The Psychiatrist And The Dying Patient

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

“Recommended for the provocative questions it raises concerning the effect on the patient of the structure of medical care, concerning the important decisions regarding policy facing the medical profession, the hospital administrator, and the public, and for the discussions of legal and economic dimensions which are frequently forgotten by personnel working directly with the patient. –Edmund C. Payne, Psychiatry in Medicine The fourteen original articles in The Dying Patient examine the problems of dying and medical conduct from the perspectives of sociology, economics, medicine, and the law.

Most of us can recall a time when we pretended to be sick to reap the benefits that go along with illness. By playing sick, we gained sympathy, care, and attention, and were excused from our responsibilities. Though doing so on occasion is considered normal, there are those who carry their deceptions to the extreme. In this book, Dr. Marc Feldman describes people’s strange motivations to fabricate or induce illness or injury to satisfy deep emotional needs. Doctors, family members, and friends are lured into a costly, frustrating, and potentially deadly web of deceit. From the mother who shaves her child’s head and tells her community he has cancer, to the co-worker who suffers from a string of incomprehensible "tragedies," to the false epilepsy victim who monopolizes her online support group, "disease forgery" is ever-present in the media and in many people’s lives. In Dying to be Ill: True Stories of Medical Deception, Dr. Feldman, with the assistance of Gregory Yates, has chronicled this fascinating world as well as the paths to healing. With insight developed from 25 years of hands-on experience, Dying to be Ill is sure to stand as a classic in the field.

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.

In recent years, the lens of the media has narrowed issues of euthanasia and assisted suicide to a drama involving two players: Dr. Kevorkian and the law. This has left suffering patients and their families unrecognized and isolated when facing the most painful life decision. Here at last is a book that addresses the role of psychiatry in dealing with a major, controversial topic in American medicine today -- treatment decisions at the end of life. End-of-Life Decisions: A Psychosocial Perspective acknowledges and explores the role psychiatrists can play as advisers to the terminally ill and their loved ones. It describes the wide range of emotional and psychiatric issues faced by the patient, family, and physician that affect choices patients make to limit treatment or seek physician assistance in dying. A distinguished group of contributors, all of whom have extensive experience dealing with end-of-life issues in clinical practice, address topics that may not have been considered previously. From dealing with issues of terminal illnesses in children, to making difficult treatment decisions for patients with AIDS; from judging the competency of clinically depressed patients for making sound decisions, to understanding the influence of family dynamics, economic forces, and language differences on doctor-patient communication -- the book uses specific case studies and data to explore the role of professionals in end-of-life decisions. End-of-Life Decisions strikes a careful balance between the need for patient autonomy and the challenge to make well-formulated treatment decisions. This book will heighten modern medicine's and society's consciousness concerning the difficult challenges faced by patients and their families when making end-of-life decisions