This book will be the first of its kind to offer intensive conversation analysis on patient-clinician interactions in the context of palliative medicine. The book focuses on a series of individual case studies of conversations that revolve, in each case, around one key critical term that is often evoked or understood differently by clinicians and patients.
The story of the end-of-life experience of a palliative care physician who helped thousands of patients to die well. We all die. Most of us spend the majority of our lives ignoring this uncomfortable truth, but Dr. Larry Librach dedicated his life and his career to helping his patients navigate their final journey. Then, in April 2013, Larry was diagnosed with terminal pancreatic cancer. Unlike the majority of us, Larry knew the death he wanted. He wanted to die at home, surrounded by his family: his wife of forty years, his children, and his grandchildren. He did. He was peaceful and calm at the end. Larry proved that the “good death” isn’t a myth. It can be done, and he showed us how. Ever the teacher, Larry made his last journey a teachable moment on how to die the best death possible, even with a pernicious disease. As hard as it is to guide patients toward dying well, it is far harder to live those precepts day by day as the clock ticks down to one’s own death, but Larry, together with author Phil Dwyer, chronicled his final journey with courage and humour.
Physicians who care for patients with life-threatening illnesses face daunting communication challenges. Patients and family members can react to difficult news with sadness, distress, anger, or denial. This book defines the specific communication tasks involved in talking with patients with life-threatening illnesses and their families. Topics include delivering bad news, transition to palliative care, discussing goals of advance-care planning and do-not-resuscitate orders, existential and spiritual issues, family conferences, medical futility, and other conflicts at the end of life. Drs Anthony Back, Robert Arnold, and James Tulsky bring together empirical research as well as their own experience to provide a roadmap through difficult conversations about life-threatening issues. The book offers both a theoretical framework and practical conversational tools that the practising physician and clinician can use to improve communication skills, increase satisfaction, and protect themselves from burnout.
Dying - which we all inevitably must do - can be appreciably better for each of us if we approach end of life conversations early, while we still have the capacity to make our own decisions. This book can help us all with this. In addition, Courageous Conversations on Dying guides physicians in their role of supporting patients and families through decision-making for end of life, concentrating on patients' goals. Whether we are physicians, patients, family members, or caring individuals who want the best possible end of life experience for ourselves and each other, we must acquire the skills for loving, fruitful conversations. In this book, you'll learn how to prepare for these conversations, including what kind of setting, what words to use, how to be a good listener, how to empathize, how to help in decision-making, how to properly document end of life wishes, and more, along with many case studies to illustrate the points.
"There is an unspoken dark side of American medicine--keeping patients alive at all costs. Two thirds of Americans die in healthcare institutions tethered to machines and tubes, even though research indicates that most prefer to die at home in comfort, surrounded by loved ones. The question How do you want to live? must be posed to the seriously ill because they deserve to choose. If doctors explain options--including the choice to forego countless medical interventions that are often of little benefit--then patients can tell doctors how they wish to spend the remainder of their lives. A doctor's heroic efforts to prolong a life can instead prolong that patient's death, and these traumatic measures also bankrupt the healthcare system. One third of the Medicare budget is spent on the last six months of life, often on technological interventions that are not helpful and inflict more suffering. Through the stories of six patients and six very different end-of-life experiences, Volandes explores the trajectory of events and treatments that occur with and without this essential conversation. He argues for a radical re-envisioning of the patient-doctor relationship--including videos to spark discussions--and offers ways for patients and their families to talk about this difficult issue to ensure that patients will be at the center and in charge of their medical care"--Provided by publisher.
The prospect of dying can be overwhelming, whether it's happening to you, a family member, or a friend. In "Good End," Dr. Michael Appleton addresses questions about hospice care and end-of-life issues with compassion and honesty. This is a must read for patients and families who are on hospice or considering hospice care.
'The Textbook of Palliative Care Communication' is the authoritative text on communication in palliative care. Uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, it unites clinicians and academic researchers interested in the study of communication.
Every day, thousands of people receive a diagnosis of serious, life-threatening illness, and their families and friends suddenly become caregivers. Despite the best of intentions it is not always easy to communicate well under these circumstances, or find deep empathy for something one has never before experienced. When is it best to speak, and when to be silent? How can someone provide real comfort, and how can relationships with loved ones facing serious illness be enhanced in this most difficult time? This book is about how to be an encouraging caregiver and friend under the most difficult circumstances, when the possibility of death is all too real The authors believe that open dialogue must not be avoided until the last minute when opportunities will be limited, but that caregivers and loved ones can embrace this time, mortal time, honestly as a way to sensitively and compassionately engage with those for whom a central fact of life is realized--that all of our lives are time-limited. In The Art of Conversation Through Serious Illness, the authors consider how to best listen to and speak with one facing life-threatening illness, with lessons on being a primary conversation partner, becoming properly empathic and receiving empathy, maintaining everyday conversation, using platitudes appropriately, understanding healthy denial, and talking about dying. Offering bedside guidance usually only available to professionals and peppered with insightful anecdotes from the authors' own experiences, this gentle, succinct book is appropriate for anyone going through this uniquely difficult yet universal life experience.
This handbook is an essential guide to caring for the community palliative care patient in relation to COVID-19, when the patient’s preferred place of care is at home or the hospice. It will guide you through appropriate care procedures and protocols in managing end-of-life patients who show symptoms of COVID-19. Key features include: Difficult conversations and communication skills Symptom management Advance care planning Caring for stable patients with palliative needs and those who are at end-of-life Supporting the family and friends of the patient Your own well-being as a healthcare professional Supported by applicable case studies from a range of community care settings, this guide will be relevant to anyone affected by the challenges of COVID-19 when managing end-of-life patients or caring for older people, including paramedics, nurses and palliative care providers.
