service provision and examines current and future issues surrounding the care of children with life-limiting illness.

Hospital-based Palliative Care Teams

R. J. Dunlop and J. M. Hockley — 2011-11-17

Author:: R. J.DunlopSt Christopher's Hospice, Sydenham, London, UKJ. M.HockleyWestern General Hospital, Edinburgh, UK
ISBN:: 9780192629807
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192629807.001.0001
Published in print:: 1998
Published Online:: 2011-11-17

When the first edition of this book was written in 1990, there were only a few advisory palliative care teams working in hospitals. Since then, the number of teams has grown rapidly. The concept of these teams is now widely accepted but there is an increased need for information about setting up a team, how they work, and how effective they are. This book looks at the need for hospital-based palliative care teams and the challenges of bringing palliative care into the acute hospital setting. It reviews the needs of patients, their families, and their professional carers, and also looks at the theoretical and practical problems that may be encountered. The book contains practical advice on setting up hospital-based palliative care teams, the selection of team members, team dynamics, and the role of the pain clinic and palliation oncology.

Hospice Care for Children

Ann Armstrong-Dailey and Sarah Zarbock — 2011-11-17

Author:: AnnArmstrong-DaileySarahZarbock
ISBN:: 9780195340709
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780195340709.001.0001
Published in print:: 2008
Published Online:: 2011-11-17

Children with life-threatening and terminal illnesses—and their families—require a unique kind of care to meet a wide variety of needs. This book, now in its third edition, provides an authoritative source for the many people involved in the care of dying children. Written by leading authorities in pediatrics and palliative medicine, it emphasizes practical topics and covers the entire range of issues related to hospice care, from psychological stress to pain and symptom management. The text has been fully updated and includes an international perspective chapter and a chapter written by Children's Hospice International with detailed all-inclusive care plans.

Hospice and Palliative Care in Africa

Michael Wright and David Clark — 2011-11-17

Author:: Michael Wright, David Clark
ISBN:: 9780199206803
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199206803.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

Eight hundred million people live in Africa, a continent which covers 22 percent of the world's surface and encompasses some fifty countries. Conflict, poverty, endemic diseases, and lack of clean water pose serious challenges for the population, made worse by a rampaging AIDS pandemic. Huge loss of life has impacted dramatically on both health systems and social and family structures. As the attention of the world focused increasingly on Africa, the International Observatory on End of Life Care was commissioned to conduct a timely review of hospice and palliative care development across the continent. The Observatory undertook this review using an approach specially designed for resource-poor settings. Information was collected against an agreed template to allow comparisons between countries and regions. As a result, an insight is given into the challenges, opportunities and successes faced by hospice and palliative care workers, country by country, throughout the twenty-six countries in Africa where a palliative care initiative is underway. Strategies and models of care are explored, and the development of palliative care is viewed from various standpoints including ethnographic, historical, ethnic, demographic and epidemiological perspectives. This is the first book to focus exclusively on palliative care and hospice development in Africa.

Handbook of Communication in Oncology and Palliative Care

David Kissane, Barry Bultz, Phyllis Butow, and Ilora Finlay — 2011-11-17

Author:: DavidKissaneJimmie C. Holland Chair in Psycho-Oncology, Attending Psychiatrist and Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center; Professor of Psychiatry, Weill Medical College of Cornell University, New York, NY, USABarryBultzDirector, Department of Psychosocial Resources, Program Leader: Psychosocial Oncology, Supportive, Pain and Palliative Care, Tom Baker Cancer Centre, and Chair and Adjunct Professor, Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Canadahttp://psychology.ucalgary.ca/profiles/barry-bultzPhyllisButowProfessor, NHMRC Principle Research Fellow, and Chair of the Australian Psycho-Oncology Co-operative Research Group, School of Psychology, University of Sydney, Australiahttp://www.psych.usyd.edu.au/staff/phyllisb/IloraFinlayProfessor, Cardiff University; Consultant in Palliative Medicine, Velindre Hospital, Cardiff; Independent Crossbench member, House of Lords, Westminster, London, UK
ISBN:: 9780199238361
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199238361.001.0001
Published in print:: 2010
Published Online:: 2011-11-17

