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Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
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."
This “comforting…thoughtful” (The Washington Post) guide to maintaining a high quality of life—from resilient old age to the first inklings of a serious illness to the final breath—by the New York Times bestselling author of Knocking on Heaven’s Door is a “roadmap to the end that combines medical, practical, and spiritual guidance” (The Boston Globe). “A common sense path to define what a ‘good’ death looks like” (USA TODAY), The Art of Dying Well is about living as well as possible for as long as possible and adapting successfully to change. Packed with extraordinarily helpful insights and inspiring true stories, award-winning journalist Katy Butler shows how to thrive in later life (even when coping with a chronic medical condition), how to get the best from our health system, and how to make your own “good death” more likely. Butler explains how to successfully age in place, why to pick a younger doctor and how to have an honest conversation with them, when not to call 911, and how to make your death a sacred rite of passage rather than a medical event. This handbook of preparations—practical, communal, physical, and spiritual—will help you make the most of your remaining time, be it decades, years, or months. Based on Butler’s experience caring for aging parents, and hundreds of interviews with people who have successfully navigated our fragmented health system and helped their loved ones have good deaths, The Art of Dying Well also draws on the expertise of national leaders in family medicine, palliative care, geriatrics, oncology, and hospice. This “empowering guide clearly outlines the steps necessary to prepare for a beautiful death without fear” (Shelf Awareness).
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.
Ageing populations mean that palliative and end of life care for older people must assume greater priority. Indeed, there is an urgent need to improve the experiences of older people at the end of life, given that they have been identified as the 'disadvantaged dying'. To date, models of care are underpinned by the ideals of specialist palliative care which were developed to meet the needs of predominantly middle-aged and 'young old' people, and evidence suggests these may not be adequate for the older population group. This book identifies ways forward for improving the end of life experiences of older people by taking an interdisciplinary and international approach. Providing a synergy between the currently disparate literature of gerontology and palliative care, a wide range of leading international experts contribute to discussions regarding priority areas in relation to ageing and end of life care. Some authors take a theoretical focus, others a very practical approach rooted in their clinical and research experience. The issues covered are diverse, as are the countries in which discussions are contextualised. Those working in both palliative care and gerontology will find the issues and advice discussed in this book hugely topical and of real practical value.
Older people are, like younger people, citizens in the communities of the nations in which they live. This book sees ageing as a life journey that incorporates a process of citizening, in which people build their identity as part of their family and community. But the social experience of illness, frailty, disability and reaching the end of life may de-citizen older people by devaluing the social identity that comes from continuing social engagement. We de-citizen older people by emphasizing dependence on services and their cost to public expenditure instead of valuing the interdependence of participation and mutual respect. This book argues that older people retain full citizenship for the whole of their lives, up to the moment of death; but what does this mean for health and social care? In this groundbreaking book, Malcolm Payne argues that social work with older people must build re-citizening practice strategies to value both the common and the special aspects of the citizenship of older people. Current models of social care and social work create dependency, rather than relying on values of participative interdependence. The failure to recognize the end of life as a crucial element in all social care and social work for older people means that the lessons learned in providing palliative and end-of-life care in healthcare have not been transferred to social care, and the priorities of end-of-life care have not been adequately encompassed in social work with older people.
Populations around the world are ageing and more people are living with the effects of serious chronic illness towards the end of life. This publication provides examples of better palliative care practices, from or relevant to the WHO European Region, that range from a whole health system perspective down to individual examples of better education or support in the community and elsewhere. While some examples remain to be fully evaluated, they will nevertheless help policy-makers, decision-makers, planners and multidisciplinary professionals to plan and support the most appropriate and effective services for the care and quality of life of older people.
Part of the Integrating Palliative Care series, this volume on surgical palliative care guides readers through the core palliative skills and knowledge needed to deliver high value care for patients with life-limiting, critical, and terminal illness under surgical care. Surgical Palliative Care is an ideal resource for surgeons, surgical nurses, intensivists, and other practitioners who wish to learn more about integrating palliative care into the surgical field.