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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.
Death, Dying and Palliative Care in Children and Young People: Perspectives from Health Psychology examines the issues relevant to children and young people living with serious illness and their families by taking a closer look at the literature and knowledge around the processes of care, health, well-being and development through a health psychology lens. The text introduces readers to the general palliative and holistic care needs of children and young people along with the nuances of caring relationships. The chapters discuss the vulnerabilities encountered in living with serious illness and facing a shortened life prognosis, being at the end of life, and issues relative to the historical concept of the ‘good death’ or ‘dying well’, grief, and bereavement. The author examines how individual and familial experiences can be multi-layered, which can consequently influence perceptions and behaviours. The text therefore offers a deep exploration of the varied ways in which people draw on different resources to navigate their palliative care lived experiences. The book will be beneficial to the students of, and individuals interested in, psychology and nursing along with other health and social care courses. It will further be of interest to individuals interested in gaining more understanding of the experiential aspects of death, dying and palliative care in children and young people from health psychology perspectives.
Talking with Children and Young People about Death and Dying is a popular resource designed to help adults talk to bereaved children and young people. Mary Turner explains the various aspects and stages of bereavement and offers useful insights into the concerns of children experiencing grief or facing an imminent bereavement. She addresses children's common fears and worries, dreams and nightmares, and acknowledges the effect of trauma on the grief process. This second edition includes a new section for adults on understanding the distress of a bereaved child and also a list of useful contacts. It is a fully photocopiable workbook that enables adults to deal with these issues sensitively and explains, for example, how to choose appropriate words to support the child. It will empower and equip adults working with bereaved children to encourage them to communicate their pain and understand the often contradictory emotions aroused by the death of someone close to them.
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.
In our society's aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Institute's budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it.
Winner of the Margaret Mead Award A classic, moving study of terminally ill children that emphasizes their agency and shows how we can relate to dying children more honestly “The death of a child,” writes Myra Bluebond-Langner, “poignantly underlines the impact of social and cultural factors on the way that we die and the way that we permit others to die.” In a moving drama constructed from her observations of leukemic children, aged three to nine, in a hospital ward, she shows how the children come to know they are dying, how and why they attempt to conceal this knowledge from their parents and the medical staff, and how these adults in turn try to conceal from the children their awareness of the child’s impending death. In contrast to many parents, doctors, nurses, and social scientists who regard the children as passive recipients of adult actions, Bluebond-Langner emphasizes the children’s role in initiating and maintaining the social order. Her sensitive and stirring portrait shows the children to be willful, purposeful individuals capable of creating their own worlds. The result suggests better ways of relating to dying children and enriches our understanding of the ritual behavior surrounding death.
Publisher description
The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.
One out of seven children will lose a parent before they are 20. The statistics are sobering, but they are also a call for preparedness. However, pastors and counselors of all types are often at a loss when dealing with a grieving child. Talking to adults about death and grief is difficult; it's all the more challenging to talk to children and teens. The stakes are high: grieving children are high-risk for substance abuse, promiscuity, depression, isolation, and suicide. Yet, despite this, most of these kids grow up to be normal or exceptional adults. But their chance to become healthy adults increases with the support of a loving community. Supporting grieving children requires intentionality, open communication, and patience. Rather than avoid all conversations on death or pretend like it never happened, normalizing grief and offering support requires us to be in-tune with kids through dialogue as they grapple with questions of “how” and “why.” When listening to children in grief, we often have to embrace the mystery, offer love and compassion, and stick with the basics. The author says, "We don’t have to answer the why and how for them, but we can assure our children that God is with us as we suffer. We can do so by doing good for others and pointing out all of those moments when someone has done something good for us. I believe that most of the time that’s as far as we will get, and that is okay."