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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."
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.
An on-the-go reference for hospice nurses and those interested in end-of-life care, this practical guide covers the essential elements in the compassionate and holistic care of terminally ill patients and their families. Nurses care for patients facing end-of-life issues in every practice specialty and, as the U.S. population continues to age, the need for proficiency in end-of-life skills will become increasingly important. Fast Facts for the Hospice Nurse: A Concise Guide to End-of-Life Care is an invaluable resource that provides emotional, administrative, and palliative support, whether in a hospice, long-term care facility, or acute care setting. This vital go-to text clearly and concisely lays out not only how to care for patients facing end-of-life issues, but also how to engage in self-care and cope with occupational stress. Beginning with an overview of hospice care, including its history and philosophy, this book offers a timeline of the growth of the hospice movement in the United States. Subsequent sections include up-to-date information on the clinical responsibilities of the hospice nurse in addressing the physical, psychological, and spiritual needs of terminally ill patients and their families in a culturally sensitive way. This book also outlines the administrative duties of the hospice nurse, including hospice documentation, a review of hospice regulations, and quality management. The closing section focuses on occupational stress in hospice nursing and how to engage in self-care. This text can serve as a useful clinical resource and also as a reference for nurses seeking hospice certification from the Hospice and Palliative Credentialing Center. Key Features Organized within the context of the scope and standards of practice of the Hospice and Palliative Nurses Association. Addresses key points about issues unique to hospice nursing and highlights evidence-based interventions Addresses important Medicare regulations and reimbursement Offers numerous clinical resources to assist with hospice nursing practice Serves as a concise study resource for hospice nursing certification
This is the second edition of the widely praised book by Drs Eduardo D. Bruera and Russell K. Portenoy on all aspects of cancer pain.
The Hospice Coordinator Passbook(R) prepares you for your test by allowing you to take practice exams in the subjects you need to study. It provides hundreds of questions and answers in the areas that will likely be covered on your upcoming exam.
Amytrophic Lateral Sclerosis (ALS or motor neurone disease) is a progressive neurodegenerative disease that can cause profound suffering for both the patient and their family. Whilst new treatments for ALS are being developed, these are not curative and offer only the potential to slow its progression. Palliative care must therefore be integral to the clinical approach to the disease. Palliative Care in Amyotrophic Lateral Sclerosis: From diagnosis to bereavement reflects the wide scope of this care; it must cover not just the terminal phase, but support the patient and their family from the onset of the disease. Both the multidisciplinary palliative care team and the neurology team are essential in providing a high standard of care and allowing quality of life (both patient and carer) to be maintained. Clear guidelines are provided to address care throughout the disease process. Control of symptoms is covered alongside the psychosocial care of patients and their families. Case studies are used to emphasise the complexity of the care needs and involvement of the patient and family, culminating in discussion of bereavement. Different models of care are explored, and this new edition utilizes the increase in both the evidence-base and available literature on the subject. New topics discussed include complementary therapies, personal and family experiences of ALS, new genetics research, and updated guidelines for patient care, to ensure this new edition remains the essential guide to palliative care in ALS.