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 : 9781101561041
Genre : Social Science
File Size : 40. 71 MB
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A palliative care doctor on the front lines of hospital care illuminates one of the most important and controversial ethical issues of our time on his quest to transform care through the end of life. It is harder to die in this country than ever before. Statistics show that the vast majority of Americans would prefer to die at home, yet 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 end-of-life care is among the biggest national crises facing us today. In addressing the crisis, politics has trumped reason. Dr. Byock explains that to ensure the best possible care for those we love-and eventually ourselves- we must not only remake our healthcare system, we must also move past our cultural aversion to talking about death and acknowledge the fact of mortality once and for all. Dr. Byock describes what palliative care really is, and-with a doctor's compassion and insight-puts a human face on the issues by telling richly moving, heart-wrenching, and uplifting stories of real people during the most difficult moments in their lives. Byock takes us inside his busy, cutting-edge academic medical center to show what the best care at the end of life can look like and how doctors and nurses can profoundly shape the way families experience loss. Like books by Atul Gawande and Jerome Groopman, The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning, life or death medical drama. It is passionate and timely, and it has the power to lead a new kind of national conversation.

The Oxford Handbook Of Ethics At The End Of Life

Author : Stuart J. Youngner
ISBN : 9780199976263
Genre : Medical
File Size : 45. 74 MB
Format : PDF
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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 : 24. 57 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.

Encyclopedia Of Cancer

Author :
ISBN : 9780128124857
Genre : Medical
File Size : 53. 87 MB
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Encyclopedia of Cancer, Third Edition provides a comprehensive, up-to-date overview of the multiple facets of the disease, including research, treatment and societal impact. This new edition comprises 180 contributions from renown experts who present the latest in Mechanisms, Hallmarks of Cancer, Causes of Cancer, Prevention and Control, Diagnosis and Therapy, Pathology and the Genetics of specific Cancers. Readers will find a comprehensive overview of the main areas of oncology, including etiology, mechanisms, prevention, and treatments, from basic science to clinical applications and public health, all set alongside the latest advances and hot topics that have emerged since the previous edition. Topics of interest in the field, including genomics and epigenomics, our understanding of the causes of cancer and the approaches to preventing it (e.g., HPV vaccination, role of obesity and nutrition, molecular markers of environmental exposures), new screening techniques (e.g., low-dose CT for lung cancer) and improvements in the treatment of many cancers (e.g., breast cancer, lung adenocarcinoma) are comprehensively and authoritatively presented. Comprises 180 contributions from renowned experts who present the latest in mechanisms, hallmarks of cancer, causes, prevention and control, diagnosis and therapy, pathology and genetics Presents a comprehensive overview of the main areas of oncology, including etiology, mechanisms, prevention, and treatments, from basic science to clinical applications and public health

Compassionate Person Centered Care For The Dying

Author : Bonnie Freeman, RN, DNP, ANP, ACHPN
ISBN : 9780826122483
Genre : Medical
File Size : 36. 81 MB
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A milestone resource for palliative care nurses that facilitates evidence-based compassionate and humanistic care of the dying "A valuable contribution to the evolving field of palliative nursing care. It is authored by a model for this field, Bonnie Freeman, and brings to the bedside what her practice embodies--evidence-based clinically expert care...The CARES tool is a long-needed resource and we are all grateful to the author for moving her passion to paper. It will touch the lives and deaths of patients, families, and the nurses who care for them." --Betty Ferrell, PhD, RN, MA, FAAN, FCPN, CHPN Professor and Director, Division of Nursing Research and Education City of Hope National Medical Center From the Foreword This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author's research-based CARES tool; a reference that synthesizes five key elements demonstrated to enable a peaceful death, as free from suffering as possible: comfort, airway management, management of restlessness and delirium, emotional and spiritual support, and selfcare for nurses. The book describes, step by step, how nurses can easily implement the basic tenets of the CARES tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible. The book identifies the most common symptom management needs in dying patients and describes, in detail, the five components of the CARES paradigm and how to implement them to enable a peaceful death and minimize suffering. It includes palliative care prompts founded on 29 evidence-based recommendations and the National Consensus Project for Palliative Care Clinical Practice Guidelines. The resource also addresses the importance of the nurse to act as a patient advocate, how to achieve compassionate communication with the patient and family, and barriers and challenges to compassionate care. Case studies emphasize the importance of compassionate nursing care of the dying and how it can be effectively achieved. Key Features: Provides nurses with a clear understanding of the most common needs of the dying and supplies practical applications to facilitate and improve care Clarifies the current and often complex literature on care of the dying Includes case studies illustrating the most common needs of dying patients and how these are addressed effectively by the CARES tool Based on extensive evidence as well as on the National Consensus Project for Palliative Care Clinical Practice Guidelines

