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The growing geriatric population in the United States has created an increasing need for palliative medicine services across the range of medical and surgical specialties. Yet, palliative medicine lacks the resources to carry such a workload itself. Geriatric Palliative Care addresses this need by encouraging individual specialties to "own" the management of elderly with the same vigor as they "own" other key management competencies within their specialty. This clinically focused and highly practical handbook, which compliments the more comprehensive text Geriatric Palliative Care by Sean Morrison and Diane Meier (Oxford University Press, 2003), encourages this process of learning and ownership across many medical specialties. Designed to be readable and easily accessible to a range of health care providers, Geriatric Palliative Care outlines specific strategies for caring for specific palliative care issues common in elderly patients. The handbook also provides evidence based advice for helping patients, relatives, and staff cope with such issues as polypharmacy, dementia and consent, multiple pathologies, home care, elderly caregivers, and supporting the elderly in the place where they would like to be.
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.
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.
Offering not only insights into the current state of policy work around the world; it also offers examples of good practice and recommendations for the future. Recommendations that can inspire, support, and direct healthcare policy and decision-making at organisational, regional, national and international levels.
Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.
This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults.
Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.
Current projections indicate that by 2050 the number of people aged over 80 years old will rise to 395 million and that by this date 25-30% of people over the age of 85 will show some degree of cognitive decline. Palliative care for older people: A public health perspective provides a comprehensive account of the current state of palliative care for older people worldwide and illustrates the range of concomitant issues that, as the global population ages, will ever more acutely shape the decisions of policy-makers and care-givers. The book begins by outlining the range of policies towards palliative care for older people that are found worldwide. It follows this by examining an array of socio-cultural issues and palliative care initiatives, from the care implications of health trajectories of older people to the spiritual requirements of palliative care patients, and from the need to encourage compassion towards end-of-life care within communities to the development of care pathways for older people. Palliative care for older people: A public health perspective is a valuable resource for professionals and academics in a range of healthcare and public health fields to understand the current state of policy work from around the world. The book also highlights the social-cultural considerations that influence the difficult decisions that those involved in palliative care face, not least patients themselves, and offers examples of good practice and recommendations to inspire, support, and direct healthcare policy and decision-making at organisational, regional, national and international levels.
Palliative and end of life care are concerned with the physical, social, psychological and spiritual care of people with advanced disease. It currently has a poorly developed research base, but the need to improve this is increasingly recognised. One of the reasons for the lack of research - and the variable quality of the research that is undertaken - is the difficulty of conducting research with very ill and bereaved people. Standard and well-established research methods may need to be adapted to work in this context. This means that existing research methods textbooks may be of limited use to palliative care practitioners seeking to do research for the first time, or to more experienced researchers wanting to apply their knowledge in palliative care settings. This research methods textbook is the first to be written specifically for palliative care. It has been edited by four experienced palliative care academics with acknowledged expertise and international reputations in this field. It encompasses methods used in both clinical and health services research in palliative care, with sections on clinical, epidemiological, survey and qualitative research, as well as a section covering skills needed in any research project. Each chapter provides readers with an up to date overview of the research method in question, an understanding of its applicability to palliative care and of the particular challenges of using it in this setting. It is essential reading for all palliative care researchers.