Palliative Care – An Integrated Approach

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

Foreword. Contributors' biographies. Acknowledgements. Dedications. 1. Historical and cultural perspectives on the evolution of palliative care. Key points. Introduction. Death in society. Dame Cicely Saunders and the origins of contemporary palliative care. An international perspective. Definitions. End-of-life care national programme. Culture. Service user involvement. Conclusion. Main implications for practice. Suggested further reading. 2. Facing progressive disease and death. Key points. Psychosocial care. Partnership - maintaining the balance. Approaches to care. Giving the bad news. Denial/avoidance. Anger. Anxiety. Depression. Social pain. Conclusion. Main implications for practice. Suggested further reading. 3. Communication skills. Key points. The impact of good communication. The impetus to teach communication skills. Facilitative styles. What Howard taught me about nursing dying people. Helpful strategies. Communicating with people with dementia. Conclusion. Main implications for practice. Suggested further reading. 4. Self-awareness and self-care. Key points. Saving a life versus stealing a death. Facing death. Making space for decision-making. Self-awareness. How much did Nicky impact on my life? Self-care. Main implications for practice. Suggested further reading. 5. The sick role and partnership working. Key points. Introduction. Partnership care - what does it mean? The sick role. Face-to-face partnership: attention to information giving. Written information. Decision aids. Special needs. Conclusion. Main implications for practice. Suggested further reading. 6. Hope and spirituality. Key points. Introduction. Hope research. Spirituality. Religious practices concerned with death. Conclusion. Main implications for practice. Suggested further reading. 7. Finding resilience together. Key points. Resilience in health care. Patient groups. Psychoneuroimmunology. The expert patient. Conclusion. Main implications for practice. Suggested further reading. 8. Living with dying. Key points. Introduction. Social death. Vulnerable groups. Informational needs. Being heard and feeling supported. Companionship. Intimacy and caring. Health needs. Difficult thoughts and letting go. Conclusion. Main implications for practice. Suggested further reading. 9. Bereavement. Key points. Definitions. Untimely deaths. Bereavement and health. Grief theorists. Mourning practices in different cultures. Bereaved children. Old age. Bereavement and dementia. Solitary grief. Bereavement services. Conclusion. Main implications for practice. Suggested further reading. 10. Pain and other major symptoms: an integrated approach. Key points. Pain theories. Psychological approaches. Physical approaches. Complementary therapies. Creative therapies. Conclusion. Main implications for practice. Suggested further reading. 11. The history of the use of strong opioids for cancer pain. Key points. Studies and narratives. WHO analgesia ladder. Side effects. Alternative routes for administration of strong opioids. Conclusion. Main implications for practice. Suggested further reading. 12. Concordance and advance care planning. Key points. Patient-centred care: concordance. Advance care planning. The Mental Capacity Act 2005. Main implications for practice. Suggested further reading. 13. Eleven prevalent symptoms. Key points. History. Pain. Nausea and vomiting. Constipation. Diarrhoea. Anorexia. Fatigue. Breathlessness. Confusion. Insomnia. Anxiety. Depression. Conclusion. Main implications for practice. Suggested further reading. Addendum: Doloplus 2 Scale. 14. Palliative issues in some common diseases. Key points. Gold standard for all. Doing the right thing at the right time. Conclusion. Main implications for practice. Suggested further reading. 15. Palliative emergencies. Key points. Palliative emergencies. Other symptoms. Main implications for practice. Suggested further reading. References. Index.