This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author’s research-based CARES Tool, a reference that synthesizes five key elements demonstrated to enable a peaceful death as free from suffering as possible: Comfort, Airway Management, Management of Restlessness and Delirium, Emotional and Spiritual Support, and Self-Care for Nurses. The book describes step-by-step how nurses can easily implement the basic tenets of the CARES Tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible.

A milestone resource for palliative care nurses that facilitates evidence-based compassionate and humanistic care of the dying "A valuable contribution to the evolving field of palliative nursing care. It is authored by a model for this field, Bonnie Freeman, and brings to the bedside what her practice embodies--evidence-based clinically expert care...The CARES tool is a long-needed resource and we are all grateful to the author for moving her passion to paper. It will touch the lives and deaths of patients, families, and the nurses who care for them." --Betty Ferrell, PhD, RN, MA, FAAN, FCPN, CHPN Professor and Director, Division of Nursing Research and Education City of Hope National Medical Center From the Foreword This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author's research-based CARES tool; a reference that synthesizes five key elements demonstrated to enable a peaceful death, as free from suffering as possible: comfort, airway management, management of restlessness and delirium, emotional and spiritual support, and selfcare for nurses. The book describes, step by step, how nurses can easily implement the basic tenets of the CARES tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible. The book identifies the most common symptom management needs in dying patients and describes, in detail, the five components of the CARES paradigm and how to implement them to enable a peaceful death and minimize suffering. It includes palliative care prompts founded on 29 evidence-based recommendations and the National Consensus Project for Palliative Care Clinical Practice Guidelines. The resource also addresses the importance of the nurse to act as a patient advocate, how to achieve compassionate communication with the patient and family, and barriers and challenges to compassionate care. Case studies emphasize the importance of compassionate nursing care of the dying and how it can be effectively achieved. Key Features: Provides nurses with a clear understanding of the most common needs of the dying and supplies practical applications to facilitate and improve care Clarifies the current and often complex literature on care of the dying Includes case studies illustrating the most common needs of dying patients and how these are addressed effectively by the CARES tool Based on extensive evidence as well as on the National Consensus Project for Palliative Care Clinical Practice Guidelines

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.

This sensitively written book offers a wealth of insight and practical advice for nurses in every specialty and setting providing end-of-life care. Nurses will learn how to address patients' spiritual concerns, ensure that physical needs are met, help patients maintain their dignity, and provide emotional support to grieving families. Nurses will also learn how to cope with their own feelings about dying and end-of-life care. Coverage includes stages of dying, nursing interventions for palliative care, pain control, alternative therapies, physical and psychological signs of grieving, and more. Vignette insights from the well-known end-of-life specialist Joy Ufema offer advice on giving compassionate care.

Working as an emergency room nurse, Margaret Coberly came in contact with death on a daily basis. However, it wasn't until her own brother was diagnosed with terminal cancer that she realized she understood very little about the emotional and spiritual aspects of caring for the terminally ill. To fill this gap she turned to the unique wisdom on death and dying found in Tibetan Buddhism. In this book Coberly offers sound, practical advice on meeting the essential needs of the dying, integrating stories from her long career in nursing with useful insights from the Tibetan Buddhist teachings. In the West, death is viewed as a tragic and horrible event. Coberly shows us how this view generates fear and denial, which harm the dying by adding unnecessary loneliness, confusion, and mental anguish to the dying process. Tibetan Buddhism focuses on the nature of death and how to face it with honesty, openness, and courage. In this view, death is not a failure, but a natural part of life that, if properly understood and appreciated, can offer the dying and their loved ones an opportunity to gain valuable insight and wisdom. Coberly argues that the Tibetan Buddhist outlook can be a useful antidote to the culture of fear and denial that surrounds death in the West and can help caregivers become more fully present, fearless, honest, and compassionate. Sacred Passage highlights two very practical teachings on death and dying from the Tibetan Buddhist tradition and presents them in clear, nontechnical language. Readers learn about the "eight stages of dissolution leading to death," a detailed roadmap of the dying process that describes the sequence of physical, psychological, and spiritual changes that occur as we die. Coberly also presents the "death meditation," a contemplative exercise for developing a new relationship to death—and life. The book also includes a lengthy, annotated list of recommended readings for added guidance and inspiration. Topics include: • How the terminally ill can experience emotional and spiritual healing even when they can't be cured • Why Western medicine's relentless focus on curing disease has led to inadequate care for the dying • What to expect during the dying process • How our fear and denial of death harm the dying • Techniques to help caregivers promote a peaceful environment for the dying and their loved ones • How to meet the changing physical and emotional needs of the dying • Helpful advice on what to say and how to behave around the terminally ill Registered nurses can earn Continuing Education Units (CEUs) by passing a written test based on this book. For more information, see http://www.shambhala.com/sacredpassage.

Originally published as a series of articles in Missouri medicine.