the best care possible a physician s quest to transform care through the end of life

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The Best Care Possible

Author : Ira Byock
ISBN : 9781583335123
Genre : Medical
File Size : 48. 13 MB
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Dr. Byock, one of the foremost palliative care physicians in the country, argues that the way we die represents a national crisis. Though the vast majority of Americans would prefer to die peacefully, at home, many will spend their last days in a disease treatment system ruled by high-tech procedures and a philosophy to 'fight disease and illness at all costs.' Dr. Byock, puts a human face on the issue by telling richly moving stories - at once heartwrenching and uplifting - of people coping with the most difficult moments in their lives. As the pace of health care reform accelerates, he shows what truly excellent care can look like, and how wise and skilful doctors, nurses, and clinical teams can profoundly shape families' experiences of illness, caregiving, and loss. Told through page-turning life-or-death medical drama, The Best Care Possibleis a compelling and passionate meditation on medicine and ethics. It has the power to lead a new national conversation. 'Dr. Byock's mission is to help everyone . . . find meaning, dignity, and peace in these final months of life.' Prevention magazine'In this strikingly important book, Byock presents an agenda for end-of-life care that should serve as an ideal template on which to build out best hopes for the final days of those we love and of ourselves - and a corrective for our society.' Sherwin B. Nuland, MD, Yale Interdisciplinary Center for Bioethics; author of How We Die

Sick To Death And Not Going To Take It Anymore

Author : Joanne Lynn
ISBN : 0520931424
Genre : Medical
File Size : 88. 49 MB
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Just a few generations ago, serious illness, like hazardous weather, arrived with little warning, and people either lived through it or died. In this important, convincing, and long-overdue call for health care reform, Joanne Lynn demonstrates that our current health system, like our concepts of health and disease, developed at a time when life was mostly short, serious illnesses and disabilities were common at every age, and dying was quick. Today, most Americans live a long life, with the disabilities and discomforts of progressive chronic illness appearing only during the final chapters of their life stories. Sick to Death and Not Going to Take It Anymore! maintains that health care and community services are not set up to meet the needs of the large number of people who face a prolonged period of progressive illness and disability before death. Lynn offers what she calls an "owner's manual for the health care system," which lays out facts, concepts, strategies, and action plans for genuine reform and gives the reader new ways to interpret information creatively, imagine innovative possibilities, and take steps to implement them.

The Oxford Handbook Of Ethics At The End Of Life

Author : Stuart J. Youngner
ISBN : 9780199976263
Genre : Medical
File Size : 81. 46 MB
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This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients' values has been recognized as the essential moral component of clinical decision-making. Technology's promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book comprises six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as a way to address the psychosocial and ethical problems of death and dying.

Meeting The Needs Of Older Adults With Serious Illness

Author : Amy S. Kelley
ISBN : 9781493904075
Genre : Medical
File Size : 65. 27 MB
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Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.

Palliative Care

Author : Harold Y. Vanderpool
ISBN : 9780786497997
Genre : Health & Fitness
File Size : 84. 89 MB
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“This wise and revealing study is sure to be valuable to the dying and those who love them, as well as to the physicians and other health professionals who care for them.”--Library Journal The long history of medical care for the dying has largely been neglected. It began in 1605 when physicians were challenged to enable persons to die peacefully. Today it includes palliation of oppressive symptoms, emotional and psychological care, and respect for the wishes and cultural backgrounds of patients and families. Especially since the 1990s, it embraces symptom-easing palliation for patients with severe life-limiting and chronic illnesses. Providing a detailed picture of contemporary palliative care, this book chronicles four centuries of the quest for a good death, covering the fight against futile end-of-life treatments, the history of life-extending treatments and technologies, the roles of nurses, the liberation of the dying from isolation in hospitals and hard-won victories to secure patients' right to choose.

Handbook Of Social Work Practice With Vulnerable And Resilient Populations

Author : Alex Gitterman
ISBN : 9780231537018
Genre : Social Science
File Size : 87. 69 MB
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When community and family support systems are weak or unavailable, and when internal resources fail, populations that struggle with chronic, persistent, acute, and/or unexpected problems become vulnerable to physical, cognitive, emotional, and social deterioration. Yet despite numerous risk factors, a large number of vulnerable people do live happy and productive lives. This best-selling handbook examines not only risk and vulnerability factors in disadvantaged populations but also resilience and protective strategies for managing and overcoming adversity. This third edition reflects new demographic data, research findings, and theoretical developments and accounts for changing economic and political realities, including immigration and health care policy reforms. Contributors have expanded their essays to include practice with individuals, families, and groups, and new chapters consider working with military members and their families, victims and survivors of terrorism and torture, bullied children, and young men of color.

Tracking Medicine

Author : John E. Wennberg
ISBN : 0199830851
Genre : Medical
File Size : 27. 45 MB
Format : PDF
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Written by a groundbreaking figure of modern medical study, Tracking Medicine is an eye-opening introduction to the science of health care delivery, as well as a powerful argument for its relevance in shaping the future of our country. An indispensable resource for those involved in public health and health policy, this book uses Dr. Wennberg's pioneering research to provide a framework for understanding the health care crisis; and outlines a roadmap for real change in the future. It is also a useful tool for anyone interested in understanding and forming their own opinion on the current debate.

Dying Well

Author : Ira Byock
ISBN : 1573226572
Genre : Family & Relationships
File Size : 75. 67 MB
Format : PDF
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Explores the important emotional work accomplished in the final months of life and offers advice on dealing with doctors, talking with friends and relatives, and mananging end-of-life care

Last Comforts

Author : Ellen Rand
ISBN : 0996615342
Genre : Family & Relationships
File Size : 60. 96 MB
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Too often, end-of-life care in the U.S. is fragmented, uncoordinated, costly, and unsustainable. But it doesn't have to be that way. Last Comforts: Notes from the Forefront of Late-Life Carespotlights many innovations that can make a significant difference as we approach the last chapters of our lives. This book will appeal to Baby Boomers."

The Four Things That Matter Most 10th Anniversary Edition

Author : Ira Byock
ISBN : 0743258606
Genre : Self-Help
File Size : 74. 55 MB
Format : PDF
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Newly updated with stories from people who have turned to this life-altering book in their time of need, this motivational teaching about what really matters reminds us how we can honor each relationship every day. Four simple phrases—“Please forgive me,” “I forgive you,” “Thank you,” and “I love you”—carry enormous power to mend and nurture our relationships and inner lives. These four phrases and the sentiments they convey provide a path to emotional wellbeing, guiding us through interpersonal difficulties to life with integrity and grace. Dr. Ira Byock, an international leader in palliative care, explains how we can practice these life-affirming words in our day-to-day lives. Too often we assume that the people we love really know that we love them. Dr. Byock demonstrates the value of “stating the obvious” and provides practical insights into the benefits of letting go of old grudges and toxic emotions. His stories help us to forgive, appreciate, love, and celebrate one another and live life more fully. Using the Four Things in a wide range of life situations, we can experience emotional healing even in the wake of family strife, personal tragedy, divorce, or in the face of death. With practical wisdom and spiritual power, The Four Things That Matter Most gives us the language and guidance to honor and experience what really matters most in our lives every day.

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