End of Life Care Issues Guidebook

Front Cover
UniversityOfHealthCare, 2005 - Medical - 275 pages
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Understanding the psychological, social, and spiritual needs at the end of life is crucial for today's health care providers. The goal of this guidebook is to provide an overview of end-of-life care, with an emphasis on the team approach to care.
 

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Contents

Introduction
1
Authors
2
End of Life Care Issues Introduction
4
Hospitalized Patient
5
Hospice Patient
6
Palliative Care Services
9
Legal Issues
10
Ethical Issues
12
Voluntary Refusal
122
Removal of Ventilation
123
Organ Donation
124
The Neonatal and Pediatric Patient
125
References
127
Physiologic Changes at the End of Life
132
End of Life Care in the United States
134
Physical Assessment
135

Cultural Influences
15
Psychological Symptoms
18
Social Dynamics
20
Spiritual Dimensions
21
Symptom Management
22
Complementary and Alternative Therapy
24
Traditional Chinese Medicine
34
References
40
Pain Assessment and Management
47
Pain as a Priority
50
Pain Defined
51
Misconceptions About Pain
52
Physiology of Pain
53
Types of Pain
55
Pain Behaviors
58
Culture and Pain
60
Pain Assessment
64
Barriers to Pain Management
68
Pharmacological Management
72
NonPharmacological Management
84
Difficult Pain Problems
87
The Pediatric Patient
88
References
92
Ethical Issues
94
Ethical Theories
97
Ethical Principles
100
Analyzing Ethical Dilemmas
105
Ethics and Culture
107
The Dying Persons Bill of Rights
108
Ethical Considerations
109
Advance Directives
110
Euthanasia
113
Assisted Suicide
116
Medical Futility
117
DoNotResuscitate Orders
118
Pain Management
119
Terminal Sedation
120
The Double Effect
121
Cardiovascular System
136
Gastrointestinal System
139
Nervous System
141
Respiratory System
150
Renal System
152
Malignancies
154
HIV and AIDS
156
Common Symptoms at the End of Life
158
References
174
Death Dying and Grief
176
The Nature of Dying
178
Needs of Caregivers
181
Supportive Aspects of Care
183
The Choice to Die at Home
188
Imminent Death
189
The Grieving Process
191
Healing From Loss and Grief
194
Cultural Differences
196
References
199
Hospice and Palliative Care
201
Epidemiology of Dying and Hospice Care in the US
203
Hospice Care
204
Pain Management
206
Managing NonPain Symptoms
207
Palliative Care
210
Differences Between Hospice and Palliative Care
214
Quality of Life at the End of Life
217
Communicating Bad News
219
Goals of Care
220
Holistic Palliative Care of the Dying Child
221
References
224
End of Life Care Issues Introduction CE Test
227
Pain Assessment and Management CE Test
237
Ethical Issues CE Test
246
Physiologic Changes at the End of Life CE Test
254
Death Dying and Grief CE Test
262
Hospice and Palliative Care CE Test
269
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About the author (2005)

Co-Founder/Co-CEO, ALLEGRA Learning Solutions, LLC

M. DANIEL FARB, M.D., CEO of UniversityOfHealthCare and UniversityOfBusiness, is a leader in the field of interactive management and healthcare e-learning. He received a BA in English Literature from Yale (where he set an academic record and studied with writers like Robert Penn Warren), an M.D. from Boston University, a degree in Executive Management from the Anderson School of Business at UCLA, and is currently working on a degree at UCLA in International Trade. He is a practicing ophthalmologist. He also has received two patents in ophthalmology and is working on others, has worked with the World Health Organization in Geneva and the National Institutes of Health in Washington, D.C. He has written scientific and popular articles, and has worked as a newspaper reporter. He helped Dr. Robbins edit one of the editions of Robbins' "Pathology" textbook for readability. He wrote an article on humor for the Massachusetts Review. He has experience in theater and television, including acting, directing, and stage-managing. He has programmed his own patient records database. He has written and edited hundreds of e-learning courses. Dr. Farb is a member of the American Academy of Ophthalmology, the Union of American Physicians and Dentists, the AOJS, the American Association of Physicians and Surgeons, the American Society for Training and Development (ASTD), the E-Learning Forum, the Southern California Biomedical Council, the PDA (Parenteral Drug Association), and the Medical Marketing Association.

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