Psycho-Oncology in Palliative and End of Life Care

Psycho-Oncology in Palliative and End-of-Life Care provides expert advice and clinical management guidelines on the impact of advanced cancer and its treatment on the life and wellbeing of a patient in palliative and end-of-life care. Employing a practical toolkit format, this volume addresses a variety of key challenges including: discussions of death and dying, poor prognoses, wishes and values of the dying person, advance care plans, anxiety, demoralization and problems with coping, depression and delirium, the needs of partners, children, families, and caregivers, and spiritual and bereavement care. Each chapter considers presenting symptoms, differential diagnoses and assessment methods to achieve the best diagnosis, so that a detailed formulation can be developed for each person that guides a comprehensive management plan. Each section concludes with professional and service issues ranging from ethical dilemmas, legal requirements, cultural needs, and training and service development issues, through to basic human rights.

Part of the Psycho-Oncology Care: Companion Guides for Clinicians series, this concise pocket guide is a resource for oncology specialists, psycho-oncologists in training, consultant nurse specialists and nurse practitioners, and allied health professionals to use as a quick reference in everyday practice. Pitched at intermediate to advanced level skills, this companion guide can be used as a standalone, or alongside existing oncology and psycho-oncology training programs.

David W. Kissane, AC, MD, FRANZCP, FAChPM, FACLP, is an academic psychiatrist, psycho-oncology researcher, and palliative care physician. Dr. Kissane is Chair of Palliative Medicine Research, School of Medicine, University of Notre Dame, Australia and Cunningham Centre for Palliative Medicine Research, St. Vincent's Hospital Sydney, NSW, Australia; Emeritus Professor of Psychiatry, Cabrini Health and Monash Health, Monash University, Melbourne, VIC, Australia; and former Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, United States. Dr Kissane is a President Emeritus of the International Psycho-Oncology Society (IPOS). His scholarship contributed significantly to the use of support groups in cancer care, developed a model of family-centered care in both palliative care and bereavement, researched the state of demoralization as a form of existential distress, and built a comprehensive communication skills training program for
oncology and palliative care.

Maggie Watson, PhD, DipClinPsych, AFBPsS, is a Clinical Psychologist in Psycho-Oncology and Visiting Professor, Research Department of Clinical, Health and Educational Psychology, University College London, UK; Honorary Research Associate in the Division of Genetics and Epidemiology at the Institute of Cancer Research, UK; Honorary Professor, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK; and Adjunct Professor, Research and Innovation, University of Southern Queensland, Australia. She is the former Head of Psychological Medicine at the Royal Marsden Hospital, UK, and the Psychology Research Group, Institute of Cancer Research, UK. Dr Watson is currently Editor-in-Chief of Psycho-oncology: Journal of Psychological, Social and Behavioral Dimensions of Cancer, Co-Founder of the British Psychosocial Oncology Society, and a President Emeritus of the International Psycho-Oncology Society (IPOS). Her clinical research interests span psychological interventions
including cognitive behavioral therapy, cancer and families, cancer genetics, and psychological aspects of prostate cancer.

William Breitbart, MD, FACLP, FAPOS, FAPA, is Chairman of the Department of Psychiatry and Behavioral Sciences and Jimmie C. Holland Chair in Psychiatric Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr Breitbart is Editor-in-Chief of the international journal Palliative and Supportive Care and a President Emeritus of the International Psycho-Oncology Society (IPOS). His research has focused on psychosocial aspects of palliative medicine with an emphasis on the study of delirium, depression, pain, fatigue, and loss of meaning. He has engaged in pharmacological and psychotherapeutic intervention trials in these areas, most notably the development of Meaning-Centered Psychotherapy for advanced cancer patients.

Contributors

1. Communication about Advanced Progressive Disease, Prognosis, and Advance Care Plans
Natasha Michael and Rajvi Shah

2. Anxiety Disorders
Daniel McFarland, William Pirl, and Maggie Watson

3. Adjustment Disorders and Demoralization
David Kissane, Luigi Grassi, and Chun-Kai Fang

4. Depressive Disorders
Daisuke Fujisawa, Tatsuo Akechi, and Yosuke Uchitomi

5. Delirium and Cognitive Impairment
Yesne Alici, Soenke Boettger, and William Breitbart

6. Diagnosing Dying, Accompaniment, and Assessing Death Wishes
Cristina Monforte-Royo, Josep Porta-Sales, and Albert Balaguer

7. Carer, Partner, and Family-Centered Support
Hannah-Rose Mitchell, Alison Applebaum, and Talia Zaider

8. Care of Dependent Children When a Parent Dies of Cancer
Jane Turner and Melissa Henry

9. Spiritually and Culturally Sensitive Care
Jayita Deodhar, Mark Lazenby, and Crystal Park

10. Bereavement Care
Wendy Lichtenthal, William Rosa, and Robert Neimeyer

11. Staff Support
Brian Kelly, Maria Die Trill, and Christian Ntizimira


Appendix 1: Example of a Question Prompt List for Palliative Care
Appendix 2: Example of an Advance Care Plan
Appendix 3: Demoralization Scale-II (DS-II)
Appendix 4: Psycho-Existential Symptom Assessment Scale (PeSAS)


Index