Palliative care is an interdisciplinary care philosophy addressing patient and family needs and goals without providing a cure for the underlying disease. Palliative care can be successfully provided alongside curative care, which does focus on treating the disease. Studies have indicated that palliative care offers a variety of quality of life benefits to both the patient and family. Prompted by rapid growth of hospital-based palliative care, we explored the literature to better understand the financial incentives and barriers to these programs. Although patients who receive palliative care in the hospital have lower hospital costs than matched patients who do not receive palliative care, many hospitals face challenges in being reimbursed for services rendered by their interdisciplinary teams. In some cases, hospitals may absorb 50 percent of the costs of their palliative care teams because of lack of adequate reimbursement. Despite the opportunity for cost savings for a variety of stakeholders, without payment reform hospitals may be constrained from providing palliative care to all who might benefit. Additional research is needed to understand how patients, hospitals, and payers may participate in cost savings attributable to palliative care so that policymakers can effectively promote these services.

Improving how individuals give birth and die in the United States requires reforming the regulatory, reimbursement, and legal structures that centralize care in hospitals and prevent the growth of community-based alternatives. In 1900, most Americans gave birth and died at home, with minimal medical intervention. By contrast, most Americans today begin and end their lives in hospitals. The medicalization we now see is due in large part to federal and state policies that draw patients away from community-based providers, such as birth centers and hospice care, and toward the most intensive and costliest kinds of care. But the evidence suggests that birthing and dying people receive too much—even harmful—medical intervention. In The Medicalization of Birth and Death, political scientist Lauren K. Hall describes how and why birth and death became medicalized events. While hospitalization provides certain benefits, she acknowledges, it also creates harms, limiting patient autonomy, driving up costs, and causing a cascade of interventions, many with serious side effects. Tracing the regulatory, legal, and financial policies that centralize care during birth and death, Hall argues that medicalization reduces competition, stifles innovation, and prevents individuals from accessing the most appropriate care during their most vulnerable moments. She also examines the profound implications of policy-enforced medicalization on informed consent and shows how medicalization challenges the healthcare community's most foundational ethical commitments. Drawing on interviews with medical and nonmedical healthcare providers, as well as surveys of patients and their families, Hall provides a broad overview of the costs, benefits, and origins of medicalized birth and death. The Medicalization of Birth and Death is required reading for academics, patients, providers, policymakers, and anyone else interested in how policy shapes healthcare options and limits patients and providers during life's most profound moments.

The first comprehensive, clinically focused guide to help hospitalists and other hospital-based clinicians provide quality palliative care in the inpatient setting. Written for practicing clinicians by a team of experts in the field of palliative care and hospital care, Hospital-Based Palliative Medicine: A Practical, Evidence-Based Approach offers: Comprehensive content over three domains of inpatient palliative care: symptom management, communication and decision making, and practical skills, Detailed information on assessment and management of symptoms commonly experienced by seriously ill patients, Advise on the use of specific communication techniques to address sensitive topics such as prognosis, goals of care, code status, advance care planning, and family meetings in a patient- and family-centered manner, Targeted content for specific scenarios, including palliative care emergencies, care at the end of life, and an overview of post-hospital palliative care options, Self-care strategies for resilience and clinician wellness which can be used to help maintain an empathic, engaged, workforce and high quality patient care, A consistent chapter format with highlighted clinical pearls and pitfalls, ensuring the material is easily accessible to the busy hospitalist and associated hospital staff. This title will be of use to all hospital clinicians who care for seriously ill patients and their families. Specialist-trained palliative care clinicians will also find this title useful by outlining a framework for the delivery of palliative care by the patient’s front-line hospital providers. Also available in the in the Hospital-Based Medicine: Current Concepts series: Inpatient Anticoagulation Margaret C. Fang, Editor, 2011 Hospital Images: A Clinical Atlas Paul B. Aronowitz, Editor, 2012 Becoming a Consummate Clinician: What Every Student, House Officer, and Hospital Practitioner Needs to Know Ary L. Goldberger and Zachary D. Goldberger, Editors, 2012 Perioperative Medicine: Medical Consultation and Co-Management Amir K. Jaffer and Paul J. Grant, Editors, 2012 Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine James C. Pile, Thomas E. Baudendistel, and Brian J. Harte, Editors, 2013 Inpatient Cardiovascular Medicine Brahmajee K. Nallamothu and Timir S. Baman, Editors 2013

