Transforming Palliative Care In Nursing Homes

The teacher and gerontological social work scholar Mercedes Bern-Klug joins experts on nursing, law, medicine, sociology, and social work to provide a thorough understanding of nursing home palliative care. Their broad definition of palliative care treats comfort care as appropriate across the illness experience, not just at the end of life. Because a majority of nursing home residents are older adults facing multiple, advanced chronic conditions, this book is grounded in the provision of palliative care-especially palliative psychosocial care. Yet its practice recommendations can also be applied to other long-term care settings, such as assisted living. The contributors combine scholarship with practical wisdom in each chapter, mixing reviews of scholarly literature with insights gleaned from clinical practice. Chapter topics comply with the eight domains of palliative care developed by the National Consensus Project for Quality Palliative Care. Some focus on care of the resident, while others concern the resident's family. A special section addresses self-care for nursing home staff members, and another discusses nursing home rituals to mark the death of a resident. Bern-Klug concludes with an overview of the factors that will shape the future of palliative care for advanced chronic illness.

This volume outlines the belief that nursing homes can and should support the physical, psychological, and social needs of residents, and that residents can thrive in nursing homes when these needs are met. The book's contributors explore the role that palliative or comfort care plays in enhancing the quality of life of nursing home residents as well as the medical, familial, psychological, cultural, and financial issues that influence decision-making about end-of-life care. The book is designed to be a tool to prepare social workers to advocate for a greater incorporation of palliative care and psychosocial care into the culture of nursing home care. The book includes discussions of the psychosocial needs of nursing home residents and families, the financing of long-term care and end-of-life care, ethical issues in chronic care and end of life, trends and characteristics in nursing home care, rituals and grief at end-of-life, and considerations for the future. Each chapter includes case examples to further illustrate points made.

Palliative Care is the first book to provide a comprehensive understanding of the new field that is transforming the way Americans deal with serious illness. Diane E. Meier, M.D., one of the field's leaders and a recipient of a MacArthur Foundation "genius award" in 2009, opens the volume with a sweeping overview of the field. In her essay, Dr. Meier examines the roots of palliative care, explores the key legal and ethical issues, discusses the development of palliative care, and presents ideas on policies that can improve access to palliative care. Dr. Meier's essay is followed by reprints of twenty-five of the most important articles in the field. They range from classic pieces by some of the field's pioneers, such as Eric Cassel, Balfour Mount, and Elizabeth Kübler-Ross, to influential newer articles on topics such as caregiving and cost savings of palliative care. The reprints cover a wide range of topics including: Why the care of the seriously ill is so important Efforts to cope with advanced illness Legal and ethical issues Pain management Cross-cultural issues Philosophical perspective The demand for palliative care has been nothing short of stunning largely because of palliative care's positive impact on both the quality and the cost of care provided to seriously ill individuals. By providing a wide-ranging perspective on this growing field, this book will serve as a guide for developing meaningful approaches that will lead to better health care for all Americans.

Palliative Nursing is an evidence-based practical guide fornurses working in areas of practice where general palliative careis provided. This may be in hospitals, nursing homes, dementiaunits, the community and any other clinical areas which are notclassified as specialist palliative care. This book first explores the history and ethos of palliativecare, and then looks at palliative nursing across various caresettings. It then looks at palliative nursing care for peoplewith specific illnesses, including heart failure, dementia, chronicobstructive pulmonary disease, cancer, and neurological conditions.Palliative care for children and young people is discussed, andthen the book finally looks at education and research in palliativenursing. Palliative Nursing will be essential readingfor all nurses working with palliative care patients in a nonspecialist role, i.e. in hospitals, primary care and nursing homes,as well as nursing students. SPECIAL FEATURES Explores the palliative nursing issues related to specificdiseases groups Written in the context of the new national tools, i.e. the endof life initiative, preferred place of care, Liverpool care pathwayand Gold standards framework. Each chapter includes practice points and cases to allow thepractitioner to undertake guided reflection to improvepractice Written by nurses for nurses Provides guidance for nurses working in all four countries ofthe UK

In our society, the overwhelming majority of people die in later life. They typically die slowly of chronic diseases, with multiple co-existing problems over long periods of time. They spend the majority of their final years at home, but many will die in hospitals or care homes. This book explores the possibilities for improving the care of older people dying in residential care and nursing homes. It argues that there are aspects of palliative care that, given the right circumstances, are transferable to dying people in settings that are not domestic or hospice based. End of Life in Care Homes describes what happens in nursing and residential care homes when a resident is dying, how carers cope, and the practical, health and emotional challenges that carers face on top of their day-to-day work. Based on detailed research from both the UK and US, the book shows how the situation can be improved.

This book examines the policies, challenges, and quality of life issues in palliative care and nursing home care facilities. Some topics discussed in this compilation include: identifying the palliative care needs of home-based dementia patients and their caregivers; the functions of sexuality in older adults living in nursing homes and increasing awareness of staff and family members to this issue; haematology and non-oncological respiratory patients in palliative care; the changing role of the licensed practical nurse in nursing home care; obese nursing residents and their special considerations; gynaecological cancer and palliative cancer care; and, neonatal palliative care.

This book provides an unique resource for registered nurses working in hospice palliative care at home and for the community, outside of acute care settings and also incorporates literature related to palliative care in acute health care settings, as part of the overall services and supports required. Very few resources exist which specifically address hospice palliative care in the home setting, despite the fact that most palliative care occurs outside acute care settings and is primarily supported by unpaid family caregivers. An overview of the concerns for individuals and families, as well as specific nursing interventions, from all ages would be an excellent support for nursing students and practicing registered nurses alike. The book structure begins with a description of the goals and objectives of hospice palliative care and the nursing role in providing excellent supportive care. Chapters include research findings and specifically research completed by the authors in the areas of pediatric palliative care, palliative care for those with dementia, and the needs of family caregivers in bereavement. Interventions developed by the editors are provided in this book, such as the “Finding Balance Intervention” for bereaved caregivers; the “Reclaiming Yourself” tool for bereaved spouses of partners with dementia; and The Keeping Hope Possible Toolkit for families of children with life threatening and life limiting illnesses. The development and application of these theory-based interventions are also highlighted. Videos and vignettes written by family caregivers about what was helpful for them, provide a patient-and family-centered approach./div The book will benefit nursing students, educators and practicing registered nurses by providing information, theory, and evidence from research.

"It is so important to advocate for things that may not always seem possible. Getting to work with patients/families at the end of their life is the ultimate honor." - Lauren G Markham, MSW, LCSW, APHSW-C "In this work, one witnesses both depths of human suffering and heights of human transcendence that can inspire both awe and fear. At those times, I have found that surrendering my need to be "an expert" and instead, allow myself to simply be a "human" is the wisest action." - Kerry Irish, LCSW, OSW-C, FAOSW"--