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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).
"This volume should be quite useful to the target audience. It provides a good foundation for evidence-based practice and further research (4 stars)." Doody's Book Review Service. The nursing community is continually challenged with expanding the empirical knowledge base that informs rural nursing practice. This volume of the prestigious Annual Review of Nursing Research, Focus on Rural Health, addresses this challenge. Contributors have developed creative and effective strategies to identify relevant research and present them in the context of the rural delivery system
This volume should be quite useful to the target audience. It provides a good foundation for evidence-based practice and further research (4 stars). Doody's Book Review Service.The nursing community is continually challenged with expanding the empirical knowledge base that informs rural nursing practice. This volume of the prestigious Annual Review of Nursing Research, Focus on Rural Health, addresses this challenge. Contributors have developed creative and effective strategies to identify relevant research and present them in the context of the rural delivery system.
Our problems seemingly develop faster than our ability to cope with those problems. The blessing of longer life has brought with it a host of new issues faced by the elderly, their families, and their caregivers. "Ethical Issues in the Care of the Dying and Bereaved Aged", twenty-three essays by some of the most eminent thinkers in the field of death and bereavement, addresses some of these problems. Victor Marshall, Miriam and Sidney Moss, Colin M. Parkes, Dennis Klass, Margaret Somerville and Elizabeth Latimer, as well as other clinicians, have written new material for this book.
It has always been a topic for debate as to how nursing students are taught to deal with death and dying and how they respond to particular methods of teaching. In my many years of experience in the nursing profession, I have come across some very difficult situations in dealing with death and dying, these have been both challenging and rewarding to me.I believe nursing students require both empathy and guidance from nurse educators' to deal with what could be already difficult situations within the hospital or community settings. This study looks at the lived experiences of clinical nurse educators who work with undergraduate nursing students in a hospital setting. It employs a phenomenological approach to focus on nurses' personal experiences of death and dying. In particular it examines how nurses perceive the experiences influence the way they instruct their students. The literature examined relevant to this study has previously identified many aspects;however this study has identified the importance of nurses sharing personal experiences. This book may be helpful to both nurse educators and nursing students.
The purpose of this study was to measure the effects of a small group education/counseling experience on the attitudes toward death and toward dying patients of nurses who work in high risk death areas of local hospitals. The subjects were from three populations: registered nurses who work in high risk death areas of local hospitals, and who registered for a continuing education course on death and dying, registered nurses from high risk death areas of local hospitals who did not register for the course, and freshman students from a local university. The experimental design used four groups of subjects. One group experienced the treatment. Another group served as a waiting list control group and then experienced the treatment. Two groups were control groups. Subjects from all groups were given the outcome measures before the course began. Subjects from the treatment group were retested at the end of the six weeks course. Subjects from the waiting list control-treatment group were retested twice: after six weeks and twelve weeks, the latter after they had attended the six-week course. The treatment consisted of attendance at a six-week continuing education course entitled, "Coping with Death and Dying in High Risk Areas of Hospitals", in which techniques from both education and counseling were used. Two instruments were used as the dependent variables in the study: the Death Anxiety Semantic Differential, Parts I and II, and the Attitude Toward Dying Patients Questionnaire. The scores on the DASD, Part I and II were analyzed by analysis of variance, analysis of covariance, and two-way analysis of variance with the following results; (1) There were no statistically significant differences between the groups at the beginning of the experiment; (2) Subjects from the first treatment group had significantly greater changes in attitude toward death and toward dying patients as measured by the DASD, Part I and II, than subjects in the waiting list control group: (3) There was no significant difference between pre-post-attendance scores of both treatment groups as measured by the DASD, Part I because of interaction. There was a statistically significant difference between pre- and post-attendance scores of subjects from both treatment groups as measured by the DASD, Part II. A change score was computed for each subject based on answers to three of the questions on the Attitude Toward Dying Patients Questionnaire. Scores were analyzed by one-way analysis of variance which showed a statistically significant difference in attitude change toward death and dying between subjects who experienced the treatment and control group subjects. Responses to nineteen questions on the Attitude Toward Dying Patients Questionnaire were examined by item analysis of coded responses. Because of the lack of statistical analyses on these items, findings are considered extremely tentative. It appears, however, that the course did have an impact in changing attitudes of subjects from the first treatment group. Change of attitude of subjects from the waiting list control-treatment group occurred less frequently. It was concluded that attendance at the continuing education/counseling course on death and dying did appear to have an impact on changing attitudes toward death and toward dying patients of the nurses from high risk death areas who attended the course
This third edition of a popular textbook has been completely revised by the joint editors, Janet Moscrop and Joy Robbins. As in previous editions, the focus is on the person dying at home, in residential care or in hospital and the emphasis is on teamwork in caring for the individual and their relatives and friends. Experts in all aspects of care have contributed to this complete revision of the previous text and each chapter is written by a different member of the multiprofessional team. The chapter on the terminal care of people suffering from AIDS has been enlarged and consideration is also given to care of those in the term inal stages of other non-malignant diseases. Other new material includes chapters on complementary therapy, the use of the day centre, the value of volunteers, diversional therapy and respite care. The chapter on bereavement covers many aspects of grief and loss and there is a sensitive approach to the need for supporting staff in this spe cialized work. Consideration is also given to the needs of dying and griev ing people from differing ethnic backgrounds with varying cultural expectations in a pluralistic society. The third edition offers a broad overview of the support given to the dying person and the carers by medical and nursing staff, physiothera pists, pharmacists, social workers, the chaplaincy and members of the pastoral care team. Students of all these disciplines should find this book both readable and informative.