Palliative care is an interdisciplinary care philosophy addressing patient and family needs and goals without providing a cure for the underlying disease. Palliative care can be successfully provided alongside curative care, which does focus on treating the disease. Studies have indicated that palliative care offers a variety of quality of life benefits to both the patient and family. Prompted by rapid growth of hospital-based palliative care, we explored the literature to better understand the financial incentives and barriers to these programs. Although patients who receive palliative care in the hospital have lower hospital costs than matched patients who do not receive palliative care, many hospitals face challenges in being reimbursed for services rendered by their interdisciplinary teams. In some cases, hospitals may absorb 50 percent of the costs of their palliative care teams because of lack of adequate reimbursement. Despite the opportunity for cost savings for a variety of stakeholders, without payment reform hospitals may be constrained from providing palliative care to all who might benefit. Additional research is needed to understand how patients, hospitals, and payers may participate in cost savings attributable to palliative care so that policymakers can effectively promote these services.

Provides comprehensive, current information for addressing the physical, psychological, and spiritual needs of hospice patients and their families Substantially updated and expanded, the second edition of this quick-access reference for hospice nurses continues to deliver the most current information on the clinical and administrative duties of the hospice nurse. It encompasses important regulatory changes and milestones, providing timely information on cultural issues, special communication considerations, and hospice care’s enduring growth. This resource provides new content on levels of care, assessment and symptom management, and occupational stress, burnout, and self-care. New treatment guidelines and algorithms are included, as are updates on quality measures, the reimbursement schedule, compliance initiatives, and electronic documentation with specific examples. An indispensable clinical resource, the book is a valuable reference for nurses who are seeking to specialize in hospice, those who work in long-term care settings, post-acute care settings, acute care setting, and those who are seeking to enhance their knowledge of end-of-life care within other specialties. New to the Second Edition: Includes new regulatory changes/milestones, such as The National Quality Forum New Priorities for Action 2019 Provides updated information about levels of care, particularly the Last 7 Days rule from Medicare Covers the use of cannabis, non-pharmacological pain management interventions, care of the dying patient, and post-mortem care New chapters are included on the hospice nurse's role as case manager, patient discharge, religious and cultural influences on end-of-life care, pain assessment and interventions, wound care, care of the dying patient, and post-mortem care. Key Features: Reflects key competencies for the hospice nurse as designated by the Hospice and Palliative Nurses Association Delineates clinical and administrative responsibilities of the hospice nurse Simplifies complex information such as Medicare regulations and compliance Provides screening tools for depression, anxiety, and wound risk Includes the Palliative Performance Scale and the Karnofsky Performance Scale Serves as a concise study resource for certification

This book provides a robust analysis of the history of clinical ethics, the philosophical theories that support its practice, and the practical institutional criteria needed to become a practicing clinical ethicist. Featuring cases and a step-by-step approach, this book combines knowledge points associated with moral philosophy and medicine with general skill objectives for ethics consultants. The book aids in developing analytic moral reasoning skills for clinical ethicists, fostering the comprehensive education and professional development of clinical ethics consultants. In addition, it offers key components of how an ethics consultation curriculum manifest in an educational venue for clinical ethicists are illustrated. Adaptable and relevant for educating multiple disciplines in health care, this resource enables ethicists to understand the philosophical foundations and practical application of clinical ethics.

