Download or read book The Challenges and Opportunities of Advance Care Planning written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2022-01-20 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Advance Care Planning(ACP)has long been a staple of caring for people with serious illness. Over its history, it has been defined in different ways. Clinicians, researchers, patients, and the public have developed a variety of perspectives about the many aspects of ACP, ranging from the definition to the timing, goals, outcomes, and value of ACP. To better understand the challenges and opportunities for ACP, acknowledge and highlight divergent viewpoints, and examine what is empirically known and not known about ACP and its outcomes, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a virtual public workshop, Advance Care Planning: Challenges and Opportunities, on October 26 and November 2, 2020. The workshop explored the paradox of ACP, its evidence base, ways to think differently about ACP, and various approaches to making it more effective.This Proceedings of a Workshop summarizes the presentations and discussions from that workshop.
Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Advance Care Planning written by Leah Rogne, Ph.D. and published by Springer Publishing Company. This book was released on 2013-07-29 with total page 402 pages. Available in PDF, EPUB and Kindle. Book excerpt: Print+CourseSmart
Download or read book Advance Care Planning in End of Life Care written by Keri Thomas and published by Oxford University Press. This book was released on 2018 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: ACP is an essential part of end of life care with patients improving their chances of 'a good death' by creating plans with their families and carers. This new edition gives a comprehensive overview of ACP, explores a wide range of issues and practicalities in providing end of life care, and offers a worldwide perspective.
Download or read book Advance Care Planning written by Leah Rogne, PhD and published by Springer Publishing Company. This book was released on 2013-07-29 with total page 401 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This is a very substantive book that encompasses the various aspects of advance care planning, both prior to and after a diagnosis of a life-limiting disease. The realistic case studies help readers understand the complexities of decision-making by the individual and the family."--Doody's Medical Reviews While advance directives hold a great deal of promise for ensuring self-determination and quality of life near its end, the majority of Americans face life-threatening illness without having completed effective advance care planning.. This volume recounts the history of advance directives, chronicling the evolution of an approach that initially focused on completing forms, to one that now emphasizes more comprehensive strategies for facilitating conversations about end-of-life care and planning for dying and death. It provides helpful strategies for initiating and guiding discussions among providers, patients, and their loved ones, easing the burdens of uncertainty, and improving the efficacy of surrogate decision making near the end of life. Scholars and practitioners from a variety of disciplines provide a well-rounded view of the history and challenges of advance directives. Authors include palliative care physicians, nurses, social workers, grief counselors, educators, lawyers, psychologists, sociologists, and medical ethicists. The book shares successful strategies on how effective advance care planning can provide smoother transitions at the end of life and ensure better quality of living before death. It incorporates effective multidisciplinary, relationship-based models of advance care planning along with multidisciplinary perspectives to help caregiving professionals initiate conversations and disseminate relevant information to patients and their loved ones and advocates. Case studies illustrate the importance of, challenges with, and prospects for advance directives and advance care planning. The book addresses common barriers to advance care planning and offers ways to overcome them, as well as detailing public health, legal, and comprehensive community planning approaches to change how our current American society deals with dying, death, and end-of-life care. Key Features: Introduces a multidisciplinary, pragmatic approach to advance care planning Addresses strategies to reform advance care planning Presents case studies illustrating the importance, benefits, and challenges of advance directives Features successful initiatives in advance care planning and new directions that shift community practice related to dying, death, and end-of-life care. Includes the contributions of physicians, grief counselors, medical ethicists, social workers, psychologists, medical ethicists, lawyers, nurses, educators, and others
Download or read book Meeting the Needs of Older Adults with Serious Illness written by Amy S. Kelley and published by Springer. This book was released on 2014-09-01 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.
