End Of Life Care

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.

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.

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

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.

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 book encourages health professionals to reconceptualise their practice in the light of the fact that their patients are deteriorating and dying, supporting them in their dichotomous role which involves affirming that person's life whilst acknowledging that that life is ending. Professionals are encouraged to think laterally, to be creative in their use of their core skills, and to use their life skills and experience to change the focus of their interventions. By making these changes, those involved with caring for the dying will be able to address issues related to burnout and feeling de-skilled. The authors share their considerable experience with the reader - what works for both patient and carer/professional when working in this field. By providing workable solutions, they empower those in disempowering situations, such as when working with terminally ill children and adults. The book is truly holistic and client-centred in its approach, upholding the philosophy of palliative care. Aimed at all who interact with children and adults who have a life-limiting condition or who are dying Offers practical examples of approaches to dilemmas and emotional issues commonly face by those working in palliative care Encourages professionals to think laterally, to be creative in their use of core skills, and to use their life skills and experience to change the focus of their interventions Moves the emphasis away from the medical model to the emotional and spiritual influences on quality of life Offers clear, workable guidelines and demonstrates practical solutions, based on proven theory and experience, to problems encountered on a day-to-day basis by patients and those coming into contact with them

Compassionate communities are communities that provide assistance for those in need of end of life care, separate from any official heath service provision that may already be available within the community. This idea was developed in 2005 in Allan Kellehear’s seminal volume- Compassionate Cities: Public Health and End of Life Care. In the ensuing ten years the theoretical aspects of the idea have been continually explored, primarily rehearsing academic concerns rather than practical ones. Compassionate Communities: Case Studies from Britain and Europe provides the first major volume describing and examining compassionate community experiments in end of life care from a highly practical perspective. Focusing on community development initiatives and practice challenges, the book offers practitioners and policy makers from the health and social care sectors practical discussions on the strengths and limitations of such initiatives. Furthermore, not limited to providing practice choices the book also offers an important and timely impetus for other practitioners and policy makers to begin thinking about developing their own possible compassionate communities. An essential read for academic, practitioner, and policy audiences in the fields of public health, community development, health social sciences, aged care, bereavement care, and hospice & palliative care, Compassionate Communities is one of only a handful of available books on end of life care that takes a strong health promotion and community development approach.