Palliative Medicine

Advanced Practice Palliative Nursing is the first text devoted to advanced practice nursing care of seriously ill and dying patients and their families. This comprehensive work addresses all aspects of palliative care, including patients’ and families’ physical, psychological, social, and spiritual needs. Chapters cover the history and role of advanced practice palliative nursing, settings where advanced practice registered nurses deliver palliative care, the role and function of the palliative advanced practice registered nurse, advanced pain and symptom management, the importance of communication in palliative nursing, special populations needing a palliative care focus, pediatric palliative care, spiritual and existential issues, reimbursement, and nursing leadership on palliative care teams. Each chapter contains case examples supported by evidence based practice to ensure the highest quality of care. The text is written by leaders in the field, including authors who have pioneered the role of advanced practice registered nurses in palliative care. This volume offers advanced practice content and practical resources for clinical practice across all settings of care and encompassing all ages, from pediatrics to geriatrics.Less

Skillful nursing care during the final hours of life can bring comfort and quality, not only to the patient but also to the patient’s loved ones who are attending the death. Symptom burden can increase during this time, and knowledgeable assessment and management are essential to providing a peaceful death. Common concerns during this time include delirium, dyspnea, death rattle, and cough. Urgent syndromes, such as superior vena cava obstruction, pleural effusion, pericardial effusion, hemoptysis, spinal cord compression, and hypercalcemia, require expert care. Although in most cases symptoms can be effectively managed, there are situations in which, despite aggressive management, symptoms remain uncontrolled. In these rare incidents of refractory symptoms, palliative sedation may be warranted. The goal of this therapy is to provide relief, not to hasten death. Finally, although assistive devices, such as mechanical ventilation, dialysis, and cardiac devices, replace failing organs, extend life, and improve quality of life by relieving symptom distress, there are times when the burden of these treatments exceeds the benefits. As a consequence, when the patient is near death or unresponsive, decisions may be made to cease these therapies. Palliative care, including expert nursing care along with an interdisciplinary team, is needed to provide a safe and comfortable experience during these final hours.Less

The Clinical Pocket Guide to Advanced Practice Palliative Nursing is a companion guide to Advanced Practice Palliative Nursing, the first text devoted to advanced practice nursing care of the seriously ill and dying. Each chapter of this pocket guide presents point-of-care guidance on palliative care issues for quick reference in daily practice. Edited by leaders in the field, this handbook provides consistency in the nursing process from assessment to management and evaluation of symptoms and various clinical situations. The Clinical Pocket Guide to Advanced Practice Palliative Nursing contains clinical pearls developed from the textbook and practical tools on pain and symptom assessment, functional status, and communication, making it an ideal resource for practicing advanced practice nurses.Less

Compassion is a complex and multifaceted concept that has been explored from a range of cultural, philosophical, theological, and sociological perspectives. It can be considered a prerequisite for optimal health care, an expectation of the general public from their health care system, and a specific approach to care which should underpin the work of health care professionals globally. Given the nature of life-limiting illness and the challenges that shifting goals of care impose, the place of compassion as the underlying construct governing health care decisions would seem paramount. Yet there is an increasing concern-particularly in the UK media and recent reviews of clinical practices around end-of-life care-suggesting that somehow compassion has been lost as a governing principle of care giving. The reasons for this are not always clear, but increased clinical intervention, the over-professionalization of care, and lack of formal teaching on the topic of compassion are all indicated. Given the complex nature of care in advanced illness and life-limiting disease, the place of compassion within palliative and end-of-life care is worthy of further exploration to try to understand this phenomenon better. This book asks an international panel of expert palliative care practitioners to consider these issues for themselves and the discipline as we move into the 21st century. Through a series of interviews with some of the world’s experts in the field, the meaning, purpose, and outcome of providing compassionate care for palliative and end-of-life care is explored and critiqued. A critical commentary of themes raised by each contributor is discussed relative to the broader literature around the topic, and further reading and learning resources indicated for practitioners, educators, and students to follow up.Less

This resource discusses how a multidisciplinary and integrative approach to pain and analgesia should be considered by pain practitioners who treat patients with pain. Some familiarity with the cultural background of patients and self-awareness of the provider's own cultural characteristics will allow the pain practitioner to better understand patients' values, attitudes and preferences. This knowledge of patients' cultural practices and their impact on biological processes, including the origin and development of pain-related disease, can help to determine response to pharmacological and non-pharmacological treatments. Less

This resource concentrates on advanced dementia, and addresses issues such as pain management, decision-making, spiritual needs, communication, the Mental Health Capacity Act, dementia in the younger patient, and the carer's perspective.Less

Providing an overview of pharmacology and prescribing advice, this second edition contains over 160 drug monographs, presented in an A-Z format. Fully revised and updated, this detailed yet concise resource will appeal to all healthcare professionals involved in the provision of palliative care and medicines information. Less

This is a practical, accessible guide to all emergency situations encountered in palliative care. It provides clinical guidance for the management of people with progressive life limiting illnesses including cancer, AIDS, end-stage organ failure and neurodegenerative diseases. Less

End of life care in the ICU presents its own unique challenges, and this resource highlights real clinical issues which need to be addressed if quality palliative care within ICUs is to be consistently delivered.Less

No specialty faces more diverse and challenging ethical dilemmas than palliative medicine. What is the best way to plan ahead for the end of life? How should physicians respond when patients refuse treatments likely to be beneficial or demand treatments not likely to be? Who makes medical decisions for patients who are too ill to decide for themselves? Do patients have the “right to die” (and, if so, what exactly does that mean)? Other ethics texts have explored these issues but often from an academic perspective that overlooks the practical realities of clinical medicine. Conversely, medical textbooks frequently lack sufficient philosophical depth to fully explore the complexities of these issues. This complete guide to the ethics of palliative care combines clinical experience with philosophical rigor to provide a comprehensive analysis of this fascinating field. Using relevant case studies, core subjects such as intensive symptom management at the end of life, physician-assisted dying, and palliative sedation are examined from historical, legal, clinical, and ethical perspectives. Whereas pediatric issues are often an afterthought in palliative care textbooks, this guide explores the unique nature of ethical dilemmas in the prenatal, neonatal, and adolescent age groups. Other important topics such as neuro-palliative care, organ donation, research, and moral distress are also covered in detail. Written with clinical nuance for medical professionals—and clear language as well as a glossary for lay readers—this guide offers all readers an opportunity to explore and understand the fascinating ethical issues facing patients suffering from life-threatening illness.Less