Download or read book Adult Congenital Heart Disease written by Michael A. Gatzoulis and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: Congenital heart disease with its worldwide incidence of 1% is themost common inborn defect. Increasingly, patients are living intoadulthood, with ongoing congenital heart and other medical needs.Sadly, only a small minority have specialist follow-up. However,all patients see their family doctor and may also seek advice fromother health professionals. This practical guide with its straightforward a,b,c approach iswritten for those professionals. Special features of this book: • Introduces the principles of congenital heart diseaseand tells you whom and when to refer for specialist care • Discusses common congenital heart lesions in a practical,easy-to-follow way, with an emphasis on diagnosis and managementissues • Includes an extensive chapter on 'Pregnancy andContraception' (by Philip J. Steer), essential both for familyplanning and for managing safely the pregnant woman with congenitalheart disease • Includes chapters on non-cardiac surgery and lifestyleissues such as work, insurability, travel and driving • Provides invaluable information on dealing with commonemergencies; what to do and what not to do With a wealth of illustrations (including diagrams, EKGs, CXRs,Echos and cardiac MRIs) and with key point tables, this is anessential guide for all health care professionals managing patientswith adult congenital heart disease.
Download or read book A Field Manual for Palliative Care in Humanitarian Crises written by Elisha Waldman and published by Oxford University Press. This book was released on 2019-11-11 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Deciding to Engage in Advance Care Planning written by Karen Joy Vander Laan and published by . This book was released on 2007 with total page 462 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Neuropalliative Care written by Claire J. Creutzfeldt and published by Springer. This book was released on 2018-10-01 with total page 312 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive guide thoroughly covers all aspects of neuropalliative care, from symptom-specific considerations, to improving communication between clinicians, patients and families. Neuropalliative Care: A Guide to Improving the Lives of Patients and Families Affected by Neurologic Disease addresses clinical considerations for diseases such as dementia, multiple sclerosis, and severe acute brain injury, as well discussing the other challenges facing palliative care patients that are not currently sufficiently met under current models of care. This includes methods of effective communication, supporting the caregiver, how to make difficult treatment decisions in the face of uncertainty, managing grief, guilt and anger, and treating the pain itself. Written by leaders in the field of neuropalliative care, this book is an exceptional, well-rounded resource of neuropalliative care, serving as a reference for all clinicians caring for patients with neurological disease and their families: neurologists and palliative care specialists, physicians, nurses, chaplains, social workers, as well as trainees in these areas.
Download or read book Implementing Quality Measures for Accountability in Community Based Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-11 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: Millions of Americans of all ages face the challenge of living with serious illnesses such as advanced cancer, heart, or lung disease. Many people with serious illness are increasingly cared for in community settings. While the number of community-based programs to provide care for those with serious illness has grown significantly, the quality of care provided is not consistent across geographic locations or care settings. Care for the serious illness population often features gaps in coordination across sites of care and poor patient and family perceptions as to the quality of care provided. In an effort to better understand and facilitate discussions about the challenges and opportunities related to identifying and implementing quality measures for accountability purposes in community-based serious illness care, the National Academies of Sciences, Engineering, and Medicine held a public workshop on April 17, 2018, in Washington, DC. Workshop participants explored the current state of quality measurement for people with serious illness, their families, and caregivers, with the aim of identifying next steps toward effectively implementing measures to drive improvement in the quality of community-based care for those facing serious illness. This publication summarizes the presentations and discussions from the workshop.
Download or read book Compassionate Communities written by Klaus Wegleitner and published by Routledge. This book was released on 2015-06-26 with total page 257 pages. Available in PDF, EPUB and Kindle. Book excerpt: Compassionate communities are communities that provide assistance for those in need of end of life care, separate from any official heath service provision that may already be available within the community. This idea was developed in 2005 in Allan Kellehear’s seminal volume- Compassionate Cities: Public Health and End of Life Care. In the ensuing ten years the theoretical aspects of the idea have been continually explored, primarily rehearsing academic concerns rather than practical ones. Compassionate Communities: Case Studies from Britain and Europe provides the first major volume describing and examining compassionate community experiments in end of life care from a highly practical perspective. Focusing on community development initiatives and practice challenges, the book offers practitioners and policy makers from the health and social care sectors practical discussions on the strengths and limitations of such initiatives. Furthermore, not limited to providing practice choices the book also offers an important and timely impetus for other practitioners and policy makers to begin thinking about developing their own possible compassionate communities. An essential read for academic, practitioner, and policy audiences in the fields of public health, community development, health social sciences, aged care, bereavement care, and hospice & palliative care, Compassionate Communities is one of only a handful of available books on end of life care that takes a strong health promotion and community development approach.
Download or read book Pediatric Palliative Care written by Betty Ferrell and published by . This book was released on 2016 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.
