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.

The most thorough text available on providing patients and families with quality end-of-life care "The study/learning questions at the end of each chapter make this book an excellent resource for both faculty who wish to test knowledge, and individual learners who wish to assess their own learning....The book is well written and easy to read. 3 Stars."--Doody's Review Service End of Life Care: A Practical Guide offers solution-oriented coverage of the real-world issues and challenges that arise daily for clinicians caring for those with life-limiting illnesses and conditions. End of Life Care: A Practical Guide includes specific clinical guidance for pain management and other common end of life symptoms. The second edition has been made even more essential with the addition of chapter-ending Q&A for self assessment and board review, new coverage of multicultural medicine, an increased number of algorithms to assist decision making on complicated clinical, legal, and ethical issues. Six sections walk you through the complexities of caring for patients who are nearing the end of life: Preparing Patients for End of Life Management of Symptoms Diagnostic and Invasive Interventions Ethical Dilemmas Special Populations Diversity No other text better assists physicians and other clinicians in providing patients near the end of life with support, guidance, and hope in the face of “hopelessness” than End of Life Care: A Practical Guide.

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.

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."

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.

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.

Nearly half of people at the end of life will receive hospice care, but few psychologists, nurses, physicians, chaplains, and hospice workers have been trained specifically to recognize and address the psychological, social, and emotional issues that may arise in patients who are dying. Patients in the midst of advanced terminal illness may experience a variety of distressing emotions, and may feel anxious, frightened, regretful, or desperate. This guide was created specifically to guide helping professionals of all kinds through the process of working through patients’ psychological issues to allow them peace and comfort in their final moments. The Helping Professional’s Guide to End-of-Life Care clarifies the spiritual and emotional care that patients need and presents an evidence-based approach integrating cognitive behavioral therapy (CBT), transpersonal psychotherapy, hypnosis, mindfulness, and guided imagery to help patients manage emotional distress at the end of life. Through case conceptualizations and detailed treatment planning guidance, readers learn to formulate comprehensive assessment and treatment plans for patients and gain skills that will help them manage the emotional intensity of this work. This secular, professional treatment model can be applied to patients of any religious or spiritual background. The book also addresses integrating the patient’s therapeutic team with the medical team, addressing the emotional needs of friends and family of the dying, crisis intervention for suicidal patients, working with clients on psychotropic medications, and how helping professionals can manage their own emotions to become more effective clinicians.

Nursing Care at the End of Life: Palliative Care for Patients and Families explores the deep issues of caring for the dying and suffering. The book is based on the Hospice Family Caregiving Model previously published by the author and focuses on the practice implications of care for the dying. The book is written in a clear and user-friendly style, and is ideal for undergraduate nursing students learning about dying, suffering, and caring for individuals and their families.

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.

This book examines the services that chaplains provide to dying patients and the unique relationship that palliative care staff construct with people at the end of life. It explores the nature of hope when faced with the inevitable and develops a theory of spiritual care rooted in relationship that has implications for all healthcare professionals.