Hospice and Palliative Care: Concepts and Practice

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ISBN: 9780763715663 | 0763715662
Cover: Paperback
Copyright: 4/1/2003

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Hospice and Palliative Care offers theoretical perspectives and practical information about this growing field, and explains how the interdisciplinary team functions in the hospice setting.They then discuss challenges to the team including symptom management, death education, ethical issues, and support groups.

Foreword	p. xvii
Preface	p. xix
The Historical Development of Hospice and Palliative Care	p. 1
The Historical Roots of Hospice	p. 2
The Modern History of Hospice	p. 3
The Legislative Role in Hospice and Palliative Care	p. 6
Recent Developments in Hospice and Palliative Care	p. 7
The Contribution of Pharmacological Innovation	p. 8
Summary	p. 10
References	p. 10
For Further Reading	p. 11
The Interdisciplinary Team	p. 13
Staff Characteristics	p. 13
Interview Process for Potential Hospice Employees/Volunteers	p. 14
Members of the Team	p. 15
The Core Team	p. 16
Ancillary Team Members	p. 22
The Office Staff as Team Members	p. 29
The Team in Action	p. 29
Family Conferences	p. 30
Office Space and Equipment	p. 31
Summary	p. 32
References	p. 32
For Further Reading	p. 33
Eligibility and Reimbursement for Hospice and Palliative Care	p. 35
Insurance	p. 36
Eligibility for Hospice	p. 36
Eligibility for Palliative Care	p. 37
Hospice Reimbursement	p. 37
Palliative Care Reimbursement	p. 39
Physician Services Reimbursement	p. 40
Advanced Practice Nurse (APN) Services Reimbursement	p. 41
Summary	p. 44
References	p. 44
For Further Reading	p. 45
Hospice/Palliative Care Settings	p. 47
Levels of Care	p. 47
Additional Non-Medical Levels of Care	p. 50
Service Settings	p. 51
Summary	p. 55
References	p. 55
Continuous Quality Improvement (CQI) in Hospice	p. 57
Assessment of Quality	p. 59
Goals and Standards	p. 59
The CQI Process	p. 62
Data Collection and Analysis	p. 63
Barriers to Implementation	p. 64
Summary	p. 64
References	p. 64
Communication at the End of Life	p. 67
Principles of Human Communication	p. 68
The Importance of Good Communication at the End of Life	p. 70
Barriers to Good Communication	p. 71
Practical Aspects of Communicating at the End of Life	p. 73
Breaking Bad News	p. 79
Assessing for Suicide Potential	p. 82
Summary	p. 83
References	p. 83
Ethical Issues in Hospice Care	p. 87
Expectations of Patients, Family, and Team	p. 88
Advance Directives	p. 92
Physician-Assisted Suicide and Euthanasia	p. 95
Summary	p. 99
References	p. 100
Legal Issues in Hospice and Palliative Care	p. 103
Introducing the Common Law	p. 104
What Is a Right and Where Does It Come From?	p. 106
The Common Law Rights of Patients, Plus One More	p. 107
Documenting the Exercise of Patient Rights: A Guide to Forms	p. 112
Dealing with Proxy Decision-Makers	p. 115
Managing the Flow of Legally Significant Documents and Conversations	p. 115
References	p. 117
Resources	p. 117
Spiritual Care of the Dying Person	p. 119
Exploration of Purpose and Meaning	p. 120
Relationship Work: Saying Goodbye	p. 123
The Return to Essence	p. 125
Summary	p. 126
References	p. 127
For Further Reading	p. 127
General Issues: Fatigue, Dyspnea, and Constipation	p. 129
Asthenia (Fatigue)	p. 130
Dyspnea	p. 133
Constipation	p. 137
Summary	p. 140
Further Reading	p. 140
Principles of Pain Management	p. 143
Etiology of Pain	p. 144
Assessment of Pain	p. 146
Barriers to Pain Management	p. 149
Misconceptions about Pain	p. 150
Overview of Approaches to Pain Management	p. 150
Nonpharmacologic Approaches to Pain Management	p. 151
Summary	p. 153
Further Reading	p. 154
Resources	p. 154
Pain Guidelines from the Agency of Health Research and Quality	p. 154
Initial Pain Assessment Tool	p. 155
Brief Pain Inventory (Short Form)	p. 157
Memorial Pain Assessment Card	p. 159
Pharmacotherapy for Chronic Pain	p. 161
Nonopioid Analgesics	p. 161
Opioid Analgesics	p. 164
Adjuvant Medications	p. 172
Further Reading	p. 174
Cultural Competence in Hospice and Palliative Care	p. 177
Cultural Competence	p. 178
Hospice and Palliative Care Issues Influenced by Culture	p. 184
Summary	p. 188
References	p. 189
Palliation in Noncancer Disease	p. 195
The Challenge of Prognostic Uncertainty	p. 196
Severity Indicators	p. 197
Treatment Considerations	p. 199
Summary	p. 205
References	p. 205
Grief and Bereavement Issues in Hospice/Palliative Care	p. 209
Literature Review	p. 209
End-of-Life Model	p. 210
Search Results	p. 212
Future Directions and Conclusions	p. 218
References	p. 218
Care of the Patient as Death Approaches in the Hospice/Palliative Care Setting	p. 221
General Issues	p. 221
Symptoms at the End of Life	p. 222
Symptoms	p. 223
General Treatment Planning	p. 226
Summary	p. 226
References	p. 227
Death Education and Family Support	p. 229
Definition of Terms	p. 229
Hospice Interdisciplinary Team	p. 230
Breaking Bad News	p. 231
When Do We Begin To Die?	p. 232
Window of Time	p. 232
Advance Directives	p. 232
Types of Support	p. 233
Bereavement Support	p. 235
Travel and Quality of Life	p. 236
Funeral/Memorial Planning	p. 236
Summary	p. 238
References	p. 239
For Further Reading	p. 240
Solving Issues in Hospice/Palliative Care through the Use of Case Problems	p. 241
Is This Person Eligible for the Hospice Medicare Benefit?	p. 241
Planning for the Future	p. 244
Pain in the Person with Cancer	p. 245
A Person with Bowel Obstruction	p. 247
Further Reading	p. 248
The Information Superhighway and Palliative Care	p. 251
Informatics and the Electronic Medical Record	p. 251
The Electronic "Curbside Consult"	p. 252
Security and Privacy	p. 253
Health Information on the Internet	p. 253
Internet Resources for the Palliative Care Professional	p. 254
Handheld Computers: Distance Insensitive Computing	p. 255
Clinical Implications	p. 256
Summary	p. 257
Appendix	p. 257
Community Resources for Hospice/Palliative Care Patients	p. 261
Social Workers	p. 264
Further Reading	p. 267
Index	p. 269
Table of Contents provided by Rittenhouse. All Rights Reserved.

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Hospice and Palliative Care: Concepts and Practice

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