Description
Book SynopsisAspects include psychosocial, spiritual and physical needs of the patient. Care and treatment are considered in a multidisciplinary and complementary way. Patient centered coverage considers treatment and care of the dying in all settings in major diseases. A highly integrated approach to pain and symptom control, including complementary therapies.
Trade Review“However, I have found myself referring to this book in recent months far more than some of the bigger, more established, textbooks – and if the measure of a good book is how well-thumbed the pages become, then the author is on to a winner. (European Journal of Palliative Care, 2010)
"The author's warmth, enthusiasm and concern for patients, their families and the professionals who care for them, combined with her scholarship, shine throughout this book. I recommend it to anyone with an interest in the care of people approaching the end of their lives in any setting." (
Palliative Medicine, 2009)
"This book will be a very welcome addition to the undergraduate curriculum for clinicians seeking to specialize in palliative care." (International Journal of Palliative Nursing, 2009)
"There is a wealth of knowledge and experience for nursing students and newly qualified nurses seeking direction.... I would recommend this for reference on general medical wards and units where patients are receiving end of life care." (Nursing Standard, April 2009)
Table of ContentsForeword x
Contributors’ biographies xii
Acknowledgements xv
Dedications xvi
1 Historical and cultural perspectives on the evolution of palliative care 1
Key points 1
Introduction 2
Death in society 2
Dame Cicely Saunders and the origins of contemporary palliative care 3
An international perspective 6
Defi nitions 8
End-of-life care national programme 12
Culture 15
Service user involvement 18
Conclusion 19
Main implications for practice 19
Suggested further reading 19
2 Facing progressive disease and death 21
Key points 21
Psychosocial care 22
Partnership – maintaining the balance 23
Approaches to care 24
Giving the bad news 26
Denial/avoidance 29
Anger 32
Anxiety 33
Depression 33
Social pain 35
Conclusion 35
Main implications for practice 36
Suggested further reading 36
3 Communication skills 37
Key points 37
The impact of good communication 38
The impetus to teach communication skills 38
Facilitative styles 40
What Howard taught me about nursing dying people 45
Helpful strategies 46
Communicating with people with dementia 56
Conclusion 57
Main implications for practice 57
Suggested further reading 58
4 Self-awareness and self-care 59
Key points 59
Saving a life versus stealing a death 60
Facing death 62
Making space for decision-making 64
Self-awareness 66
How much did Nicky impact on my life? 68
Self-care 69
Main implications for practice 72
Suggested further reading 72
5 The sick role and partnership working 73
Key points 73
Introduction 73
Partnership care – what does it mean? 75
The sick role 76
Face-to-face partnership: attention to information giving 78
Written information 81
Decision aids 82
Special needs 83
Conclusion 83
Main implications for practice 83
Suggested further reading 84
6 Hope and spirituality 85
Key points 85
Introduction 86
Hope research 86
Spirituality 94
Religious practices concerned with death 100
Conclusion 104
Main implications for practice 104
Suggested further reading 105
7 Finding resilience together 106
Key points 106
Resilience in health care 107
Patient groups 108
Psychoneuroimmunology 108
The expert patient 111
Conclusion 114
Main implications for practice 115
Suggested further reading 115
8 Living with dying 116
Key points 116
Introduction 117
Social death 118
Vulnerable groups 119
Informational needs 121
Being heard and feeling supported 122
Companionship 123
Intimacy and caring 125
Health needs 125
Diffi cult thoughts and letting go 127
Conclusion 128
Main implications for practice 128
Suggested further reading 129
9 Bereavement 130
Key points 130
Defi nitions 131
Untimely deaths 131
Bereavement and health 132
Grief theorists 134
Mourning practices in different cultures 141
Bereaved children 143
Old age 143
Bereavement and dementia 143
Solitary grief 144
Bereavement services 145
Conclusion 148
Main implications for practice 149
Suggested further reading 149
10 Pain and other major symptoms: an integrated approach 150
Key points 150
Pain theories 152
Psychological approaches 154
Physical approaches 158
Complementary therapies 163
Creative therapies 170
Conclusion 172
Main implications for practice 172
Suggested further reading 172
11 The history of the use of strong opioids for cancer pain 173
Key points 173
Studies and narratives 174
WHO analgesia ladder 177
Side effects 182
Alternative routes for administration of strong opioids 184
Conclusion 187
Main implications for practice 188
Suggested further reading 188
12 Concordance and advance care planning 189
Key points 189
Patient-centred care: concordance 190
Advance care planning 192
The Mental Capacity Act 2005 196
Main implications for practice 196
Suggested further reading 197
13 Eleven prevalent symptoms 198
Key points 198
History 198
Pain 199
Nausea and vomiting 206
Constipation 212
Diarrhoea 216
Anorexia 218
Fatigue 223
Breathlessness 227
Confusion 232
Insomnia 236
Anxiety 238
Depression 240
Conclusion 244
Main implications for practice 244
Suggested further reading 245
Addendum: Doloplus 2 Scale 245
14 Palliative issues in some common diseases 248
Key points 248
Gold standard for all 248
Doing the right thing at the right time 249
Conclusion 280
Main implications for practice 280
Suggested further reading 280
Contents ix
15 Palliative emergencies 282
Key points 282
Palliative emergencies 282
Other symptoms 286
Main implications for practice 287
Suggested further reading 287
References 288
Index 315