This book provides clinicians with practical and evidence-based guidelines to achieve effective, patient-centred communication in the areas of cancer and palliative care. It breaks communication down into key modules that cover the life-cycle of cancer care and includes coverage of diagnosis and treatment including clinical trials, empathic support in response to distress, transition to survivorship or palliative therapies, discussion of prognosis, conduct of family meetings, and care of the dying. Complementary training of cancer patients in their communication with the doctor completes the interactive dyad. The art of teaching, impact of gender and power in the consultation and the ethical context are carefully considered. Special communication challenges include discussion of genetic risk, rehabilitative and salvage surgery, promotion of treatment adherence, unanticipated adverse outcomes, intercultural issues, and fertility and sexuality. The value of decision aides, question prompt lists, audio-recording of consultations and use of the internet is illustrated. Theoretical models are examined from the medical school to the highly specialized practice, facilitation training and actor training are made explicit, and international approaches to communication skills training are compared and contrasted. Finally, research tools that assist in coding cancer consultations, evaluating training courses, and employing mixed methods in studies aid the reader in providing clear and sensitive communication when handling challenging situations whilst treating cancer sufferers and palliative care patients.

Family Carers in Palliative Care

Peter Hudson and Sheila Payne — 2011-11-17

Author:: PeterHudsonAssociate Professor and Director, Centre for Palliative Care Education and Research, St Vincent's Hospital and The University of Melbourne, AustraliaSheilaPayneProfessor, Help the Hospices Chair in Hospice Studies, International Observatory on End of Life Care, Lancaster University, UKhttp://www.lancs.ac.uk/shm/dhr/profiles/Sheila-Payne/
ISBN:: 9780199216901
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199216901.001.0001
Published in print:: 2008
Published Online:: 2011-11-17

Support for the family is a key component of palliative care practice and philosophy, with both patient and family construed as the ‘unit of care’. However, there is not always formal acknowledgement of the importance of the family carer role, or that of friends, neighbours, and other non-professional, informal carers. Consequently, health and social care professionals find carer support work particularly challenging. Symptom management, personal care, and administering medications are just some of the tasks taken on by this group of non-professionals, and the impact of this role can have negative emotional, physical, financial and social implications on the care-giver. Furthermore, family carers consistently report unmet needs, and there has been a lack of intervention studies aimed at improving carer support. This book provides an evidence-based, practical guide to enable health and social care professionals to assess and respond to family carer needs. It also explores the wider sociological, policy, and research issues related to family carers and palliative care.

Evaluating Palliative Care

Margaret Robbins — 2011-11-17

Author:: Margaret Robbins
ISBN:: 9780192626219
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780192626219.001.0001
Published in print:: 1998
Published Online:: 2011-11-17

The past 30 years has seen a huge expansion in the provision of palliative care services. Because palliative medicine is a multidisciplinary specialty – combining the expertise of oncologists, anaesthetists, nurses, and many other therapeutic groups – the effectiveness of such treatment can be very difficult to measure. Additionally, research involving terminally ill patients and their carers can also present a number of practical and ethical problems. In spite of this, current health policy demands evidence of the effectiveness and value for money of health service interventions at all levels of complexity, including the service level. This book provides an introduction to the theory and practice of the evaluation of palliative care services. It examines the methodological issues involved in the evaluation of palliative care and outlines a practical approach that is readily applicable to many other health care interventions. In particular, research issues involving terminally ill patients and their carers are analysed and discussed, and approaches suggested for future work.

Enhancing Cancer Care

Jennifer Barraclough — 2011-11-17

Author:: JenniferBarracloughBach Foundation Registered Practitioner, Auckland, New Zealand; former Consultant in Psychological Medicine, Oxford Radcliffe Hospital NHS Trust, United Kingdom
ISBN:: 9780199297559
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199297559.001.0001
Published in print:: 2007
Published Online:: 2011-11-17

This book is a guide to complementary cancer therapies, also described as natural or holistic therapies. More and more patients are turning to these therapies as there is now considerable evidence that they can help with symptom control and quality of life, and that some may also extend survival. Complementary therapies can also provide the patient with a greater sense of control regarding the management of their illness. The book provides commentary on a broad range of complementary therapies and features practical advice on how to implement therapies to enhance current practice. The first part of the book deals with the general principles behind complementary therapies and the factors driving their growing popularity, the challenges of evaluating their benefits and unwanted effects, and experience of using them in oncology units, hospices, the private sector and primary care. The second part includes chapters on specific interventions, including complementary therapies such as acupuncture and aromatherapy massage; lifestyle modifications through diet and exercise; creative therapies using art and music; and psychological and spiritual support for individuals and groups. These chapters provide descriptions of the therapies, a summary of the evidence for their benefits in cancer care, and illustrative case histories. The emphasis throughout this book is on enhancing practice; that is, using the therapies alongside conventional medicine, rather than as alternatives to it.

