The Best Care Possible


Book Description

A doctor on the front lines of hospital care illuminates one of the most important and controversial social issues of our time. It is harder to die in this country than ever before. Though the vast majority of Americans would prefer to die at home—which hospice care provides—many of us spend our last days fearful and in pain in a healthcare system ruled by high-tech procedures and a philosophy to “fight disease and illness at all cost.” Dr. Ira Byock, one of the foremost palliative-care physicians in the country, argues that how we die represents a national crisis today. To ensure the best possible elder care, Dr. Byock explains we must not only remake our healthcare system but also move beyond our cultural aversion to thinking about death. The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning life-or-death medical drama. It has the power to lead a new national conversation.




The Physician and Hospice Care


Book Description

The Physician and Hospice Care is an informative overview of the roles and attitudes of physicians on the hospice staff, and the challenges they encounter in their work with terminally ill patients. An enlightening reference book, it prepares novice hospice physicians for the often demanding hospice environment by exploring issues they may encounter, such as the physician's role in hospice team management, the developing concept of palliative care and the hospice, and the changing patterns of care for the terminally ill. Hospice staff will gain valuable insights for working with physicians through examinations of doctors'attitudes about palliative care, particularly their difficulty with accepting death as the inevitable outcome of an illness. This indispensable book includes guidelines for physicians on the management of various care activities including pain and symptom management, medical ethics regarding euthanasia, recurrent life-threatening illness, home care for the terminally ill, and ethical considerations related to patient suicide. New physicians and other health care professionals in a variety of disciplines involved in the care of the dying will gain a better understanding of their own roles and contributions to hospice care from this perceptive book. Some of the important topics covered by The Physician and Hospice Care include: collaboration between physicians and social workers physicians'roles as educators of hospice volunteers physicians'reactions to death issues of hospice care for noncancer patients house calls for terminally ill ethical dilemmas in feeding advanced cancer patients nonverbal communication and sexuality in dying patients psychosocial aspects of care for end-stage lung disease staff and family perceptions of death in hospitals home care of the advanced cancer patient This unique book provides sensitive guidelines for physicians and other professionals to use in their work with terminally ill patients. It is an eye-opener of tremendous value to upper level medical students, interns, residents, oncological radiotherapists, oncological subspecialists, young attending physicians in academic and private practice, hospice physicians, and all members of the hospice staff from clergy to volunteers.




50 Studies Every Palliative Care Doctor Should Know


Book Description

50 Studies Every Palliative Doctor Should Know presents key studies that have shaped the practice of palliative medicine. Selected using a rigorous methodology, the studies cover topics including: palliative care, symptom assessment and management, psychosocial aspects of care and communication, and end-of-life care. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for health care professionals and anyone who wants to learn more about the data behind clinical practice.




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."




Physician-Assisted Dying


Book Description

In this volume, a distinguished group of physicians, ethicists, lawyers, and activists come together to present the case for the legalization of physician-assisted dying, for terminally ill patients who voluntarily request it. To counter the arguments and assumptions of those opposed to legalization of assisted suicide, the contributors examine ethical arguments concerning self-determination and the relief of suffering; analyze empirical data from Oregon and the Netherlands; describe their personal experiences as physicians, family members, and patients; assess the legal and ethical responsibilities of the physician; and discuss the role of pain, depression, faith, and dignity in this decision. Together, the essays in this volume present strong arguments for the ethical acceptance and legal recognition of the practice of physician-assisted dying as a last resort -- not as an alternative to excellent palliative care but as an important possibility for patients who seek it.




Palliative and Serious Illness Patient Management for Physician Assistants


Book Description

The first resource of its kind, Palliative and Serious Illness Patient Management for Physician Assistants provides a fundamental framework for physician assistants and physician associates to incorporate palliative care medicine, including end-of-life care, into their practice. The book focuses on pharmacologic and integrative medical therapeutic modalities, as well as the evaluation and treatment of special populations, which reflects the reality of a physician assistant's day-to-day job. It uses a patient-centered approach to address the comprehensive management of serious illness patients, as well as their designated families, significant others, caregivers, and health care providers. Chapters are organized into six sections that cover the essential aspects of care, symptom management, and transitioning care at the end-of-life. This book is ideal for physician assistant trainers (didactic or clinical), students, and practicing clinicians who seek to enhance their communication and medical skills in the treatment of all seriously illness patient populations in any specialty, and in the management of their symptoms at any stage of their disease or condition.




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.




Dying Well


Book Description

From Ira Byock, prominent palliative care physician and expert in end of life decisions, a lesson in Dying Well. Nobody should have to die in pain. Nobody should have to die alone. This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning. Ira Byock is also the author of The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life.




Hospice Coordinator


Book Description

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.




Improving Palliative Care for Cancer


Book Description

In our society's aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Institute's budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it.