There has been a steady growth in the provision of day care services for people with life-threatening illnesses who live at home. This book includes details of the range of therapies and services that a multi-disciplinary team can provide to address the physical, emotional, psycho-social and spiritual needs of these patients and their families, thus enabling them to remain in their own homes.
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.
Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.
The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.
Day care centres are growing important in palliative care, providing a variety of services from out-patient clinics to art therapy classes. They are proving to be a cost-effective way of providing care, and of accustomising patients to the hospice environment before full time admittance. They can also improve quality of life by giving patients and carers time away from one another. This book provides a comprehensive overview of the current philosophy, patterns and policies of pallaitive day care. It places emphasis on the need to evaluate performance in palliative day care and describes in detailk audit, health economics, research and their associated problems and pitfalls.
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 are among the critical issues in palliative care. This book explores progress made and future goals.
This title is directed primarily towards health care professionals outside of the United States. Palliative Care: The Nursing Role is an introductory text for nurses and other health care professionals who deliver palliative care across a range of settings. It lays a clear foundation of knowledge focusing on the needs and perspectives of patients and families who face the challenge of advanced, incurable illness. The style is highly accessible yet challenges readers to analyze key issues that present within palliative care. Covering the wide range of care provision in hospices, hospitals and patients' homes, the book draws widely from practice based examples to explain and expand upon theoretical issues. Research evidence underpins each of the chapters. Guided activities encourage readers to reflect, in a focused way, on their clinical experience and current practice. This new edition has been fully updated to reflect ongoing developments and shifting trends in palliative care education and practice. It will suit the needs of both pre and post-qualifying students seeking to develop their knowledge and is well suited to practitioners working within either generalist or specialist palliative care settings, or within acute or community settings as well as those studying a range of palliative care educational curricula. The authors have a wide range of experience in palliative care and all are actively engaged in practice and/or education. A clear, broad-based approach offers a thorough introduction for the non-specialist nurse. Written and edited by an experienced team of nurses working in this field, grounding it in current practice. Learning outcomes listed at the start of each chapter aid learning and comprehension. Reflective practice activities and an outline of CPD is especially useful for students working independently. Case histories, recommended reading lists, and references provide a solid evidence base for clinically based practice and facilitate further study. Thoroughly revised and updated to reflect changes in policy direction. A new chapter on pain and symptom management. Revised content reflects the recent shift in the evidence base concerning spirituality. Includes psychosocial issues of loss for the patient, their family, and careers.
Taking as its focus a highly emotive area of study, The Dying Process draws on the experiences of daycare and hospice patients to provide a forceful new analysis of the period of decline prior to death. Placing the bodily realities of dying very firmly centre stage and questioning the ideology central to the modern hospice movement of enabling patients to 'live until they die', Julia Lawton shows how our concept of a 'good death' is open to interpretation. Her study examines the non-negotiable effects of a patient's bodily deterioration on their sense of self and, in so doing, offers a powerful new perspective in embodiment and emotion in death and dying. A detailed and subtle ethnographic study, The Dying Process engages with a range of deeply complex and ethically contentious issues surrounding the care of dying patients in hospices and elsewhere.
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. Palliative Care for Non-Cancer Patients 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.