End of Life in Care Homes

Jeanne Samson Katz and Sheila M. Peace — 2011-11-17

Author:: Jeanne SamsonKatzhttp://www.open.ac.uk/hsc/people/profile.php?name=Jeanne_KatzSheila M.PeaceSenior Lecturers, School of Health and Social Welfare, Open University, Milton Keynes, UK
ISBN:: 9780198510710
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine and Older People, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198510710.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

In our society, the overwhelming majority of people die in later life. They typically die slowly of chronic diseases, with multiple co-existing problems over long periods of time. They spend the majority of their final years at home, but many will die in hospitals or care homes. This book explores the possibilities for improving the care of older people dying in residential care and nursing homes. It argues that there are aspects of palliative care that, given the right circumstances, are transferable to dying people in settings that are not domestic or hospice based. The book describes what happens in nursing and residential care homes when a resident is dying, how carers cope, and the practical, health, and emotional challenges that carers face on top of their day-to-day work. Based on research from both the UK and US, the book shows how the situation can be improved.

End of Life Choices

Fiona Randall and Robin Downie — 2011-11-17

Author:: Fiona Randall, Robin Downie
ISBN:: 9780199547333
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780199547333.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

A book for nurses, doctors and all who provide end of life care, this volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. Dived into two parts, the book introduces and explains clinical decision making-processes about which there is broad consensus, in line with guidance documents issued by the WHO, BMA, GMC, and similar bodies. The changing political and social context where ‘patient choice’ has become a central idea, and the broadened scope of patients' best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These include patient choice, consent, life-prolonging treatment, and symptom relief including sedation. Part two explores the more controversial current end of life care initiatives, such as advance care planning, preferred place of care and death, euthanasia and assisted suicide, extended ideas of ‘best interests’, and the view that there are therapeutic duties to the relatives. Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of consumerist choice, they reject its place in the health service, proposing a realistic, fair, humane and widely adoptable system of end of life care. An appendix on ethical theories and terms is available online.

Education in Palliative Care

Bee Wee and Nic Hughes — 2011-11-17

Author:: BeeWeeConsultant and Senior Clinical Lecturer in Palliative Medicine, Sir Michael Sobell House and Nuffield Department of Medicine; Associate Director of Clinical Studies and Fellow of Harris Manchester College, Oxford University, UKhttp://www.hmc.ox.ac.uk/pages/default.asp?id=16&sID=86&cP=302NicHughesLecturer in Nursing and Macmillan Research Fellow, School of Health Care, University of Leeds, UKhttp://www.ncl.ac.uk/iah/staff/profile/julian.hughes
ISBN:: 9780198569855
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198569855.001.0001
Published in print:: 2007
Published Online:: 2011-11-17

Despite the fact that most palliative care educators are involved in teaching, there is little literature devoted to education specifically within palliative care. This book bridges that gap, giving a wide-ranging, global view of palliative care education. It offers theoretical and practical insights, along with specific suggestions for developing knowledge and skills for teaching. It also contains extensive accounts of important contextual matters which influence the range and quality of palliative care education, including: interprofessional learning; continuing professional development; evaluation; and educational leadership. The development of palliative care as a clinical speciality is increasingly conducted at an international level, and a special feature of this book is the inclusion of chapters reviewing palliative care education in each continent. This encourages the sharing of knowledge across diverse healthcare systems and cultures. There is also an acknowledgement of the multi-professional team involved in palliative care, as education and training are looked at from the perspectives of doctors, nurses, and allied health professionals. The book is split into three distinct parts: Part 1 sets the scene for existing palliative care education, both in the UK and internationally. Part 2 focuses on the theory underpinning each aspect of teaching, learning and assessment, and then examines the practicalities of delivering these in the clinical setting. Part 3 explores ways of building and nurturing a culture of learning in palliative care, whether as an individual or as an organization.