The new global cancer data suggests that the global burden has risen to 18.1 million new cases per year and 9.6 million cancer deaths per year. A number of factors appear to be driving this increase, in particular, a growing and aging global population and an increase of exposure to cancer risk factors linked to social and economic development. For rapidly-growing economies, the data suggests a shift from poverty- or infection-related cancers to those associated with lifestyles more typical in industrialized countries. There is still large geographical diversity in cancer occurrence and variations in the magnitude and profile of the disease between and within world regions. There are specific types of cancer that dominate globally: lung, female breast and colorectal cancer, and the regional variations in common cancer types signal the extent to which societal, economic and lifestyle changes interplay to deferentially impact on the profile of this most complex group of diseases. Unfortunately, despite advances in cancer care, a significant proportion of patients at home, experience sub-optimal outcomes. Barriers to successful treatment outcomes include, but are not limited to: access to oncologists in the primary health centers, non-adherence, lack of experienced oncology and palliative care nurses in the community, inadequate monitoring and the lack of training of family and pediatric physicians. Telemedicine approaches, including telephone triage/education, telemonitoring, teleconsultation and status tracking through mobile applications, have shown promise in further improving outcomes, in particular for chronic cancer patients following their hospitalization. Lessons can be learned from existing hospices in North America, the United Kingdom, Australia, Centers of Excellence in African (Uganda) and modern community services in India (Kerala). An important goal of this book is to describe and encourage professionals to develop new community programs in palliative care, which include training and empowering physicians and nurses in the community on the principles of palliative care. The Middle East Cancer Consortium (MECC) together with the American Society of Clinical Oncology (ASCO) and the American Oncology Nursing Society (ONS) have conducted multiple courses ranging from basic palliative care to more specialized training in palliative care for multiple nationalities in Europe, Asia and Africa. Our experience clearly indicates that, to promote such activities, one needs strong leadership and confirmed political will to support the endeavor. The new book will emphasize the importance of having a core of multiple stakeholders including community leaders, government, NGOs and media to be actively involved in advocating for the cause and generating public awareness. This text will provide the reader with a comprehensive understanding of the outside-of-the-hospital treatment of cancer patients by medical, paramedical and volunteer personnel. In doing so, this text will encourage the creation of new palliative care services improving upon the existing ones and stimulate further research in this field. Part 1 of the text will begin with an overview of the current state of affairs of services provided to cancer patients while being cared for by primary health centers. It will also review the current literature regarding medical and psychological-based therapy options in the community for cancer patients at different stages of their disease. Part 2 will address the unique role of the community nurse, within the framework of the multidisciplinary team treating the patient, in the attempt to provide optimal evaluation and care in very challenging situations (such as with terminal patients). Part 3 will provide insightful models of this new discipline and serve as a valuable resource for physicians, nurses, social workers and others involved in the care of cancer patients. The book will take a multidisciplinary approach, integrating clinical and environmental data for practical management to enhance the efficacy of treatment while relieving suffering. Part 4 will also discuss the application of modern technological approaches to track symptoms, quality of life, diet, mobility, duration of sleep and medication use (including pain killers) in chronic cancer patients in the community. Part 5 of the book will also be devoted to modes of developing a collaborative program between governmental and non-governmental organization sectors. This includes volunteer workers in close collaboration with medical professionals for providing emotional and spiritual support, nursing care, nutritional support and empowering family caregivers. Such a model makes palliative care in the community a “people’s movement”, thus transferring part of the responsibility and ownership to the community.

When the first edition of this book (Terminal Care Support Teams: the hospital-hospice interface, 1990) was written, there were only a few advisory palliative care teams working in hospitals. Since then the number of teams has grown rapidly. The concept of these teams in now widely accepted but there is an increased need for information about setting up a team, how they work and how effective they are. This book looks at the need for hospital- based palliative care teams and the challenges of bringing palliative care into the acute hospital setting. It reviews the needs of patients, their families and their professional carers, and also looks at the theoretical and practical problems which may be encountered. For example there is practical advice on setting up hospital-based palliative care teams, the selection of team members as well as coverage of team dynamics, and the role of the pain clinic and palliation oncology.

The effects of a disaster on healthcare can range from conditions that immediately besiege the system with large numbers of patients, to catastrophes that strain its long-term sustainability. Nurses, as frontline health professionals, must have an understanding of the situations they may face before, during and after a disaster and they must develop the skills and strategies to provide effective and immediate care. International Disaster Nursing is the first truly comprehensive and internationally focused resource to address the diversity of issues and myriad scenarios that nurses and other health personnel could encounter during a disaster event. This text defines the many roles of the nurse within a multidisciplinary team, and aids the implementation of the community's disaster plans in a crisis. With an alarming increase in the occurrence of disasters in the last decade, International Disaster Nursing is the hallmark text in the field.

Textbook of Palliative Medicine provides an alternative, truly international approach to this rapidly growing specialty. This textbook fills a niche with its evidence-based, multi-professional approach and global perspective ensured by the international team of editors and contributing authors. In the absence of an international curriculum for the study of palliative medicine, this textbook provides essential guidance for those both embarking upon a career in palliative medicine or already established in the field, and the structure and content have been constructed very much with this in mind. With an emphasis on providing a service anywhere in the world, including the important issue of palliative care in the developing nations, Textbook of Palliative Medicine offers a genuine alternative to the narrative approach of its competitors, and is an ideal complement to them. It is essential reading for all palliative care physicians in training and in practice, as well as palliative care nurses and other health professionals in the palliative care team