The Meaning of Mortality in Modern Life

2021 ◽  
pp. 13-20
Author(s):  
Gary Rodin ◽  
Sarah Hales
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Psychological Impact ◽  
Healthcare Providers ◽  
Human Dimensions ◽  
Social Dimensions ◽  
Medical Interventions ◽  
Physical Suffering ◽  
Societal Interest

This chapter contextualizes Managing Cancer and Living Meaningfully (CALM) in relation to growing societal interest in the psychological impact of disease and the central role of healthcare providers in managing the threat of mortality and the end of life. There has been increasing recognition that the enormous investment in biotechnology and aggressive medical interventions for advanced disease has not been matched by complementary attention to the human dimensions of these conditions. There is now a growing public voice of patients and their families for more support in managing the psychological, emotional, and spiritual elements of advanced disease. The global palliative care movement emerged to address these unmet needs, but there has been less systematic attention in this field to the relief of psychological than physical suffering. CALM is a psychosocial intervention that is uniquely integrated with oncology and palliative care and focused on the psychological and social dimensions of advanced cancer.

The Second Domain of Palliative Care

2018 ◽  
Author(s):  
E. Alessandra Strada
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Treatment Adherence ◽  
Psychological Factors ◽  
Physical Symptoms ◽  
Team Work ◽  
Advanced Illness ◽  
Interdisciplinary Work ◽  
Physical Suffering

This chapter proposes palliative psychology competencies in the second domain of palliative care: physical aspects of care. It discusses the importance of interdisciplinary work in assessment and management of pain and other physical symptoms. Palliative psychologists with the necessary knowledge, skills, and attitudes can contribute greatly to team work by identifying and managing psychological factors that can contribute to the patient’s physical suffering. This chapter also briefly describes relevant approaches to dyspnea and constipation. Clinical examples of pain assessment and intervention are provided based on real case scenarios. The basics of pharmacological approaches to pain management in advanced illness are discussed, in order to facilitate the role of palliative psychologists in promoting communication and treatment adherence. The use of integrative medicine modalities to improve physical symptoms is highlighted.

Communication in oncology pharmacy

2017 ◽  
Author(s):  
Bethan Tranter ◽  
Simon Noble
Keyword(s):  
Palliative Care ◽  
Treatment Adherence ◽  
Drug Safety ◽  
Medication Compliance ◽  
Healthcare Providers ◽  
Optimal Drug ◽  
Treatment Medication ◽  
Hospice And Palliative Care ◽  
Timely Treatment

Pharmacists are considered to have a pivotal role in the provision of information in oncology, and in hospice and palliative care. Effective communication is essential for optimal drug safety, timely treatment, medication compliance, and education. The role of the pharmacist has expanded to offer enhanced pharmaceutical care, which serves to improve the communication between healthcare providers and the function of the multidisciplinary team. Furthermore, through optimal communication with patients there will be increased treatment adherence and improved overall care. This chapter focuses on the breadth of communication issues faced by pharmacists involved in cancer care through the full length of the cancer journey, be it curative or palliative.

CALM and the Desire for Death

2021 ◽  
pp. 77-86
Author(s):  
Gary Rodin ◽  
Sarah Hales
Keyword(s):  
Advanced Cancer ◽  
Longitudinal Research ◽  
Advanced Disease ◽  
Healthcare Providers ◽  
Clinical Implications ◽  
Hastened Death ◽  
Will To Live ◽  
Desire For Death ◽  
The Will

This chapter considers the loss of the will to live, the desire for hastened death, and suicidality in patients with advanced disease. The challenge of distinguishing the loss of the will to live as a manifestation of depression from nonpathological death acceptance is explored and the clinical implications of such distinctions are examined. The quantitative findings from our longitudinal research regarding the prevalence, trajectory, and correlates of the desire for death in patients with advanced cancer are presented. The qualitative findings from this research revealed three distinct dimensions of the desire for death, only one of which reflects the literal wish to end life. The role of Managing Cancer and Living Meaningfully (CALM) in alleviating death anxiety, in examining the desire for death, in enhancing death preparation, and in improving communication with healthcare providers is considered here.

