The Hospice Companion

Dr. Perry G. Fine is a Professor in the Department of Anesthesiology, School of Medicine, University of Utah, where he serves on the faculty of the Division of Pain Medicine and the Pain Research Center, and he is an attending physician in the Pain Management Center.

1. General Processes
Palliative Care at the End of Life: Blending Structure and Function
The Interdisciplinary Team (IDT)
Documentation

2. Personal, Social, and Environmental Processes
Abuse in the Home
Advance Care Planning and Directives for Health-Care Interventions
Changes in Body Image and Loss of Independence
Changes in Family Dynamics
Completing Worldly Business and Life Closure
Controlled Substances: Misuse and Abuse
Cultural Differences: Respect, Understanding, and Adapting Care
Denial
Grief Reactions
Living Environment, Finances, and Support Systems
Basic Home Safety
Suicide: Risk Assessment, Prevention, and Coping If It Happens

3. Clinical Processes and Symptom Management
Agitation and Anxiety
Air Hunger (Dyspnea)
Anorexia and Cachexia
Belching and Burping (Eructation)
Bleeding, Draining, and Malodorous Lesions
Confusion/Delirium
Constipation
Coughing
Depression
Diarrhea and Anorectal Problems
Dysphagia and Oropharyngeal Problems
Edema: Peripheral Edema, Ascites, and Lymphedema
Fatigue, Weakness (Aesthenia), and Excessive Sedation
Fever, Flushing, and Diaphoresis
Hiccups (Singultus)
Imminent Death
Insomnia and Nocturnal Restlessness
Nausea and Vomiting
Pain
Pruritus
Seizures
Skeletal Muscle and Bladder Spasms
Skin Breakdown: Prevention and Treatment
Urinary Problems
Xerostomia (Dry Mouth)

4. Appendices
Appendix 1: Ketamine Protocol
Appendix 2: Clinical/Functional Assessment and Staging
Appendix 3: Lidocaine Infusions for Refractory Neuropathic Pain
Appendix 4: Cannabis and Cannabinoids