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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.
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.
Updated with NANDA-I Nursing Diagnoses 2018-20 The all-in-one care planning resource! Here’s the step-by-step guidance you need to develop individualized plans of care while also honing your critical-thinking and analytical skills. You’ll find about 160 care plans in all, covering acute, community, and home-care settings across the life span. Each plan features… Client assessment database for each medical condition Complete listings of nursing diagnoses organized by priority Diagnostic studies with explanations of the reason for the test and what the results mean Actions and interventions with comprehensive rationales NANDA, NIC, and NOC’s most recent guidelines and terminology Evidence-based citations Index of nursing diagnoses and their associated disorders
Using a practical, question-and-answer approach, Evidence-Based Practice of Palliative Medicine, 2nd Edition, helps you provide optimal care for patients and families who are dealing with serious illness. This unique reference focuses on patient and family/caregiver-centered care, highlighting the benefits of palliative care and best practices for delivery. The highly practical, user-friendly format sets it apart from other texts in the field, with concise, readable chapters organized around clinical questions that you're most likely to encounter in everyday care. - Uniquely organized using a question-and-answer approach, making it easy to find answers to common questions asked by practitioners and patients. - Up-to-date, reader-friendly chapters explore interventions, assessment techniques, treatment modalities, recommendations and guidelines, communication techniques, and available resources for palliative care. - Expanded discussions on hospice in every chapter, and a new emphasis on pediatrics, with increased material on pediatric malignancies, developmental delays, cystic fibrosis, and perinatal palliative care. - New chapters on wellness of the palliative care practitioner, patients with opioid use disorders, telehealth in palliative care, health disparities, rural palliative care, caring for people with hematologic malignancies, integrative and alternative therapies, LGBTQ+ populations, mobile health technologies, and national palliative care implementation strategies. - High-quality evidence gathered and reviewed by leading experts in palliative medicine, including clinicians, educators, and researchers across a broad range of disciplines. - Numerous algorithms throughout help you make informed decisions, and "take-home" points in every chapter provide a quick summary of key content. - Any additional digital ancillary content may publish up to 6 weeks following the publication date.
In the 14 years since the first edition of Addictions was published, a wealth of substantive and crucial new findings have been added to our knowledge of alcohol and other substance use disorders. This primary reference has now been updated and expanded to include 38 chapters, all completely rewritten to reflect new knowledge gained about the science of alcohol and other drugs, as well as new treatment approaches and research trends. Addictions: A Comprehensive Guidebook, Second Edition, features a roster of senior scientists covering the latest findings in the study of alcohol and other drug use, abuse, and dependence. Skillfully edited by Drs. Barbara S. McCrady and Elizabeth E. Epstein, the chapters primarily review the literature published in the last 14 years since the first edition. The volume covers seven different content areas: Section I addresses broad conceptual issues as well as information on the etiology, neuroscience, epidemiology and course of alcohol and other drug use, abuse, and dependence. Section II provides detailed pharmacological and clinical information on the major drugs of abuse, including alcohol. Sections III, IV, and V focus on knowledge of importance to clinical practice, including a section on assessment and treatment planning, information on a range of empirically supported treatments, and issues related to clinical practice. Section VI provides information about specific population groups, and Section VII addresses policy, prevention, and economic issues in the field. The book is appropriate for a wide variety of readers who are either treating, learning to treat, doing research on, or teaching about addictions. Comprehensive and succinct, it is written in a manner that is accessible and useful to practitioners, students, clinician trainees, and researchers. It is also an ideal textbook for graduate courses and training programs in psychology, psychiatry, social work, and addictions certifications, and for advanced undergraduate courses on alcohol and other substance use disorders
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.