Dementia and frailty

2019 ◽  
pp. 579-618
Keyword(s):  
Palliative Care ◽  
Hospital Admissions ◽  
Advanced Disease ◽  
Psychological Symptoms ◽  
Management Strategies ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
The Uk ◽  
End Stage

This chapter outlines the symptoms, epidemiology, aetiology, and differential diagnosis of dementia, with emphasis on advanced disease. It discusses the role of dementia treatments, the challenges faced with advanced disease, and guides to recognition and treatment of common symptoms, including behavioural and psychological symptoms of dementia and pain. The chapter also discusses pharmacological and non-pharmacological approaches to management of dementia symptoms, highlighting the role of palliative care, when it is appropriate to refer, and terminal care. The chapter illustrates some of the controversial aspects of care. At the current rate there will be 850,000 people with dementia in the UK by 2015, and this number is forecast to increase to over 1 million by 2025 and over 2 million by 2051.This is contributing to one in four hospital admissions, with the health and social costs of dementia estimated to be more than stroke, heart disease, and cancer combined. Along with these worrying progressive epidemiological figures, we need to take into account the immense caring burden for families, carers, and society. End-stage dementia often falls between the cracks of specialization, with professionals feeling under-prepared for the intricacies of end-stage dementia management strategies. Palliative care has been slow in its involvement for multiple reasons, but primarily because dementia has a much slower disease trajectory than cancer, with an unclear prognosis.

The role of nursing in caring for patients undergoing palliative surgery for advanced disease

2015 ◽  
pp. 793-801
Author(s):  
Anna Cathy Williams ◽  
Betty R. Ferrell ◽  
Gloria Juarez ◽  
Tami Borneman
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Palliative Surgery ◽  
Team Members ◽  
Health Team ◽  
Disease Trajectory ◽  
Rapid Pace ◽  
Role Of Nursing ◽  
Traditional Setting

Although newer in the traditional setting, palliative care and surgeries are emerging at a very rapid pace. As the path of the surgeon, the patient‘s disease trajectory, and the path of palliative intervention overlap, it is possible for professional and personal conflicts to arise, with negotiations needing to take place. Surgeons and palliative care colleagues, along with other health team members and patients, will need to collaborate on a very intimate level, and often.

The role of nutritional support in the provision of palliative care

2020 ◽  
pp. 55-64
Author(s):  
N. Zarechnov ◽  
A. Kuznetsov ◽  
N. Seliverstova
Keyword(s):  
Palliative Care ◽  
Nutritional Support

The article is devoted to the problem of nutrition of patients receiving palliative care. The authors emphasize the importance of nutritional support for this group of patients and describe the experience of enteral and paraenteral nutrition.

Diagnosis, assessment, and treatment of depression in advanced disease

2018 ◽  
Author(s):  
Matthew Hotopf
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Antidepressant Treatment ◽  
Population Level ◽  
Care Staff ◽  
Care Services ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Palliative Care Services ◽  
Key Issues

Depression in palliative care is common, under-recognised and has significant impacts for sufferers. There are effective treatments but often a shortage of staff to provide them. This chapter sets out a number of key issues to consider when assessing and treating individual patients and considers the way in which palliative care services can innovate to provide a population level response to depression. Palliative care staff can be trained to deliver basic depression care and follow simple protocols to initiate, monitor and adjust antidepressant treatment. These approaches have been tested in trials in cancer care but the challenge is to take these approaches from research trials conducted in centres of excellence with good resources, to other settings.

scholarly journals Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers

2021 ◽  
pp. 104990912110126
Author(s):  
Valeria Cardenas ◽  
Anna Rahman ◽  
Yujun Zhu ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Condition ◽  
Insurance Companies ◽  
Structured Interviews ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.

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