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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.
ACP is an essential part of end of life care with patients improving their chances of 'a good death' by creating plans with their families and carers. This new edition gives a comprehensive overview of ACP, explores a wide range of issues and practicalities in providing end of life care, and offers a worldwide perspective.
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Contains expanded content on economics and outcomes of treatment, as well as acute kidney injury. Covers hot topics such as the genetic causes of chronic kidney disease, ethical challenges and palliative care, and home hemodialysis. Discusses the latest advances in hypertensive kidney disease, vitamin D deficiency, diabetes management, transplantation, and more. Provides a clear visual understanding of complex information with high-quality line drawings, photographs, and diagnostic and treatment algorithms.
This comprehensive guide thoroughly covers all aspects of neuropalliative care, from symptom-specific considerations, to improving communication between clinicians, patients and families. Neuropalliative Care: A Guide to Improving the Lives of Patients and Families Affected by Neurologic Disease addresses clinical considerations for diseases such as dementia, multiple sclerosis, and severe acute brain injury, as well discussing the other challenges facing palliative care patients that are not currently sufficiently met under current models of care. This includes methods of effective communication, supporting the caregiver, how to make difficult treatment decisions in the face of uncertainty, managing grief, guilt and anger, and treating the pain itself. Written by leaders in the field of neuropalliative care, this book is an exceptional, well-rounded resource of neuropalliative care, serving as a reference for all clinicians caring for patients with neurological disease and their families: neurologists and palliative care specialists, physicians, nurses, chaplains, social workers, as well as trainees in these areas.
"This advance care planning resource was developed by doctors for doctors. It comprises nine modules that will support doctors and other health professionals to: have the conversation with patients about end-of-life decision making, engage patients in decisions about their care, help them to undertake advance care planning" -- publisher's website.
This book is designed to present an overview of common geriatrics ethical issues that arise during patient care and research activities. Each chapter includes a case example and practical learning pearls that are useful in day-to-day patient care. Coverage includes a brief overview of geriatric epidemiology, highlighting the high rates of dementia, use of surrogate decisions makers at the end-of-life, relocation from home to long-term care facilities, and low health literacy in the geriatrics population. Sections are devoted to issues around capacity, surrogate decision making, end-of-life care, hemodialysis in the elderly, and futility as well as challenges presented by independence questions, such as dementia care, driving, feeding, and intimacy in nursing homes. The text also addresses questions around recognizing, reporting, and treating elder abuse and self-neglect, ethics related to research and technology in the geriatric population, and the use of e-mail, Facebook, and open notes. Written by experts in the field, Ethical Considerations and Challenges in Geriatrics is a valuable tool for trainees at a variety of levels including medical students, residents, and fellows. In addition, it provides practical guidance and a useful reference for practicing geriatricians, primary care physicians, geriatric nurses, social workers, nursing home workers, hospice care employees, and all medical health professionals working with the elderly.
A comprehensive reference covering all aspects of the clinical management of adult and child dialysis patients. This edition includes seven new chapters including one on EPO use in dialysis patients and one on the HIV positive patient.
"This is a very substantive book that encompasses the various aspects of advance care planning, both prior to and after a diagnosis of a life-limiting disease. The realistic case studies help readers understand the complexities of decision-making by the individual and the family."--Doody's Medical Reviews While advance directives hold a great deal of promise for ensuring self-determination and quality of life near its end, the majority of Americans face life-threatening illness without having completed effective advance care planning.. This volume recounts the history of advance directives, chronicling the evolution of an approach that initially focused on completing forms, to one that now emphasizes more comprehensive strategies for facilitating conversations about end-of-life care and planning for dying and death. It provides helpful strategies for initiating and guiding discussions among providers, patients, and their loved ones, easing the burdens of uncertainty, and improving the efficacy of surrogate decision making near the end of life. Scholars and practitioners from a variety of disciplines provide a well-rounded view of the history and challenges of advance directives. Authors include palliative care physicians, nurses, social workers, grief counselors, educators, lawyers, psychologists, sociologists, and medical ethicists. The book shares successful strategies on how effective advance care planning can provide smoother transitions at the end of life and ensure better quality of living before death. It incorporates effective multidisciplinary, relationship-based models of advance care planning along with multidisciplinary perspectives to help caregiving professionals initiate conversations and disseminate relevant information to patients and their loved ones and advocates. Case studies illustrate the importance of, challenges with, and prospects for advance directives and advance care planning. The book addresses common barriers to advance care planning and offers ways to overcome them, as well as detailing public health, legal, and comprehensive community planning approaches to change how our current American society deals with dying, death, and end-of-life care. Key Features: Introduces a multidisciplinary, pragmatic approach to advance care planning Addresses strategies to reform advance care planning Presents case studies illustrating the importance, benefits, and challenges of advance directives Features successful initiatives in advance care planning and new directions that shift community practice related to dying, death, and end-of-life care. Includes the contributions of physicians, grief counselors, medical ethicists, social workers, psychologists, medical ethicists, lawyers, nurses, educators, and others