Dyspnoea in Advanced Disease

Sara Booth and Deborah Dudgeon — 2011-11-17

Author:: SaraBoothMacmillan Consultant in Palliative Medicine and Lead Clinician in Palliative Care, Cambridge University Hospitals NHS Foundation Trust; Honorary Senior Lecturer, Department of Palliative Care and Policy, Kings College, London, UKDeborahDudgeonW Ford Connell Professor of Palliative Care Medicine, Queen's University, Kingston, Ontario, Canada
ISBN:: 9780198530039
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780198530039.001.0001
Published in print:: 2005
Published Online:: 2011-11-17

Dyspnoea (breathlessness) is an uncomfortable awareness of breathing that occurs in approximately 30–75% of terminal cancer patients. It is one of the most distressing symptoms for both patients and family members and can seriously impact on quality of life. Typically, dyspnoea is associated with congestive heart failure, end-stage chronic obstructive pulmonary disease, or lung cancer. This book provides palliative care doctors and specialist nurses with practical guidelines to help manage and treat patients with breathlessness. It includes the science behind the symptom in an attempt to explain the pathology and physiology of this complex condition. The book has been organized to address generalized aspects of breathlessness in advanced illness and more specific aetiologies and managements relevant to particular underlying diseases. It summarizes the epidemiology and the pathophysiology of breathlessness, measurement, research approaches, rehabilitation and exercise, clinical approaches that can be taken at the bedside, pharmacological and non-pharmacological approaches, and surgical interventions. The care of patients with dyspnoea requires input from a variety of disciplines such as palliative care, physiotherapy, respiratory medicine, and nursing, and this is reflected in the multidisciplinary list of contributors.

Doctoring

Eric J. Cassell — 2011-11-17

Author:: Eric J. Cassell
ISBN:: 9780195113235
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780195113235.001.0001
Published in print:: 1997
Published Online:: 2011-11-17

This book shows how much better fitted advanced concepts of primary care medicine are to America's health-care needs. It offers insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training, the book notes, arose at a time when medical science was in ascendancy. Thus the ideals of science — objectivity, rationality — became the ideals of medicine, and disease — the target of most medical research — became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general — which is how they learn about the disease — rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. Most important, this book argues that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, the book shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. It shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.

Crossing Over

David Barnard, Anna M. Towers, Patricia Boston, and Yanna Lambrinidou — 2011-11-17

Author:: David Barnard, Anna M. Towers, Patricia Boston, Yanna Lambrinidou
ISBN:: 9780195123432
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
DOI:: 10.1093/acprof:oso/9780195123432.001.0001
Published in print:: 2000
Published Online:: 2011-11-17

This book provides a unique view of patients, families, and their caregivers striving together to maintain comfort and hope in the face of incurable illness. The narratives weave together emotions, physical symptoms, spiritual concerns, and the stresses of family life, as well as the professional and personal challenges of providing hospice and palliative care. Based on a vast amount of participant observation and in-depth interviews, the book moves far beyond dry technical manuals for symptom control and tired clichés about death with dignity, to depict the sights, sounds, tastes, and smells of the daily in patients' homes and the palliative care unit. It captures the breathtaking diversity of people's aspirations and ideals as they face death, and the views of the professionals who care for them. Anger and fear, tenderness and reconciliation, jealousy and love, social support and falling through the cracks, unexpected courage and unshakable faith—all of these are part of facing death in late twentieth-century North America, and this book brings them to life in a portrait of the processes of giving and receiving palliative care.

