End-of-Life Care in Cardiovascular Disease


Book Description

End-of-life issues in cardiology are becoming increasingly important in the management of patients in the cardiac unit, but there is frequently a lack of understanding regarding their impact on cardiology practice. The cardiac unit is increasingly becoming the location whereby a number of key clinical decisions relating to end-of-life care are being made, such as the decision to remove medications, the appropriate removal of cardiac devices, the management of do not resuscitate orders and the requirement for other cardiac procedures in light of the management of the terminally ill cardiac patients. Those working in palliative care need input from the cardiovascular team as the cardiologist is frequently still managing these patients until they are moved to the hospice. That this move into a hospice is often delayed until the very last moment, there is considerable onus on the cardiovascular management of these patients to be much broader in scope and take account of some of the more palliative medical decisions needed in this group of patients. This concise reference will detail the practical issues open to cardiovascular physicians and those medical professionals who manage patients reaching the end of their life from a cardiology perspective. It will detail the full management options open to them to ensure that their practice is in line with the requirements of the patient nearing the end of their life whether the cause be cardiovascular in origin or who need appropriate management of secondary cardiovascular symptoms. It will also include the various ethical, cultural and geographical issues that need to be considered when managing these patients.







Textbook of Palliative Care


Book Description

This second edition provides the most up-to-date information on all aspects of palliative care including recent developments (including COVID-19), global policies, service provision, symptom management, professional aspects, organization of services, palliative care for specific populations, palliative care emergencies, ethical issues in palliative care, research in palliative care, public health approaches and financial aspects of care. This new Textbook of Palliative Care remains a unique, comprehensive, clinically relevant and state-of-the art book, aimed at advancing palliative care as a science, a clinical practice and as an art. Palliative care has been part of healthcare for over fifty years but we still needs to be explained. Healthcare education and training has been slow to recognize the vital importance of ensuring that all practitioners have a good understanding of what is involved in the care of people with serious or advanced illnesses and theirfamilies. However, the science of palliative care is advancing and this new edition will contribute to a better understanding of this specialty. This new edition offers 20 new chapters out of over 120, written by experts in their given fields provide up-to-date information on a wide range of topics of relevance to those providing care towards the end of life no matter what the disease may be. We present a global perspective on contemporary and classic issues in palliative care with authors from a wide range of disciplines involved in this essential aspect of care. The Textbook includes sections addressing aspects such as symptom management and care provision, organization of care in different settings, care in specific disease groups, palliative care emergencies, ethics, public health approaches and research in palliative care. This new Textbook will be of value to practitioners in all disciplines and professions where the care of people approaching death is important, specialists as well as non-specialists, in any setting where people with serious advanced illnesses are residing. It is also an important resource for researchers, policy-and decision-makers at national or regional levels. Neither the science nor the art of palliative care will stand still so the Editors and contributors from all over the world aim to keep this Textbook updated so that the reader can find new evidence and approaches to care.




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."




Adult Congenital Heart Disease


Book Description

Congenital heart disease with its worldwide incidence of 1% is themost common inborn defect. Increasingly, patients are living intoadulthood, with ongoing congenital heart and other medical needs.Sadly, only a small minority have specialist follow-up. However,all patients see their family doctor and may also seek advice fromother health professionals. This practical guide with its straightforward a,b,c approach iswritten for those professionals. Special features of this book: • Introduces the principles of congenital heart diseaseand tells you whom and when to refer for specialist care • Discusses common congenital heart lesions in a practical,easy-to-follow way, with an emphasis on diagnosis and managementissues • Includes an extensive chapter on 'Pregnancy andContraception' (by Philip J. Steer), essential both for familyplanning and for managing safely the pregnant woman with congenitalheart disease • Includes chapters on non-cardiac surgery and lifestyleissues such as work, insurability, travel and driving • Provides invaluable information on dealing with commonemergencies; what to do and what not to do With a wealth of illustrations (including diagrams, EKGs, CXRs,Echos and cardiac MRIs) and with key point tables, this is anessential guide for all health care professionals managing patientswith adult congenital heart disease.




Pediatric Palliative Care


Book Description

Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.




Heart Failure and Palliative Care


Book Description

Heart failure is a very common terminal condition but few patients receive proper palliative care. This text is full of practical, evidence based advice, and encourages a multidisciplinary team based approrach.




Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery


Book Description

This comprehensive yet concise book addresses current best practice in the combined areas of cardiac surgery and anesthesia, interventional minimally invasive cardiac procedures, perioperative management and monitoring, and critical care recovery. This book not only provides the latest best practices in the perioperative management of cardiac surgical patients, but also it summarizes the current clinical guidelines and algorithms from leading cardiac programs and professional societies. Contemporary best practice approaches are written by experts from leading cardiac surgical centers. The preoperative, intraoperative and postoperative management and recovery of surgical patients, including medication, monitoring techniques, and innovative surgical procedures, are presented by experts in the field of cardiac anesthesia and surgery. Perioperative clinical care guidelines, postoperative recovery pathways and models of care are presented with supporting protocols. Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery is aimed at all cardiac anesthesiology consultants, fellows, and trainees; all cardiac surgery consultants, fellows, and trainees; nurses in perioperative care and those involved in patient recovery management; cardiac program administrative professionals; and all critical care consultants and trainees looking after cardiovascular surgical patients in the modern era.




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.




Cancer Pain Relief and Palliative Care


Book Description

Considers what can - and should - be done to comfort patients suffering from the distressing symptoms of advanced cancer. Prepared by nine renowned experts in oncology, neurology, pain management and nursing care, the book draws together the evidence and arguments needed to define clear lines of action, whether on the part of the medical and nursing professions or in the form of national legislation. Throughout, arguments for palliative care take their force from the magnitude of unrelieved suffering currently borne by the majority of terminally ill patients. Although methods for the relief of pain are emphasized, other physical, psychological, and spiritual needs for comfort are also included in the report's comprehensive recommendations. The concept of palliative care is explained in terms of its concern with quality of life and comfort before death, emphasis on the family as the unit of care, dependence on teamwork, and relationship to curative interventions. Subsequent sections concentrate on measures for the relief of pain and other physical symptoms, the psychosocial needs of the patient and family, and the need for spiritual comfort. A section devoted to ethics provides several important statements concerning the legal and ethical distinction between killing the pain and killing the patient, and the need to recognize the limits of medicine. ..". crammed with very valuable information ... an altogether excellent book..." - Family Practice ..". a comprehensive report on cancer pain relief and active supportive care ... a valuable reference for those specializing in cancer care and for the generalist caring for dying patients..." - Nursing and Health care WHO definition of palliative care