Palliative Care: An Integrated Approach (eBook)

Jenny Buckley is Head of Education at St Wilfrid's Hospice.

Palliative Care: An Integrated Approach 1
Contents 7
Foreword 12
Contributors’ biographies 14
Acknowledgements 17
Dedications 18
Chapter 1: Historical and cultural perspectives on the evolution of palliative care 19
KEY POINTS 19
INTRODUCTION 20
DEATH IN SOCIETY 20
DAME CICELY SAUNDERS AND THE ORIGINS OF CONTEMPORARY PALLIATIVE CARE 21
AN INTERNATIONAL PERSPECTIVE 24
DEFINITIONS 26
END-OF-LIFE CARE NATIONAL PROGRAMME 30
CULTURE 33
SERVICE USER INVOLVEMENT 36
CONCLUSION 37
MAIN IMPLICATIONS FOR PRACTICE 37
SUGGESTED FURTHER READING 37
Chapter 2: Facing progressive disease and death 39
KEY POINTS 39
PSYCHOSOCIAL CARE 40
PARTNERSHIP – MAINTAINING THE BALANCE 41
APPROACHES TO CARE 42
GIVING THE BAD NEWS 44
DENIAL/AVOIDANCE 47
ANGER 50
ANXIETY 51
DEPRESSION 51
SOCIAL PAIN 53
CONCLUSION 53
MAIN IMPLICATIONS FOR PRACTICE 54
SUGGESTED FURTHER READING 54
Chapter 3: Communication skills 55
KEY POINTS 55
THE IMPACT OF GOOD COMMUNICATION 56
THE IMPETUS TO TEACH COMMUNICATION SKILLS 56
FACILITATIVE STYLES 58
WHAT HOWARD TAUGHT ME ABOUT NURSING DYING PEOPLE 63
HELPFUL STRATEGIES 64
COMMUNICATING WITH PEOPLE WITH DEMENTIA 74
CONCLUSION 75
MAIN IMPLICATIONS FOR PRACTICE 75
SUGGESTED FURTHER READING 76
Chapter 4: Self-awareness and self-care 77
KEY POINTS 77
SAVING A LIFE VERSUS STEALING A DEATH 78
FACING DEATH 80
MAKING SPACE FOR DECISION-MAKING 82
SELF-AWARENESS 84
HOW MUCH DID NICKY IMPACT ON MY LIFE? 86
SELF-CARE 87
MAIN IMPLICATIONS FOR PRACTICE 90
SUGGESTED FURTHER READING 90
Chapter 5: The sick role and partnership working 91
KEY POINTS 91
INTRODUCTION 91
PARTNERSHIP CARE – WHAT DOES IT MEAN? 93
THE SICK ROLE 94
FACE-TO-FACE PARTNERSHIP: ATTENTION TO INFORMATION GIVING 96
WRITTEN INFORMATION 99
DECISION AIDS 100
SPECIAL NEEDS 101
CONCLUSION 101
MAIN IMPLICATIONS FOR PRACTICE 101
SUGGESTED FURTHER READING 102
Chapter 6: Hope and spirituality 103
KEY POINTS 103
INTRODUCTION 104
HOPE RESEARCH 104
SPIRITUALITY 112
RELIGIOUS PRACTICES CONCERNED WITH DEATH 118
CONCLUSION 122
MAIN IMPLICATIONS FOR PRACTICE 122
SUGGESTED FURTHER READING 123
Chapter 7: Finding resilience together 124
KEY POINTS 124
RESILIENCE IN HEALTH CARE 125
PATIENT GROUPS 126
PSYCHONEUROIMMUNOLOGY 126
THE EXPERT PATIENT 129
CONCLUSION 132
MAIN IMPLICATIONS FOR PRACTICE 133
SUGGESTED FURTHER READING 133
Chapter 8: Living with dying 134
KEY POINTS 134
INTRODUCTION 135
SOCIAL DEATH 136
VUNERABLE GROUPS 137
INFORMATIONAL NEEDS 139
BEING HEARD AND FEELING SUPPORTED 140
COMPANIONSHIP 141
INTIMACY AND CARING 143
HEALTH NEEDS 143
DIFFICULT THOUGHTS AND LETTING GO 145
CONCLUSION 146
MAIN IMPLICATIONS FOR PRACTICE 146
SUGGESTED FURTHER READING 147
Chapter 9: Bereavement 148
KEY POINTS 148
DEFINITIONS 149
UNTIMELY DEATHS 149
BEREAVEMENT AND HEALTH 150
GRIEF THEORISTS 152
MOURNING PRACTICES IN DIFFERENT CULTURES 159
BEREAVED CHILDREN 161
OLD AGE 161
BEREAVEMENT AND DEMENTIA 161
SOLITARY GRIEF 162
BEREAVEMENT SERVICES 163
CONCLUSION 166
MAIN IMPLICATIONS FOR PRACTICE 167
SUGGESTED FURTHER READING 167
Chapter 10: Pain and other major symptoms: an integrated approach 168
KEY POINTS 168
PAIN THEORIES 170
PSYCHOLOGICAL APPROACHES 172
PHYSICAL APPROACHES 176
COMPLEMENTARY THERAPIES 181
CREATIVE THERAPIES 188
CONCLUSION 190
MAIN IMPLICATIONS FOR PRACTICE 190
SUGGESTED FURTHER READING 190
Chapter 11: The history of the use of strong opioids for cancer pain 191
KEY POINTS 191
STUDIES AND NARRATIVES 192
WHO ANALGESIA LADDER 195
SIDE EFFECTS 200
ALTERNATIVE ROUTES FOR ADMINISTRATION OF STRONG OPIOIDS 202
CONCLUSION 205
MAIN IMPLICATIONS FOR PRACTICE 206
SUGGESTED FURTHER READING 206
Chapter 12: Concordance and advance care planning 207
KEY POINTS 207
PATIENT-CENTRED CARE: CONCORDANCE 208
ADVANCE CARE PLANNING 210
THE MENTAL CAPACITY ACT 2005 214
MAIN IMPLICATIONS FOR PRACTICE 214
SUGGESTED FURTHER READING 215
Chapter 13: Eleven prevalent symptoms 216
KEY POINTS 216
HISTORY 216
PAIN 217
NAUSEA AND VOMITING 224
CONSTIPATION 230
DIARRHOEA 234
ANOREXIA 236
FATIGUE 241
BREATHLESSNESS 245
CONFUSION 250
INSOMNIA 254
ANXIETY 256
DEPRESSION 258
CONCLUSION 262
MAIN IMPLICATIONS FOR PRACTICE 262
SUGGESTED FURTHER READING 263
ADDENDUM: DOLOPLUS 2 SCALE 263
Chapter 14: Palliative issues in some common diseases 266
KEY POINTS 266
GOLD STANDARD FOR ALL 266
DOING THE RIGHT THING AT THE RIGHT TIME 267
CONCLUSION 298
MAIN IMPLICATIONS FOR PRACTICE 298
SUGGESTED FURTHER READING 298
Chapter 15: Palliative emergencies 300
KEY POINTS 300
PALLIATIVE EMERGENCIES 300
OTHER SYMPTOMS 304
MAIN IMPLICATIONS FOR PRACTICE 305
SUGGESTED FURTHER READING 305
References 306
Index 333

"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)