Handbook Of Social Work Practice With Vulnerable And Resilient Populations

Author : Alex Gitterman
ISBN : 9780231537018
Genre : Social Science
File Size : 81. 71 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.

Sterblich Sein

Author : Atul Gawande
ISBN : 9783104035840
Genre : Self-Help
File Size : 41. 59 MB
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Ein Buch über das Sterben, das das Leben lehrt Die Medizin scheint über Krankheit und Tod zu triumphieren, doch sterben wir so trostlos wie nie zuvor. Der Bestsellerautor und renommierte Arzt Atul Gawande schreibt in seinem beeindruckenden Buch über das, was am Ende unseres Lebens wirklich zählt. Ungewöhnlich offen spricht er darüber, was es bedeutet, alt zu werden, wie man mit Gebrechen und Krankheiten umgehen kann und was wir an unserem System ändern müssen, um unser Leben würdevoll zu Ende zu bringen. Ein mutiges und weises Buch eines großartigen Autors, voller Geschichten und eigener Erfahrungen, das uns hilft, die Geschichte unseres Lebens gut zu Ende zu erzählen. »Dieses Buch ist nicht nur weise und sehr bewegend, sondern gerade in unserer Zeit unbedingt notwendig und sehr aufschlussreich.« Oliver Sacks »Die medizinische Betreuung ist mehr auf Heilung ausgelegt als auf das Sterben. Dies ist Atuls Gawandes stärkstes und bewegendstes Buch.« Malcolm Gladwell

Trauer Ist Das Ding Mit Federn

Author : Max Porter
ISBN : 9783446250192
Genre : Fiction
File Size : 83. 61 MB
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Eine junge Frau ist gestorben. Ihre Kinder, zwei kleine Jungen, und ihr Mann sind noch betäubt vom Schock, haben haufenweise Beileidsbekundungen und Lasagne zum Aufwärmen entgegengenommen, die notwendigen Dinge organisiert, und nun setzt die unerträgliche Leere ein. Da klingelt es an der Tür. Totenschwarz und gefiedert bricht es herein, packt den Vater und verkündet: "Ich gehe erst wieder, wenn du mich nicht mehr brauchst." Die überlebensgroße Krähe nistet sich rücksichtslos in der Familie ein, meldet sich mit drastischem Witz zu Wort und wird dabei zu einer Art subversivem Therapeuten, eine herrlich anarchische Mary Poppins. Max Porter ist ein bildmächtiges, wildes Buch über die Trauer gelungen.

Last Comforts

Author : Ellen Rand
ISBN : 0996615342
Genre : Family & Relationships
File Size : 34. 75 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."

Oscar

Author : Dr. David Dosa
ISBN : 9783426558539
Genre : Self-Help
File Size : 41. 34 MB
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Wenn sich Oscar, der Stationskater, zu einem Patienten auf das Bett legt, dann wissen Doktor Dosa und die Schwestern des Pflegeheims, dass es so weit ist. Denn Oscar spürt, wann ein Mensch sterben wird. Schnurrend schmiegt er sich an ihn – und bleibt bis zum letzten Atemzug. Oscar gibt Sterbenden, was ihnen von den Menschen oft verwehrt wird: tröstenden Beistand am Lebensende.

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