The Skill Of End Of Life Communication For Clinicians

With a focus on end-of-life discussion in aging and chronically ill populations, this book offers insight into the skill of communicating in complex and emotionally charged discussions. This text is written for all clinicians and professionals in the fields of healthcare and public health who are faced with questions of ethical deliberation when a patient’s illness turns from chronic to terminal. This skill is required to manage care well in an age of advanced technology, and numerous autonomous choices. With a palliative care and ethics focus, the manuscript provides case studies illustrating issues which occur in the acuity and chronicity of end of life. Clear tools for clinicians, such as scripting and “the advance care planning video library" are included. The book focuses on the unique concept of outpatient ethics, including readmission prevention and shortened length of stay through good communication for clinicians who will be required to conduct this discussion with patients. The ethical undertone in this text provides a perfect opening for application in healthcare ethics classes, both in fields of public health and healthcare. Medical scholars and physicians, nurse practitioners and physician’s assistants, as well as social workers, both in practice and training, will benefit from this text.

'The Textbook of Palliative Care Communication' is the authoritative text on communication in palliative care. Uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, it unites clinicians and academic researchers interested in the study of communication.

Communication is a core skill for medical professionals when treating patients, and cancer and palliative care present some of the most challenging clinical situations. This book provides a comprehensive curriculum to help oncology specialists optimize their communication skills.

"The first edition of Communication in Palliative Nursing was published in 2012 and became the market leader for nurses wanting to learn more about how to improve and teach palliative care communication. For the last 8 years, it has remained the only text solely focused on the vital role of nurses in palliative care. During this time, the COMFORT model was taught to nurses nationwide who brought the curriculum back to their own institutions and taught components of the model to more than 10,000 healthcare providers across the United States (Wittenberg, Ferrell, Goldsmith, Ragan, & Buller, 2017). Numerous journal articles and research studies have been produced to highlight the principle components of the COMFORT model and test its effectiveness among healthcare audiences across a variety of clinical and educational settings. Through this all, as the model was disseminated to clinical audiences of bedside nurses, nurse leaders, nursing students, and interprofessional learners, feedback was captured about COMFORT. Comments revealed major components of the model that were working and weren't working for the nurses and other healthcare providers who utilized the strategies with patients and families, and began using curriculum tools for teaching and integrating palliative care communication instruction. So, much like the model's grounding in a transactional communication approach, which relies on the co-created interaction between parties, it was clear that the COMFORT model was also ebbing and flowing and had to change. More importantly, palliative care has been growing, changing, expanding, and becoming more sophisticated, more wide-spread! Now more than ever before, palliative care is provided in the home, clinic, or inpatient setting and serves patients who are seriously or chronically ill and their families. It became evident that in order to continue improvements to the model and to keep up with the changing landscape of palliative care and palliative patient populations, a new edition was necessary. Before we highlight the changes, it is never too early to overstate our steadfast commitment to the following principles: We believe that communication research and theory can shape palliative care practices, providing tools for a variety of contexts. We believe that palliative care, offering compassionate, holistic treatment for patients and their families, will not be possible without caring for the entire person (body and mind). We believe that communicating about palliative care must begin at diagnosis of serious illness, not just at end-stages. We believe in a patient-centered approach to communication that emphasizes the role of the family caregiver in the illness trajectory. We believe that intentional communication emphasizing team processes among physicians, nurses, social workers, chaplains, and other healthcare professionals improves palliative care practice. We believe that palliative care should be introduced early in the communication education of all health professionals. We believe that education about palliative care and communication must extend to patients and families who can then advocate for and partner more productively in such services. We believe that communication with the family caregiver is essential for the treatment of pain and symptom management. We believe that frequent conversations are needed across the disease/care trajectory, as patients and families encounter ongoing points of decision-making"--

Communication in Palliative Nursing unites complementary work in communication studies and nursing research to present a theoretically grounded curriculum for teaching palliative care communication to nurses. The chapters outline the COMFORT curriculum, comprised of these elements: Communication, Orientation and opportunity, Mindful presence, Family, Openings, Relating, and Team communication. Central to this curriculum is the need for nurses to practice self-care. Based on a narrative approach to communication, which addresses communication skills development holistically, this volume teaches nurses to consider a holistic model of communication that aligns with the holistic nature of palliative care. This work moves beyond the traditional and singular view of the nurse as patient and family teacher, to embrace more complex communication challenges present in palliative care -- namely, providing care and comfort through communication at a time when patients, families, and nurses themselves are suffering. In addition to collaborating with physicians, the nurse's role involves speaking with patients and families after they have received bad news and often extends to discussions of spiritual and religious concerns. This book covers communication theory, clinical tools, and teaching resources to help nurses enhance their own communication and create comfort for themselves, as well as for patients and their families.

This book provides the best information available on the ways priorities are currently set for health care around the world. It describes the methods now used in the six countries leading the process, and contrasts the differences between them. It shows how, except in the UK, frameworks have now been developed to set priorities. Making Choices for Health Care sets forth the key issues that need to be tackled in the years ahead. Descriptions of the leading trends are accompanied by suggestions to resolve outstanding difficulties. Topics include: the need for national research and development funding for new treatments, ways to shift resources permanently towards prevention and chronic care, and how DALYs may replace QALYs. While the concepts and values underlying priority setting have been discussed elsewhere, Making Choices for Health Care highlights real current practice. It is a vital tool for policy-makers, health care managers, clinicians, patient organizations, academics, and executives in pharmaceutical and medical supply industries.

Physicians who care for patients with life-threatening illnesses face daunting communication challenges. Patients and family members can react to difficult news with sadness, distress, anger, or denial. This book defines the specific communication tasks involved in talking with patients with life-threatening illnesses and their families. Topics include delivering bad news, transition to palliative care, discussing goals of advance-care planning and do-not-resuscitate orders, existential and spiritual issues, family conferences, medical futility, and other conflicts at the end of life. Drs Anthony Back, Robert Arnold, and James Tulsky bring together empirical research as well as their own experience to provide a roadmap through difficult conversations about life-threatening issues. The book offers both a theoretical framework and practical conversational tools that the practising physician and clinician can use to improve communication skills, increase satisfaction, and protect themselves from burnout.

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.