Specialisation In Palliative Medicine For Physicians In Europe 2014

Current projections indicate that by 2050 the number of people aged over 80 years old will rise to 395 million and that by this date 25-30% of people over the age of 85 will show some degree of cognitive decline. Palliative care for older people: A public health perspective provides a comprehensive account of the current state of palliative care for older people worldwide and illustrates the range of concomitant issues that, as the global population ages, will ever more acutely shape the decisions of policy-makers and care-givers. The book begins by outlining the range of policies towards palliative care for older people that are found worldwide. It follows this by examining an array of socio-cultural issues and palliative care initiatives, from the care implications of health trajectories of older people to the spiritual requirements of palliative care patients, and from the need to encourage compassion towards end-of-life care within communities to the development of care pathways for older people. Palliative care for older people: A public health perspective is a valuable resource for professionals and academics in a range of healthcare and public health fields to understand the current state of policy work from around the world. The book also highlights the social-cultural considerations that influence the difficult decisions that those involved in palliative care face, not least patients themselves, and offers examples of good practice and recommendations to inspire, support, and direct healthcare policy and decision-making at organisational, regional, national and international levels.

Palliative medicine was first recognised as a specialist field in 1987. One hundred years earlier, London based doctor William Munk published a treatise on 'easeful death' that mapped out the principles of practical, spiritual, and medical support at the end of life. In the intervening years a major process of development took place which led to innovative services, new approaches to the study and relief of pain and other symptoms, a growing interest in 'holistic' care, and a desire to gain more recognition for care at the end of life. This book traces the history of palliative medicine, from its nineteenth-century origins, to its modern practice around the world. It takes in the changing meaning of 'euthanasia', assesses the role of religious and philanthropic organisations in the creation of homes for the dying, and explores how twentieth-century doctors created a special focus on end of life care. To Comfort Always traces the rise of clinical studies, academic programmes and international collaborations to promote palliative care. It examines the continuing need to support development with evidence, and assesses the dilemmas of unequal access to services and pain relieving drugs, as well as the periodic accusations of creeping medicalization within the field. This is the first history of its kind, and the breadth of information it encompasses makes it an essential resource for those interested in the long-term achievements of palliative medicine as well as the challenges that remain.

This sixth edition of the Oxford Textbook of Palliative Medicine takes us now into the third decade for this definitive award-winning textbook. It has been rigorously updated to offer a truly global perspective, highlighting the best current evidence-based practices, and collective wisdom from more than 200 experts around the world. This leading textbook covers all the new and emerging topics, updated and restructured to reflect major developments in the increasingly widespread acceptance of palliative medicine as a fundamental public health need. The sixth edition includes new sections devoted to family and caregiver issues, cardio-respiratory symptoms and disorders, and genitourinary symptoms and disorders. In addition, the multi-disciplinary nature of palliative care is emphasized throughout the textbook, covering areas from ethical and communication issues, the treatment of symptoms, and the management of pain. The Oxford Textbook of Palliative Medicine is a truly comprehensive text. No hospital, hospice, palliative care service, or medical library should be without this essential source of information. This sixth edition of the Oxford Textbook of Palliative Medicine is dedicated to the memory of Professor Kenneth Fearon husband of Professor Marie Fallon and a surgeon who became a world leader in the research and management of anorexia and cachexia. He modeled a work-life balance that is so critical in our field, with devotion to both his patients and his family.

Law, Palliative Care and Dying critically examines the role of the legal framework in shaping the boundaries of palliative care practice. The work underlines the importance of a distinct legal framework for specialist palliative care which can provide clarity for both the healthcare professional and the patient. It examines the legal and ethical justifications for specialist palliative care practices and, in doing so, it questions the legitimacy of the distinction between euthanasia and practices such as palliative sedation. Moreover, this work discusses the influence of a human rights discourse on palliative care and examines the contribution of autonomy, dignity, and the right to palliative care. This book includes detailed comparative research on several European jurisdictions. The jurisdictions illustrate varied approaches to palliative care regulation and promotion. In this manner, the role of professional guidelines and legislation are drawn out and common themes in the regulation of palliative care emerge.

