Living at the End of Life


Book Description

An updated edition of the most respected book on hospice care—for both patients and caregivers. This warm and informative resource on hospice and other end-of-life care options now gets an update. It receives a new preface and revised guidance on elders who need more long-term care and support, recommendations on pain medications, and advice for those living extended lives with treatable, but not curable, diseases. Written by a hospice nurse, Living at the End of Life reassures us that this difficult time also offers an opportunity to explore and rediscover a richer meaning in life. Drawing on her years of experience, Bell has created a comprehensive, insightful guide to every aspect of hospice care and the final stages of life. For people in hospice, as well as their friends and families, this is an indispensable and trustworthy source of comfort and spiritual healing.




Life in a Hospice


Book Description

Highly Commended, BMA Medical Book Awards 2008 This book is about hospices, seen through the eyes of the people who work in them. Their individual voices, perspectives and stories invite readers into the day-to-day complexities of hospice life. There is growing public and professional attention to end of life care and the way dying patients and their families are treated. How can hospices make the process dignified and peaceful as possible? What sort of people dedicate their careers to helping the dying? What difficulties are they up against in providing this care, and what makes it all worthwhile?This inspirational book provides vivid, real-life accounts of hospice life from managers, doctors, nurses, carers and support staff. The thought-provoking narratives provide vital insights into the type of work undertaken in a hospice setting. They examine the differences between hospice and hospital care, and explore the challenges, personal motivations and the many ways hospices strive to meet the needs of patients and their families with sensitivity and respect. "Life in a Hospice" is enlightening reading for all healthcare professionals in palliative care, including volunteer, administrative and support staff. It is also highly recommended for nurses and others in caring roles considering a move into hospice work. Therapists, counsellors and religious leaders will discover poignant and encouraging insights, and people with a family member approaching the end of life will find the book reassuring and informative.




Hospice Social Work


Book Description

The first text to explore the history, characteristics, and challenges of hospice social work, this volume weaves leading research into an underlying framework for practice and care. A longtime practitioner, Dona J. Reese describes the hospice social work role in assessment and intervention with individuals, families, groups, organizations, and the community, while honestly confronting the personal and professional difficulties of such life-changing work. She introduces a well-tested model of psychosocial and spiritual variables that predict hospice client outcomes, and she advances a social work assessment tool to document their occurrence. Operating at the center of national leaders' coordinated efforts to develop and advance professional organizations and guidelines for end-of-life care, Reese reaches out with support and practice information, helping social workers understand their significance in treating the whole person, contributing to the cultural competence of hospice settings, and claiming a definitive place within the hospice team.




Hospice: A Memoir of Life Among the Dying


Book Description

Hospice is an often-misunderstood medical specialty. The reality of the work is complex, poignant, challenging, fulfilling, and even humorous. These essays shine light on the struggles, gratifications, and life lessons from a hospice social worker.




Values at the End of Life


Book Description

This insightful study examines the deeply personal and heart-wrenching tensions among financial considerations, emotional attachments, and moral arguments that motivate end-of-life decisions. America’s health care system was built on the principle that life should be prolonged whenever possible, regardless of the costs. This commitment has often meant that patients spend their last days suffering from heroic interventions that extend their life by only weeks or months. Increasingly, this approach to end-of-life care is coming under scrutiny, from a moral as well as a financial perspective. Sociologist Roi Livne documents the rise and effectiveness of hospice and palliative care, and growing acceptance of the idea that a life consumed by suffering may not be worth living. Values at the End of Life combines an in-depth historical analysis with an extensive study conducted in three hospitals, where Livne observed terminally ill patients, their families, and caregivers negotiating treatment. Livne describes the ambivalent, conflicted moments when people articulate and act on their moral intuitions about dying. Interviews with medical staff allowed him to isolate the strategies clinicians use to help families understand their options. As Livne discovered, clinicians are advancing the idea that invasive, expensive hospital procedures often compound a patient’s suffering. Affluent, educated families were more readily persuaded by this moral calculus than those of less means. Once defiant of death—or even in denial—many American families and professionals in the health care system are beginning to embrace the notion that less treatment in the end may be better treatment.




Dying in America


Book Description

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.




Fast Facts for the Hospice Nurse


Book Description

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




Living with Grief Since COVID-19


Book Description

A comprehensive review of grief and loss issues facing professionals and families due to the COVID-19 pandemic.




Approaching Death


Book Description

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."




The Crisis of US Hospice Care


Book Description

Exploring the failure of hospice in America to care for patients and families at the end of life. Hospice is the dominant form of end-of-life care in the United States. But while the US hospice system provides many forms of treatment that are beneficial to dying people and their families, it does not encompass what is commonly referred to as long-term care, which includes help with the activities of daily living: feeding, bathing, general safety, and routine hygienic maintenance. Frequently, such care is carried out by an informal network of unpaid caregivers, such as the person's family or loved ones, who are often ill-prepared to offer this type of support. In The Crisis of US Hospice Care, Harold Braswell argues that the stress of providing long-term care typically overwhelms family members and that overdependence on familial caregiving constitutes a crisis of US hospice care that limits the freedom of dying people. Arguing for the need to focus on the time just before death, Braswell examines how the relationship of hospice to familial caregiving evolved. He traces the history of hospice over the past fifty years and describes the choice that people dying with inadequate familial support face between a neglectful home environment and an impersonal nursing home. A nuanced look at the personal and political dimensions that shape long-term, end-of-life care, this historical and ethnographic study demonstrates that the crisis in US hospice care can be alleviated only by establishing the centrality of hospice to American freedom. Providing a model for the transformative work that is required going forward, The Crisis of US Hospice Care illustrates the potential of hospice for facilitating a new way of living our last days and for having the best death possible.