Cicely Saunders – Founder of the Hospice Movement

David Clark — 2011-11-17

Author:: David Clark
ISBN:: 9780198569695
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research
DOI:: 10.1093/acprof:oso/9780198569695.001.0001
Published in print:: 2005
Published Online:: 2011-11-17

Cicely Saunders

Cicely Saunders and David Clark — 2011-11-17

Author:: Cicely Saunders, David Clark
ISBN:: 9780198570530
Publisher:: Oxford University Press
Subjects:: Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780198570530.001.0001
Published in print:: 2006
Published Online:: 2011-11-17

Cicely Saunders is universally acclaimed as a pioneer of modern hospice care. Trained initially in nursing and social work, she qualified in medicine in 1958 and subsequently dedicated the whole of her professional life to improving the care of the dying and bereaved people. Founding St Christopher's Hospice in London in 1967, she encouraged a radical new approach to end of life care combining attention to physical, social, emotional and spiritual problems, captured in her concept of ‘total pain’. Her ideas about clinical care, education and research have been hugely influential, leading to numerous prizes and awards in recognition of her humanitarian achievements. This book includes a selection of Cicely Saunders' most important writings throughout a period of over forty years. Full articles, chapters, editorials, reviews, and commentaries include important clinical themes relating to the care of dying people such as pain and symptom management, issues of communication and truth telling, and the needs of particular patient groups, such as those with cancer and other diseases. The book includes pieces that reflect on the wider development of the palliative care field and on policy and organisational issues. Some of the papers take up the theme of spiritual care at the end of life, as well as the question of euthanasia, raising in turn issues of a wider theological and philosophical nature. The book is a testimony to the personal contribution of Cicely Saunders and the influence she has had upon the modern field of palliative and end of life care.

Chronic and Terminal Illness: new perspectives on caring and carers

Sheila Payne and Caroline Ellis-Hill — 2011-11-17

Author:: SheilaPayneUniversity of Sheffieldhttp://www.lancs.ac.uk/shm/dhr/profiles/Sheila-Payne/CarolineEllis-HillUniversity of Southamptonhttp://onlineservices.bournemouth.ac.uk/academicstaff/Profile.aspx?staff=cehill
ISBN:: 9780192631671
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780192631671.001.0001
Published in print:: 2001
Published Online:: 2011-11-17

Most chronically and terminally ill patients are cared for in their own homes by family and friends, rather than in hospitals or hospices. These carers are an invaluable free resource and there is an increasing amount of research into their role and the experiences of caring for the terminally ill, patients with cancer, and patients with other chronic diseases. This book provides a critique of the theoretical concept of caring, carers, and caregivers. The material is based on empirical evidence from recent studies of adults with acquired chronic illnesses, including terminal illness. The empirical data within the book has been gathered from the perspective of those providing personal, domestic, or emotional care to others already known to them by virtue of kinship, co-habitation, or friendship, rather than carers organised on a professional or voluntary basis. This new evidence is used to make suggestions about possible ways forward within health and social care practice.

Children's Palliative Care in Africa

Justin Amery — 2011-11-17

Author:: JustinAmerySpecialist GP in Children's Palliative Care, Bury Knowle Health Centre, Oxford, UK; Consultant to Diana Princess of Wales Memorial Fund; African Children's Palliative Care Network; and Clinical Director, Hospice Africa Uganda
ISBN:: 9780199567966
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199567966.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

Children's palliative care has developed rapidly as a discipline, as health-care professionals recognise that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 84% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed. Written by a group with wide experience of caring for dying children in Africa, this book provides guidance on improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care — including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end-of-life care, and tips for the professional on compassion and conservation of energy — but always retains the focus on the particular needs of the health-care professional in Africa. Whilst containing some theory, the emphasis is on practical action throughout.

Caring for Patients at the End of Life

Timothy Quill — 2011-11-17

Author:: Timothy Quill
ISBN:: 9780195139402
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
DOI:: 10.1093/acprof:oso/9780195139402.001.0001
Published in print:: 2001
Published Online:: 2011-11-17

In this book, the author uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section One utilizes the near-death experiences of two patients to explore values underlying medical humanism, and then presents the case of “Diane” to explore the fundamental clinical commitments of partnership and non-abandonment. Section Two explores, illustrates, and provides practical guidance for clinicians, patients, and families about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In Section Three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assisted suicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In the final chapter, the author discusses the tragic death of his brother, which occurred as this book was being completed, and how his family made the most emotionally challenging decisions of their lives. The author exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision making, ensuring medical and palliative care expertise, and committing to see the dying process through to the patient's death, is vividly illustrated.

