A Practical Guide to Palliative Care

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  • Edition: 1st
  • Format: Hardcover
  • Copyright: 2007-05-17
  • Publisher: LWW

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Designed for easy use at the bedside, this manual contains the practical information health care professionals need to provide optimal end-of-life care. The book presents a multidimensional, holistic approach to assessment and management of the physical, psychological, social, and spiritual needs of the patient and family. Topics covered include cultural diversity in end-of-life care; communicating with patients and families; predicting life expectancy; terminal care; non-pain symptom management; pain control; palliative interventions; pediatric palliative care; record keeping; and ethics. The succinct, user-friendly presentation features bullet points and numerous quick-reference tables. Each chapter includes an "In a Nutshell" summary of key points.

Table of Contents

The palliative care approachp. 1
Definitionsp. 3
Philosophy - from "cure" to "comfort"p. 5
The transition from "diagnose and treat" to "palliate"p. 8
Historical perspective : what has changed?p. 10
Cultural diversity in end-of-life carep. 13
Planning for diverse populationsp. 15
African american culture and end of lifep. 18
Hispanic views on death and dyingp. 21
Understanding the Jewish culturep. 24
Mourning in the Asian culturep. 25
Death practices in the Muslim culturep. 27
Building cultural bridges with other culturesp. 28
Approach to the patientp. 31
Delivering bad newsp. 33
The family conferencep. 36
Dealing with angerp. 39
The spiritual assessmentp. 42
Giving realistic hopep. 47
The DNR or AND discussion in seriously ill patientsp. 51
Advanced directives in health carep. 54
Decision-making abilityp. 57
Goal settingp. 60
The hospice conversationp. 63
Telling the childrenp. 67
What if a patient asked you to pray?p. 70
Death pronouncementp. 72
Completing the death certificatep. 75
Informing significant others of a patient's deathp. 78
Writing a condolence letterp. 81
Caring for the familyp. 83
Predicting life expectancyp. 87
"How long do I have?"p. 89
Guidelines for hospicep. 91
Physician prediction of life expectancyp. 93
Palliative performance scorep. 95
Specific diseases : noncancer diagnosesp. 97
Delivery of palliative carep. 105
The hospital palliative care unitp. 107
Consulting in the hospitalp. 109
Hospice in delivery of palliative carep. 113
Hospice in the nursing homep. 115
Terminal carep. 119
The syndrome of imminent deathp. 121
Near death awarenessp. 124
Terminal deliriump. 127
Grief : uncomplicated vs. complicatedp. 130
Nonpain symptom managementp. 133
Tips for maximizing chances of successp. 135
Dyspnea, air hunger, shortness of airp. 137
Oral care basicsp. 140
Fever near the end of lifep. 142
Agitation and anxietyp. 143
Sexual needsp. 144
Spiritual and existential sufferingp. 145
Nausea and vomitingp. 146
Dizzinessp. 149
Hiccupsp. 151
Fatiguep. 153
Anorexiap. 155
Constipationp. 157
Deliriump. 159
Diarrheap. 162
Incontinencep. 164
Depressionp. 166
Nonhealing woundsp. 167
Pruritusp. 169
Insomniap. 171
Nightmaresp. 173
Pain controlp. 175
Myths about opioid usep. 177
Legal liability of undertreating painp. 180
Principles of pain managementp. 183
Assessment of painp. 187
Converting one opioid to another (equianalgesic dosing)p. 190
Opioid dose escalationp. 195
Managing opioid side effectsp. 199
Opioid withdrawalp. 202
Morphinep. 204
Hydrocodone for painp. 208
Oxycodone for painp. 210
Methadone for pain controlp. 213
Gabapentin (Neurontin) for painp. 216
Naloxone (Narcan)p. 219
Meperidine (Demerol) : not recommended for painp. 222
Propoxyphene (Darvon, Darvocet)p. 224
Blocksp. 226
Addiction vs. painp. 228
Pseudo-addictionp. 232
Palliative interventionsp. 235
Tube feeding in palliative carep. 237
Palliative chemotherapyp. 240
Palliative radiationp. 242
"Response rate" in cancer chemotherapyp. 244
Ventilator withdrawalp. 246
Bowel obstructionp. 250
Treating the death rattlep. 253
Aggressive wound treatmentp. 255
The palliative pediatric patientp. 259
Children and deathp. 261
Neonatal populationp. 265
Pediatric intensive care unitp. 268
Pediatric withdrawal of life supportp. 271
The dying adolescentp. 274
Chartingp. 277
Documentation in palliative carep. 279
Coding and billing for hospice/palliative carep. 288
Ethics at the end of lifep. 293
Ethics and legal issuesp. 295
Hastened death : the rule of double effectp. 297
When to stop - medical futilityp. 299
Caring for yourself and avoiding burnoutp. 301
Table of Contents provided by Blackwell. All Rights Reserved.

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