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When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."
Ten years after the death of Elisabeth K bler-Ross, this commemorative edition of her final book combines practical wisdom, case studies, and the authors' own experiences and spiritual insight to explain how the process of grieving helps us live with loss. Includes a new introduction and resources section. Elisabeth K bler-Ross's On Death and Dying changed the way we talk about the end of life. Before her own death in 2004, she and David Kessler completed On Grief and Grieving, which looks at the way we experience the process of grief. Just as On Death and Dying taught us the five stages of death--denial, anger, bargaining, depression, and acceptance--On Grief and Grieving applies these stages to the grieving process and weaves together theory, inspiration, and practical advice, including sections on sadness, hauntings, dreams, isolation, and healing. This is "a fitting finale and tribute to the acknowledged expert on end-of-life matters" (Good Housekeeping).
Palliative care and hospice philosophies, practice, and research can be understood as a movement to counter dehumanizing aspects of the medicalization of death--a movement to ?reclaim? the individuality of dying. However, this push to singularize dying (as one's own) becomes part of a universalizing process as death is managed within institutional spaces and medical discourses. From an ontological perspective, the individuality of mortality--i.e., dying--can be understood in opposition to the universality of death. In contemporary society, there is a paradoxical relationship within the management of death: there is an attempt to universalize the singularity of dying. This thesis is proposed to address contemporary conceptual "problems" of dying and responses to them, as historically and contextually situated, through a Heideggerian phenomenological understanding and methodological critique of selected phenomenological nursing research related to dying. The intent is to explore the ways dying is constructed as an object of phenomenology through an analysis of the ontological and epistemological ambiguities within this literature to pose the ensuing methodological implications. The thesis hopes to propose an alternate way to conceptualize dying for this literature and it aims to suggest implications for theory and method in this field of research.
Investigates the ways in which nurses cope with the dying patient and the acute patient who will recover. Factors which influence transition between the two types of care are also examined.
A milestone resource for palliative care nurses that facilitates evidence-based compassionate and humanistic care of the dying "A valuable contribution to the evolving field of palliative nursing care. It is authored by a model for this field, Bonnie Freeman, and brings to the bedside what her practice embodies--evidence-based clinically expert care...The CARES tool is a long-needed resource and we are all grateful to the author for moving her passion to paper. It will touch the lives and deaths of patients, families, and the nurses who care for them." --Betty Ferrell, PhD, RN, MA, FAAN, FCPN, CHPN Professor and Director, Division of Nursing Research and Education City of Hope National Medical Center From the Foreword This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author's research-based CARES tool; a reference that synthesizes five key elements demonstrated to enable a peaceful death, as free from suffering as possible: comfort, airway management, management of restlessness and delirium, emotional and spiritual support, and selfcare for nurses. The book describes, step by step, how nurses can easily implement the basic tenets of the CARES tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible. The book identifies the most common symptom management needs in dying patients and describes, in detail, the five components of the CARES paradigm and how to implement them to enable a peaceful death and minimize suffering. It includes palliative care prompts founded on 29 evidence-based recommendations and the National Consensus Project for Palliative Care Clinical Practice Guidelines. The resource also addresses the importance of the nurse to act as a patient advocate, how to achieve compassionate communication with the patient and family, and barriers and challenges to compassionate care. Case studies emphasize the importance of compassionate nursing care of the dying and how it can be effectively achieved. Key Features: Provides nurses with a clear understanding of the most common needs of the dying and supplies practical applications to facilitate and improve care Clarifies the current and often complex literature on care of the dying Includes case studies illustrating the most common needs of dying patients and how these are addressed effectively by the CARES tool Based on extensive evidence as well as on the National Consensus Project for Palliative Care Clinical Practice Guidelines
Revised edition of the best-selling memoir that has been read by over a million people worldwide with translations in 29 languages. After too many years of unfulfilling work, Bronnie Ware began searching for a job with heart. Despite having no formal qualifications or previous experience in the field, she found herself working in palliative care. During the time she spent tending to those who were dying, Bronnie's life was transformed. Later, she wrote an Internet blog post, outlining the most common regrets that the people she had cared for had expressed. The post gained so much momentum that it was viewed by more than three million readers worldwide in its first year. At the request of many, Bronnie subsequently wrote a book, The Top Five Regrets of the Dying, to share her story. Bronnie has had a colourful and diverse life. By applying the lessons of those nearing their death to her own life, she developed an understanding that it is possible for everyone, if we make the right choices, to die with peace of mind. In this revised edition of the best-selling memoir that has been read by over a million people worldwide, with translations in 29 languages, Bronnie expresses how significant these regrets are and how we can positively address these issues while we still have the time. The Top Five Regrets of the Dying gives hope for a better world. It is a courageous, life-changing book that will leave you feeling more compassionate and inspired to live the life you are truly here to live.
When a patient has an advanced disease, considerable demands are placed on the whole family. Whilst coping with their own profound emotions, close relatives commonly have to support their loved ones through a range of treatments as the disease progresses through stages of remission and recurrence, until finally, a shift to a palliative mode of treatment must be faced. In such situations, family roles and relationships are likely to be disrupted and family members? coping resources can be stretched to the limit. It is clear from this that by the time the terminal stage of the patient?s illness is reached, the family may have travelled a long and difficult road, and close relatives are likely to be emotionally vulnerable and in need of support.This study explores the needs of relatives of terminally ill patients and the concerns of nurses who provide care in the hospital. The research data is used to design, implement and evaluate clinical standards for improved family support.