The new global cancer data suggests that the global burden has risen to 18.1 million new cases per year and 9.6 million cancer deaths per year. A number of factors appear to be driving this increase, in particular, a growing and aging global population and an increase of exposure to cancer risk factors linked to social and economic development. For rapidly-growing economies, the data suggests a shift from poverty- or infection-related cancers to those associated with lifestyles more typical in industrialized countries. There is still large geographical diversity in cancer occurrence and variations in the magnitude and profile of the disease between and within world regions. There are specific types of cancer that dominate globally: lung, female breast and colorectal cancer, and the regional variations in common cancer types signal the extent to which societal, economic and lifestyle changes interplay to deferentially impact on the profile of this most complex group of diseases. Unfortunately, despite advances in cancer care, a significant proportion of patients at home, experience sub-optimal outcomes. Barriers to successful treatment outcomes include, but are not limited to: access to oncologists in the primary health centers, non-adherence, lack of experienced oncology and palliative care nurses in the community, inadequate monitoring and the lack of training of family and pediatric physicians. Telemedicine approaches, including telephone triage/education, telemonitoring, teleconsultation and status tracking through mobile applications, have shown promise in further improving outcomes, in particular for chronic cancer patients following their hospitalization. Lessons can be learned from existing hospices in North America, the United Kingdom, Australia, Centers of Excellence in African (Uganda) and modern community services in India (Kerala). An important goal of this book is to describe and encourage professionals to develop new community programs in palliative care, which include training and empowering physicians and nurses in the community on the principles of palliative care. The Middle East Cancer Consortium (MECC) together with the American Society of Clinical Oncology (ASCO) and the American Oncology Nursing Society (ONS) have conducted multiple courses ranging from basic palliative care to more specialized training in palliative care for multiple nationalities in Europe, Asia and Africa. Our experience clearly indicates that, to promote such activities, one needs strong leadership and confirmed political will to support the endeavor. The new book will emphasize the importance of having a core of multiple stakeholders including community leaders, government, NGOs and media to be actively involved in advocating for the cause and generating public awareness. This text will provide the reader with a comprehensive understanding of the outside-of-the-hospital treatment of cancer patients by medical, paramedical and volunteer personnel. In doing so, this text will encourage the creation of new palliative care services improving upon the existing ones and stimulate further research in this field. Part 1 of the text will begin with an overview of the current state of affairs of services provided to cancer patients while being cared for by primary health centers. It will also review the current literature regarding medical and psychological-based therapy options in the community for cancer patients at different stages of their disease. Part 2 will address the unique role of the community nurse, within the framework of the multidisciplinary team treating the patient, in the attempt to provide optimal evaluation and care in very challenging situations (such as with terminal patients). Part 3 will provide insightful models of this new discipline and serve as a valuable resource for physicians, nurses, social workers and others involved in the care of cancer patients. The book will take a multidisciplinary approach, integrating clinical and environmental data for practical management to enhance the efficacy of treatment while relieving suffering. Part 4 will also discuss the application of modern technological approaches to track symptoms, quality of life, diet, mobility, duration of sleep and medication use (including pain killers) in chronic cancer patients in the community. Part 5 of the book will also be devoted to modes of developing a collaborative program between governmental and non-governmental organization sectors. This includes volunteer workers in close collaboration with medical professionals for providing emotional and spiritual support, nursing care, nutritional support and empowering family caregivers. Such a model makes palliative care in the community a “people’s movement”, thus transferring part of the responsibility and ownership to the community.

This text is concerned with the organization, ideas and problems of palliative care in the European context. As a result of a BIOMED project, various organizations, concepts and problematic issues of palliative care have been studied and described.