Download or read book The Challenge of Palliative Psychology Across the Lifespan Between New Health Emergencies and Paradigm Shifts written by Ines Testoni and published by Frontiers Media SA. This book was released on 2022-11-17 with total page 203 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Chronic Kidney Disease Dialysis and Transplantation E Book written by Jonathan Himmelfarb and published by Elsevier Health Sciences. This book was released on 2018-11-06 with total page 768 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contains expanded content on economics and outcomes of treatment, as well as acute kidney injury. Covers hot topics such as the genetic causes of chronic kidney disease, ethical challenges and palliative care, and home hemodialysis. Discusses the latest advances in hypertensive kidney disease, vitamin D deficiency, diabetes management, transplantation, and more. Provides a clear visual understanding of complex information with high-quality line drawings, photographs, and diagnostic and treatment algorithms.
Download or read book Advance Care Planning written by Laura Charlotte Prater and published by . This book was released on 2018 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advance Care Planning (ACP) refers to the communication of decisions regarding end-of-life treatment decisions prior to incapacitation. ACP has been associated with better health outcomes at the end of life such as less aggressive care prior to death, improved bereavement outcomes, earlier acceptance of a terminal condition and earlier acceptance of palliative care and hospice. The completion and documentation of ACP in the Electronic Health Record (EHR) is important so that end-of-life treatment decisions can be honored when patients are unable to speak for themselves. This process is multi-faceted and burdened with inconsistencies. Through three related studies, this dissertation used Donabedian's Structure, Process, and Outcome model as a framework for understanding the problem. Study one focused on the structural component of the EHR as it relates to the functionality and documentation of ACP. Results from a survey of over 400 end-of-life physicians indicated a mutual understanding of the importance of ACP documentation in the EHR coupled with critical challenges. Specific challenges included a lack of time and training. Having a consistent tab or area within the EHR was cited as a specific opportunity for facilitating the completion of ACP in the EHR. Study two analyzed the association between several process-related predictors and the completion of ACP documentation in the EHR. Findings indicated that older adults (over age 70) were less likely to have several process-related components of ACP and more likely to operationalized elements of ACP such as a verified Do Not Resuscitate (DNR) order. These findings indicate that there may be a gap in comprehensive communication with older adults, and they are more likely to have a DNR without documentation of a prior conversation or a scanned document in the medical record. Study three examined the association between outcomes and the documentation of ACP in the EHR. Findings indicate that having a DNR documented in the EHR and having an ACP note in the problem list are associated with reduced odds of an admission in the last 30 days of life. Having ACP documentation in the EHR was not associated with reduced charges at the end of life. The results of this dissertation may be used to strengthen the case that improvement in the documentation and functionality of ACP in the EHR is required. There are several key practical considerations resulting from these studies that could be applied in the form of local quality improvement initiatives aimed at improving consistency in documentation. Other implications from these studies point toward continuing to support efforts to reimburse physicians for ACP conversations and improving standardized end-of-life communication training requirements for all clinicians.
Download or read book The Conversation written by Angelo E. Volandes and published by Bloomsbury Publishing USA. This book was released on 2015-01-13 with total page 241 pages. Available in PDF, EPUB and Kindle. Book excerpt: "There is an unspoken dark side of American medicine--keeping patients alive at all costs. Two thirds of Americans die in healthcare institutions tethered to machines and tubes, even though research indicates that most prefer to die at home in comfort, surrounded by loved ones. The question How do you want to live? must be posed to the seriously ill because they deserve to choose. If doctors explain options--including the choice to forego countless medical interventions that are often of little benefit--then patients can tell doctors how they wish to spend the remainder of their lives. A doctor's heroic efforts to prolong a life can instead prolong that patient's death, and these traumatic measures also bankrupt the healthcare system. One third of the Medicare budget is spent on the last six months of life, often on technological interventions that are not helpful and inflict more suffering. Through the stories of six patients and six very different end-of-life experiences, Volandes explores the trajectory of events and treatments that occur with and without this essential conversation. He argues for a radical re-envisioning of the patient-doctor relationship--including videos to spark discussions--and offers ways for patients and their families to talk about this difficult issue to ensure that patients will be at the center and in charge of their medical care"--Provided by publisher.
