Handbook Of Psychiatry In Palliative Medicine Psychosocial

"From its origins, with leaders such as Dame Cicely Saunders, Eric Wilkes, Colin Murray and James in the United Kingdom, Balfour Mount in Canada, Vittorio in Italy, and Elizabeth Ross and Avery Weisman in the United States, hospice and palliative care has always embraced the "whole" person, in the context of their family. From her observations of people with advanced and progressive illness, Dame Cicely Saunders introduced the concept of "total pain." Pain had physical, emotional, social, and spiritual components, all of which needed to be addressed. Of course, excellent control of pain and other symptoms is vital, but the role of the palliative care team, including the physicians, is much more than this. It also extends beyond expertise in the management of physical and psychiatric symptoms. Effective symptom control may be necessary before other goals of hospice and palliative care can be achieved. But equally, failure to address emotional, social, or spiritual components of symptoms may lead to inadequate symptom control. Physicians can and should contribute to this holistic assessment and care. This is why palliative medicine is a rewarding field for physicians-there is much opportunity to practice comprehensive whole person care"--

Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.

One of the most challenging roles of the psycho-oncologist is to help guide terminally-ill patients through the physical, psychological, and spiritual aspects of the dying process. Patients with cancer, AIDS, and other life-threatening illnesses are at increased risk for the development of major psychiatric complications, and have an enormous burden of both physical and psychological symptoms. Concepts of adequate palliative care must be expanded beyond the current focus on pain and physical symptom control to include the psychiatric, psychosocial, existential, and spiritual aspects of care. The psycho-oncologist, as a consultant to or member of a palliative care team, has a unique role and opportunity to fulfill this promise of competent and compassionate palliative care for those with life-threatening illnesses. Psychosocial Palliative Care guides the psycho-oncologist through the most salient aspects of effective psychiatric care of patients with advanced illnesses. This handbook reviews basic concepts and definitions of palliative care and the experience of dying, the assessment and management of major psychiatric complications of life-threatening illness, including psychopharmacologic and psychotherapeutic approaches, and covers issues such as bereavement, spirituality, cultural sensitivity, communication and psychiatric contributions to common physical symptom control. A global perspective on death and palliative care is taken throughout the text, and an Appendix provides a comprehensive list of international palliative care resources and training programs.

In recent years, palliative care has emerged as the leading model of person-centered care focused on preserving quality of life and alleviating distress for people and families experiencing serious and life-limiting medical illness. Alongside this development has come a growing recognition of the need for expertise in psychiatric diagnosis, psychopharmacology, and psychotherapy within the interdisciplinary team of specialists tasked with identifying and addressing the varied sources of suffering in patients with advanced medical illnesses. The Clinical Manual of Palliative Care Psychiatry was written to motivate and guide readers -- whether mental health clinicians or palliative care providers -- to deepen their understanding of the psychosocial dimensions of suffering for the benefit of seriously ill patients and the support of their families. Great care has been exercised in the choice of topics and features: Chapter content emphasizes practical aspects of assessment and management that are unique to the palliative care setting, ensuring that clinicians are equipped to address the most common challenges they are likely to face. Each chapter ends with a list of supplemental materials -- including key publications (e.g., "Fast Facts" from the Center to Advance Palliative Care) and links to relevant modules from the Education in Palliative and End-of-Life Care curriculum (e.g., EPEC for Oncology) -- aimed at extending and enhancing reader knowledge of the topics covered. The authors provide thorough coverage of medication use, including off-label applications, which are common in palliative care. A wealth of tables and figures present clinically relevant information in a concise and easy-to-grasp manner. Practical and brimming with essential information and useful techniques, the Clinical Manual of Palliative Care Psychiatry empowers both mental health clinicians and palliative care practitioners to more skillfully respond to psychosocial suffering in seriously ill and dying patients.

This Second Edition of The Psychiatry of Palliative Medicine remains a practical and pragmatic distillation of the psychiatry relevant to the terminally ill. Revised throughout and greatly expanded by the addition of two entirely new chapters, it reviews the major psychiatric syndromes encountered in palliative care - depression, anxiety, delirium - and examines psychopharmacological and psychological interventions in detail. It succinctly considers the psychiatric aspects of pain, sleep, cognitive impairment, terminal neurodegenerative diseases, sedation, artificial feeding and euthanasia. The dying, chronically ill psychiatric patient is also discussed. The author has drawn on his great experience in both consultation-liaison psychiatry and palliative medicine to produce an essential, evidence-based guide for all healthcare professionals involved in palliative care. These include consultants and senior nurses, as well as psychiatrists, especially consultation-liaison psychiatrists, and trainees. 'I find this an immensely sympathetic book, beautifully written. It is a testimony to the summation of specialist psychiatric knowledge, broad scholarship and a rich personal practice in bedside palliation.' From the Foreword by Ian Maddocks Reviews of the first edition: '...a relevant, highly readable and reasonably priced book which will be of interest to all, whether from a psychiatric or palliative care background, who seek to improve the care of dying patients INTERNATIONAL PSYCHOGERIATRICS 'Practical, scientifically based and scholarly, addressing a comprehensive set of common and important clinical problems in palliative care. The book will doubtlessly be highly valued by palliative care clinicians for its practical and thorough overview of some of the most challenging clinical problems they face. Excellent and timely.' AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY

This practical guide briefly covers the historical and epidemiological background of palliative care and the growth of palliative medicine as a specialty, before dealing with major physical, psychological, spiritual, and symptom management issues from diagnosis to bereavement care.

Maintaining dignity for patients approaching death is a core principle of palliative care. Dignity therapy, a psychological intervention developed by Dr. Harvey Max Chochinov and his internationally lauded research group, has been designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as they grapple with the reality of life drawing to a close. In the first book to lay out the blueprint for this unique and meaningful intervention, Chochinov addresses one of the most important dimensions of being human. Being alive means being vulnerable and mortal; he argues that dignity therapy offers a way to preserve meaning and hope for patients approaching death. With history and foundations of dignity in care, and step by step guidance for readers interested in implementing the program, this volume illuminates how dignity therapy can change end-of-life experience for those about to die - and for those who will grieve their passing.

Palliative Care Within Mental Health: Ethical Practice explores the comprehensive concerns and dilemmas that occur surrounding people experiencing mental health problems and disorders. Working beyond narrow, stereotypical definitions of palliative care as restricted to terminal cancer patients, this balanced and thought-provoking volume examines the many interrelated issues that face the individual, families, and caregivers, setting the groundwork for improved, ethical relationships and interventions. Chapters by experts and experienced practitioners detail the challenges, concerns, and best practices for ethical care and responses in a variety of individual and treatment contexts. This is an essential and thoughtful new resource for all those involved in the fast-developing field of palliative mental health.