For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Caring for the Dying describes a whole new way to approach death and dying. It explores how the dying and their families can bring deep meaning and great comfort to the care given at the end of a life. Created by Henry Fersko-Weiss, the end-of-life doula model is adapted from the work of birth doulas and helps the dying to find meaning in their life, express that meaning in powerful and beautiful legacies, and plan for the final days. The approach calls for around-the-clock vigil care, so the dying person and their family have the emotional and spiritual support they need along with guidance on signs and symptoms of dying. It also covers the work of reprocessing a death with the family afterward and the early work of grieving. Emphasis is placed on the space around the dying person and encourages the use of touch, guided imagery, and ritual during the dying process. Throughout the book Fersko-Weiss tells amazing and encouraging stories of the people he has cared for, as well as stories that come from doulas he has trained and worked with over the years. What is unique about this book is the well-conceived and thorough approach it describes to working skillfully with the dying. The guidance provided can help a dying person, their family, and caregivers to transform the dying experience from one of fear and despair into one that is uplifting and even life affirming. You will see death in a new light and gain a different perspective on how to help the dying. It may even change the way you live your life right now.

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Although the need for improved care for dying patients is widely recognized and frequently discussed, few books address the needs of the physicians, nurses, social workers, therapists, hospice team members, and pastoral counselors involved in care. Care of the Dying Patient contains material not found in other sources, offering advice and solutions to anyone—professional caregiver or family member—confronted with incurable illness and death. Its authors have lectured and published extensively on care of the dying patient and here review a wide range of topics to show that relief of physical suffering is not the only concern in providing care. This collection encompasses diverse aspects of end-of-life care across multiple disciplines, offering a broad perspective on such central issues as control of pain and other symptoms, spirituality, the needs of caregivers, and special concerns regarding the elderly. In its pages, readers will find out how to: effectively utilize palliative-care services and activate timely referral to hospice, arrange for care that takes into account patients’ cultural beliefs, and respond to spiritual and psychological distress, including the loss of hope that often overshadows physical suffering. The authors especially emphasize palliative care and hospice, since some physicians fear that such referrals may be viewed by patients and families as abandonment. They also address ethical and legal risks in pain management and warn that fear of overprescribing pain medication may inadvertently lead to ineffective pain relief and even place the treating team at risk of liability for undertreatment of pain. While physicians have the ability to treat disease, they also help to determine the time and place of death, and they must recognize that end-of-life choices are made more complex than ever before by advances in medicine and at the same time increasingly important. Care of the Dying Patient addresses some of the challenges frequently confronted in terminal care and points the way toward a more compassionate way of death.

The new edition of this successful book has been up-dated to incorporate recent advances in both approach to, and treatment of, the terminally ill. Based on many years of monitoring clinical practice and research at St Christopher's Hospice, Dame Cicely Saunders presents practical, balanced advice on the general ethical and medical principles of caring for dying patients. This will continue to be an invaluable handbook for all hospice physicians and nurses as a compassionate source of factual information.

As humanitarian aid organizations have evolved, there is a growing recognition that incorporating palliative care into aid efforts is an essential part of providing the best care possible. A Field Manual for Palliative Care in Humanitarian Crises represents the first-ever effort at educating and providing guidance for clinicians not formally trained in palliative care in how to incorporate its principles into their work in crisis situations. Written by a team of international experts, this pocket-sized manual identifies the needs of people affected by natural hazards, political or ethnic conflict, epidemics of life-threatening infections, and other humanitarian crises. Later chapters explore topics including pain management, skin conditions, non-communicable diseases, palliative care emergencies, the law and ethics of end of life care, and more. Concise and highly accessible, this manual is an ideal educational tool pre-deployment or during fieldwork for clinicians involved in planning and providing humanitarian aid, local care providers, and medical trainees.