Chapter 1. The Historical Development of Hospice and Palliative Care
David A. Bennaum
The Historical Roots of Hospice
The Modern History of Hospsice
The Legislative Role in Hospice and Palliative Care
Recent Developments in Hospice and Palliative Care
The Contribution of Pharmacological Innovation
Summary
References
For Further Reading
Chapter 2. The Interdisciplinary Team
N. Elizabeth Eustler and Jeanne M. Martinez
Staff Characteristics
Interview Process for Potential Hospice Employees/Volunteers
Members of the Team
The Core Team
Ancillary Team Members
The Office Staff as Team Members
The Team in Action
Family Conferences
Office Space and Equipment
Summary
References
For Further Reading
Chapter 3. Eligibility and Reimbursement for Hospice and Palliative Care
Constance M. Dahlin
Insurance
Eligibility for Hospice
Eligibility for Palliative Care
Hospice Reimbursement
Palliative Care Reimbursement
Physician Services Reimbursement
Advanced Practice Nurse (APN) Services Reimbursement
Summary
References
For Further Reading
Chapter 4. Hospice/Palliative Care Settings
Judith A. Kitzes, Betty L. Schmoll, Carol E. Dixon
Levels of Care
Additional Non-Medical Levels ofCare
Service Settings
Summary
References
Chapter 5. Continuous Quality Improvement (CQI) in Hospice
Michele Y. Lee
Assessment of Quality
Goals and Standards
The CQI Process
Data Collection and Analysis
Barriers to Implementation
Summary
References
Chapter 6. Communication at the End of Life
Jacqueline Mauk
Principles of Human Communication
The Importance of Good Communication at the End of Life
Barriers to Good Communication
Practical Aspects of Communicating at the End of Life
Breaking Bad News
Assessing for Suicide Potential
Summary
References
Chapter 7. Ethical Issues in Hospice Care
David Barnard
Expectations of Patients, Family, and Team
Advance Directives
Physician-Assisted Suicide and Euthanasia
Summary
References
Chapter 8. Legal Issues in Hospice and Palliative Care
Lynn McKeever
Introducing the Common Law
What Is a Right and Where Does it Come From?
The Common Law Rights of Patients, Plus One More
Documenting the Exercise of Patient Rights: A Guide to Forms
Dealing with Proxy Decision-Makers
Managing the Flow of Legally-Significant Documents and Conversation
References
Resources
Chapter 9. Spiritual Care of the Dying Person
Constance B. McPeak
Exploration of Purpose and Meaning
Relationship Work: Saying Goodbye
The Return of Essence
Summary
References
For Further Reading
Chapter 10. General Issues: Fatigue, Dyspnea, and Constipation
Diletta M. Renier-Berg
Asthenia (Fatigue)
Pharmacological Therapy
Psychological Distress
Treatment
General Matters
Dyspnea
Constipation
Summary
Further Reading
Chapter 11. Principles of Pain Management
Marijo Letizia
Etiology of Pain
Assessment of Pain
Barriers to Pain Management
Misconceptions about Pain
Overview of Approaches to Pain Management
Nonpharmacologic Approaches to Pain Management
Summary
Further Reading
Resources
Pain Guidelines from the Agency of Health Research and Quality
Initial Pain Assessment Tool
Brief Pain Inventory (Short Form)
Memorial Pain Assessment Card
Chapter 12. Pharmacotherapy for Chronic Pain
Robert P. Anderson
Nonopioid Analgesics
Opioid Analgesics
Adjuvant Medications
Further Reading
Chapter 13. Cultural Competence in Hospice and Palliative Care
Polly Mazanac and Judith A. Kitzes
Cultural Competence
Hospice and Palliative Care Issues Influenced by Culture
Summary
References
Chapter 14. Palliation in Noncancer Disease
Brad Stuart
The Challenges of Prognostic Uncertainty
Severity Indicators
Treatment Considerations
Summary
References
Chapter 15. Grief and Bereavement Issues in Hospice/Palliative Care
M. Murray Mayo
Literature Review
End-of-Life Model
Search Results
Future Directions and Conclusions
References
Chapter 16. Care of the Patient as Death Approaches in the Hospice/Palliative Care Setting
Walter B. Forman and Denice Kopchak Sheehan
General Issues
Symptoms at End of Life
Symptoms
General Treatment Planning
Summary
References
Chapter 17. Education and Family Support
Diana Longeway
Definition of Terms
Hospice and Interdisciplinary Team
Breaking Bad News
When Do We Begin To Die?
Window of Time
Advance Directives
Types of Support
Bereavement Support
Travel and Quality of Life
Funeral/Memorial Planning
Summary
References
For Further Reading
Chapter 18. Solving Issues in Hospice/Palliative Care through the Use of Case Problems
Walter B. Forman
Case Problem 1: Is This Person Eligible for Hospice Medicare Benefit?
Case Problem 2: Planning for the Future
Case Problem 3: Pain in the Person with Cancer
Case Problem 4: A Person with Bowel Obstruction
Further Reading
Chapter 19. The Information Superhighway and Palliative Care
Dennis Pacl
Informatics and the Electronic Medical Record
The Electronic "Curbside Consult"
Security and Privacy
Health Information on the Internet
Internet Resources for the Palliative Care Professional
Handheld Computers: Distance Insensitive Computing
Clinical Implications
Summary
Appendix
Chapter 20. Community Resources for Hospice/Palliative Care Patients
N. Elizabeth Eustler
Social Workers
Further Reading
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