The goals of palliative care are easy. Realizing them, however, is not. When one tries to realize these goals realistically, the institutional limitations, human foibles, problems with providing care in teams, and challenges of cultural diversity often serve as stumbling blocks, hindering the total realization of the aims of palliative care. Dying even with the best intentions can be difficult and can be muddled by different factors. Nevertheless, despite these challenges, dying comfortably and humanely can be achieved. This is the core of this book. In it, images of giving and receiving palliative care are illustrated with the stories and narratives of actual patients, families, and their support teams and care givers who strived to provide comfort and hope in the face of incurable illness and impending death. The book provides a comparison of the palliative care ideals with the narratives that portray the actual practice of the discipline. To construct the narratives presented in it, several methods are used to elicit the most significant information that will provide a clear picture of the battle with incurable diseases, the inevitable death, and the services of hospice and palliative care programs. Methods used in this study are: 1) the medical and biographical background of the patient; 2) clinical course of the illness; 3) patient and family perceptions; and 4) health care provider's perceptions. Included as well are tape-recorded interviews with the patients, families, and caregivers; chart reviews; and participant-observation.
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