Care of the Dying

John Ellershaw and Susie Wilkinson — 2011-11-17

Author:: JohnEllershawProfessor of Palliative Medicine, University of Liverpool and Director of the Marie Curie Palliative Care Institute, Liverpool, UKhttp://www.edgehill.ac.uk/profiles/john-ellershawSusieWilkinsonHead of Palliative Care Research, Marie Curie Palliative Care Research & Development Unit, Royal Free & University College Medical School, London, UK
ISBN:: 9780199550838
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199550838.001.0001
Published in print:: 2010
Published Online:: 2011-11-17

Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality-improvement programmes. This book includes chapters on symptom control, ethical issues, communication skills, and spiritual care, which underpin the use of the LCP.

Care for the Dying: A Pathway to Excellence

John Ellershaw and Susie Wilkinson — 2011-11-17

Author:: JohnEllershawMedical Director, Marie Curie Centre, Liverpool, and Consultant in Palliative Medicine/Honorary Senior Lecturer, Royal Liverpool University Hospitalshttp://www.edgehill.ac.uk/profiles/john-ellershawSusieWilkinsonHead of Palliative Care Research, Marie Curie Palliative Care Research & Development Unit, Royal Free & University College Medical School, London, UK
ISBN:: 9780198509332
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780198509332.001.0001
Published in print:: 2003
Published Online:: 2011-11-17

Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Integrated Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care, which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality improvement programmes. The book also includes chapters on symptom control, ethical issues, communication skills, and spiritual care.

Brief Interventions with Bereaved Children

Barbara Monroe and Frances Kraus — 2011-11-17

Author:: BarbaraMonroeChief Executive, St Christopher's Hospice, London; and Honorary Professor, International Observatory on End of Life Care, Lancaster University, UKhttp://www.eolc-observatory.net/information/staff/bmonroe.phpFrancesKrausCandle Project Leader, St Christopher's Hospice, London, UK
ISBN:: 9780199561643
Publisher:: Oxford University Press
Subjects:: Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
DOI:: 10.1093/acprof:oso/9780199561643.001.0001
Published in print:: 2009
Published Online:: 2011-11-17

Recent years have seen increasing interest in the needs of children facing bereavement, and a corresponding increase in services to support them. This book addresses and explains the theoretical concepts and practical implications behind the idea of brief work with bereaved children and families. Flexible and accessible short-term services delivered at the right time underpin the strengths of bereaved children, supporting their recovery rather than pathologizing the grief process. In this way the book also speaks to the current interest in the concept of resilience and working with families' strengths and possibilities, rather than merely identifying their problems. This second edition of the text within the growing field of childhood bereavement contains new chapters that discuss managing situations with learning disability, supporting very young children and emotional literacy. The book also presents cases from the service user's perspective. It looks at different approaches to intervention, such as the importance of assessment and the value of group work, and also covers work with children and families before a death. The editors have more than twenty-five years experience as practitioners within the field, as service providers and educators. The book features chapters from contributors with backgrounds in healthcare, education, social work, and the police, alongside theoretical and practice-based chapters from workers in the field of bereavement care for children.

Advance Care Planning in End of Life Care

Keri Thomas and Ben Lobo — 2011-11-17

Author:: KeriThomasClinical Lead for the National Gold Standards Framework Centre, Honorary Professor in End of Life Care, University of Birmingham, UK, Royal College of General Practitioners Clinical Champion in End of Life Care, and Clinical Director for Omega, the National Association of End of Life Care, UKBenLoboNational Clinical Lead for Advance Decisions to Refuse Treatment; Medical Director; and Consultant Physician and Community Geriatrician, Derbyshire Community Health Service, Derbyshire County PCT, UK
ISBN:: 9780199561636
Publisher:: Oxford University Press
Subjects:: Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
DOI:: 10.1093/acprof:oso/9780199561636.001.0001
Published in print:: 2010
Published Online:: 2011-11-17

Advance Care Planning is an essential part of the new NHS National Programme on End-of-Life Care, aiming to improve the chances of ‘a good death’ by discussing and planning how this might be managed. This book helps readers explore a wide range of issues and practicalities in providing Advance Care Planning (ACP) for their patients nearing the end of life. This book takes a comprehensive look at the subject of ACP; frames the purpose, process, and outcomes; and includes contributions from experts from around the world.