End Of Life Care

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

At the end of life, each story is different. Death comes suddenly, or a person lingers, gradually fading. For some older people, the body weakens while the mind stays alert. Others remain physically strong, but cognitive losses take a huge toll. Although everyone dies, each loss is personally felt by those close to the one who has died. End-of-life care is the term used to describe the support and medical care given during the time surrounding death. Such care does not happen only in the moments before breathing ceases and the heart stops beating. Older people often live with one or more chronic illnesses and need a lot of care for days, weeks, and even months before death. The goal of End of Life: Helping with Comfort and Care is to provide guidance and help in understanding the unfamiliar territory of death. This information is based on research, such as that supported by the National Institute on Aging (NIA), along with other parts of the National Institutes of Health.

This title is directed primarily towards health care professionals outside of the United States. Content has been thoroughly revised and updated in line with changes in practice and policy both locally and internationally, particularly the UK NICE guidance on Supportive and palliative care for people with cancer and the Care of the Dying Pathway. It reflects the rapid development of palliative nursing as an emerging specialty. It helps in the process of defining palliative nursing and how it interfaces with other disciplines within the specialty. The text is divided into three sections and comprehensively, yet sensitively, covers all aspects of palliative nursing. Key themes covered include pain control, symptom control, loss and grief, and handling loss. . A strong emphasis is placed on the integration of theory and practice and evidence based care. . Reconciliation of the theory and practice is achieved by the use of case studies. . It addresses malignant and non-malignant palliative care. . Research and extensive literature support each chapter. Content has been thoroughly revised and updated in line with changes in practice and policy both locally and internationally, particularly the UK NICE guidance on Supportive and palliative care for people with cancer and the Care of the Dying Pathway . Three new chapters on: . Sexuality . Care of the Dying Pathway . Changing roles of the nurse in palliative care . New appendix on North American drug names equivalents for the international market

Updated with stories from people who have been inspired by the original text, a guide to connecting with what matters most identifies four phrases for honoring relationships, letting go of unhealthy emotions, and living life fully.

“This 5th edition is an important achievement; it is a symbol of commitment to the field of palliative nursing, where we have been and where we are going.” - Betty Rolling Ferrell, PhD, MA, FAAN, FPCN, CHPN From the Foreword The aging population has only grown since the first edition of this comprehensive and seminal publication nearly 20 years ago. Based on the need to humanize rather than medicalize the illness experience for patients, this text delves into palliative care beyond the specific diseases affecting the patient. Instead, content focuses on the whole person and family. Palliative patients struggle with chronic, debilitating, and painful conditions, and grapple with the fact that life as they knew it has already passed away. Families and friends reciprocally suffer, not knowing how to help and therefore become the secondary victims of the disease. This is not the challenge of a lone nurse, or a single physician, therapist, or social worker. Rather, palliative and hospice care requires the expertise and unique roles of an interprofessional team to help the patient and family strengthen their resilience, continue to find meaning and purpose in life, and cure what can be cured. Palliative Care Nursing, Fifth Edition, delivers advanced empirical, aesthetic, ethical and personal knowledge. This new edition brings an increased focus on outcomes, benchmarking progress, and goals of care. It expounds upon the importance of the cross-disciplinary collaboration introduced in the previous edition. Every chapter in Sections I, II, and III includes content written by a non-nursing member of the interprofessional team. Based on best-evidence and clinical practice guidelines, this text presents comprehensive, targeted interventions responsive to the needs of palliative and hospice patients and family. Each chapter contains compassionate, timely, appropriate, and cost-effective care for diverse populations across the illness trajectory. Key Features The expanded new edition offers current, comprehensive, one-stop source of highly-relevant clinical information on palliative care Life-span approach: age-appropriate nursing considerations (e.g. geriatric, pediatric and family) Includes disease-specific and symptom-specific nursing management chapters Promotes a holistic and interdisciplinary approach to palliative care Offers important legal, ethical and cultural considerations related to death and dying Case Studies with Case Study Conclusion in each clinical chapter New to The Fifth Edition: An expanded chapter on Palliative Care incorporates most up to date scope and standards, information on Basic and Advanced HPNA certification, self-reflection and self-care for nurses. A chapter on Interprofessional Collaboration Instructor Resources: Power points and Test bank

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

Originally published as a series of articles in Missouri medicine.