Physician's Guide to End-of-Life Care. (Book Reviews).Physician's Guide to End-of-Life Care Editors: Lois Snyder, JD and Timothy E. Quill, MD Publisher: American College of Physicians The American College of Physicians (ACP) is a national organization of doctors of internal medicine (internists), physicians who specialize in the prevention, detection and treatment of illnesses in adults. , 2001 The past few decades have witnessed dramatic changes in western civilization Noun 1. Western civilization - the modern culture of western Europe and North America; "when Ghandi was asked what he thought of Western civilization he said he thought it would be a good idea" Western culture . Life expectancy Life Expectancy 1. The age until which a person is expected to live. 2. The remaining number of years an individual is expected to live, based on IRS issued life expectancy tables. has increased, and acute life-threatening diseases that were once rapidly fatal are now easily treatable. On the other hand, chronic diseases are quite common especially among the older population and, in addition to gradually eroding the person's physical independence and social autonomy, tend to have a profound psycho-economic impact. Physicians are often ill-equipped to help patients and their families navigate through the stormy waters Stormy Waters may refer to:
The book is targeted to all physicians, generalists as well as specialists providing care to seriously ill patients. The book is divided into three sections. The first section discusses communication with the patients and their families including the following issues: when and how to initiate discussion about palliative care palliative care (paˑ·lē·ā·tiv kerˑ), n an approach to health care that is concerned primarily with attending to physical and emotional comfort rather ; strategies for building consensus among care providers, patient, and family when the patient is no longer able to speak; the effects of culture on the decision-making process for end-of-life decisions; and the role and responsibilities of physicians when caring or dying patients. The second section presents practical, evidence-based approaches to common end-of-life problems. Each chapter in this section presents a "real" case and is followed over a period of time to illustrate how the challenges change as patients approach death. The cases presented include advanced prostate cancer prostate cancer, cancer originating in the prostate gland. Prostate cancer is the leading malignancy in men in the United States and is second only to lung cancer as a cause of cancer death in men. , depression in a severely ill patient, delirium delirium Condition of disorientation, confused thinking, and rapid alternation between mental states. The patient is restless, cannot concentrate, and undergoes emotional changes (e.g., anxiety, apathy, euphoria), sometimes with hallucinations. , difficulties encountered while trying to decide about foregoing life-prolonging therapy in the intensive care unit, and how to address grief and bereavement Bereavement Definition Bereavement refers to the period of mourning and grief following the death of a beloved person or animal. The English word bereavement in family members. The third section reviews the legal, financial, and quality issues in end-of-life care. The book is very well written, geared at a practical level, and easy to read. The lay-out, use of titles and subtitles, different fonts, shades, and tables further enhance the readability of the book and facilitate future reference to specific parts of the book. The liberal use of "conversations" with patients and families illustrates the pitfalls to avoid, how to react to potentially embarrassing situations, and how best to approach the patients and their families. I highly recommend this book to all clinicians who provide care to patients and families facing the biggest challenge in their lives: death. |
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