Using a practical, question-and-answer approach, Evidence-Based Practice of Palliative Medicine, 2nd Edition, helps you provide optimal care for patients and families who are dealing with serious illness. This unique reference focuses on patient and family/caregiver-centered care, highlighting the benefits of palliative care and best practices for delivery. The highly practical, user-friendly format sets it apart from other texts in the field, with concise, readable chapters organized around clinical questions that you’re most likely to encounter in everyday care.
1. Cover image - p. i 2. Title page - p. ii 3. Table of Contents - p. iii 4. Copyright - p. iv 5. List of Contributors - p. v 6. Preface - p. xvii 7. Foreword - p. xviii 8. Dedication - p. xix 9. Part I: Symptom Management - p. xx 10. Section A: Pain - p. 1 11. 1. How Should Opioids Be Started and Titrated? - p. 2 12. 2. What Principles Should Guide Opioid Dose Conversions? - p. 11 13. 3. How Is Patient-Controlled Analgesia Best Used to Control Pain? - p. 19 14. 4. Which Opioids Are Safest and Most Effective in Patients With Renal or Hepatic Failure? - p. 25 15. 5. How Should Methadone Be Started and Titrated in Opioid-Naïve and Opioid-Exposed Patients? - p. 38 16. 6. What Is Neuropathic Pain and How Is It Best Managed? - p. 46 17. 7. How Are Adjuvant Medications Such as Corticosteroids and NSAIDs Used for Pain Management? - p. 53 18. 8. What Are the Approaches to Pain in Skeletal Bone Disease? - p. 61 19. 9. When and How Should Radiotherapy Be Considered for Pain Management? - p. 68 20. 10. What Principles Should Guide the Prescribing of Opioids for Noncancer Pain? - p. 78 21. 11. How Does the Opioid Epidemic Impact Palliative Medicine Practice? - p. 85 22. 12. How Does One Approach the Patient With an Opioid Use Disorder? - p. 94 23. 13. When Should Epidural or Intrathecal Medications and Pumps Be Considered for Pain Management? - p. 108 24. 14. When Should Nerve Blocks Be Used for Pain Management? - p. 115 25. Section B: Dyspnea - p. 120 26. 15. What Interventions Are Effective for Managing Dyspnea in People With Cancer? - p. 121 27. 16. What Interventions Are Effective for Managing Dyspnea in COPD? - p. 131 28. 17. What Interventions Are Effective for Managing Dyspnea in Heart Failure? - p. 138 29. Section C: Gastrointestinal - p. 146 30. 18. What Medications Are Effective in Preventing and Relieving Constipation in the Setting of Opioid Use? - p. 147 31. 19. How Should Medications Be Initiated and Titrated to Reduce Acute and Delayed Nausea and Vomiting in the Setting of Chemotherapy? - p. 155 32. 20. How Should Medications Be Initiated and Titrated to Prevent and Treat Nausea and Vomiting in Clinical Situations Unrelated to Chemotherapy? - p. 163 33. 21. What Interventions Are Effective for Relieving Acute Bowel Obstruction in Cancer and Other Conditions? - p. 171 34. Section D: Anorexia/Cachexia/Feeding Difficulties - p. 178 35. 22. What Therapies Are Effective in Improving Anorexia and Weight Loss in Cancer? - p. 179 36. 23. What Therapeutic Strategies Are Effective in Improving Anorexia and Weight Loss in Nonmalignant Disease? - p. 186 37. 24. What Is the Role of Parenteral and Enteral Nutrition in Patients With Cancer and With Noncancer Illness? - p. 192 38. Section E: Psychiatric Symptoms - p. 203 39. 25. What Treatments Are Effective for Depression in Palliative Care Settings? - p. 204 40. 26. How Are Anxiety and Fear Best Treated in Patients With Serious Illness and in Those Facing the End of Life? - p. 219 41. 27. What Is the Approach to the Patient Seeking a Hastened Death? - p. 229 42. Section F: Delirium - p. 233 43. 28. What Is Delirium and How Should It Be Managed? - p. 234 44. 29. What Are Effective Pharmacological and Nonpharmacological Treatments for Delirium? - p. 243 45. Section G: Symptoms at the End of Life - p. 247 46. 30. How Do Symptoms Change for Patients in the Last Days/Hours of Life? - p. 248 47. Part II: Communication - p. 261 48. 31. How is Prognosis Estimated and Communicated for People Facing Serious Illness? - p. 262 49. 32. What Are the Key Elements to Having a Conversation About Communicating Serious News and Setting Goals? - p. 269 50. 33. What Are the Elements of Advance Care Planning and What Is the Evidence That Advance Care Planning Changes Patient Outcomes? - p. 278 51. 34. What Are the Special Communication Issues Involved in Caring for Pediatric Patients? - p. 284 52. Part III: Disease-Specific Topics - p. 293 53. Section A: Cancer - p. 293 54. 35. What Is the Role for Palliative Care in Patients With Advanced Solid-Tumor Malignancies? - p. 294 55. 36. What Is the Clinical Course of Advanced Solid-Tumor Cancers? - p. 300 56. 37. What Is the Role for Palliative Care in Patients With Advanced Hematologic Malignancies? - p. 308 57. 38. What Is the Clinical Course of Hematologic Malignancies? - p. 316 58. 39. What Is the Role for Palliative Care in Children With Cancer? - p. 321 59. 40. What Is the Clinical Course of Pediatric Cancers? - p. 333 60. Section B: Dementia - p. 344 61. 41. What Is the Clinical Course of Advanced Dementia? - p. 345 62. 42. What Are Appropriate Palliative Interventions for Patients With Advanced Dementia? - p. 350 63. Section C: Advanced Liver Disease - p. 356 64. 43. What Are the Causes and Complications of Chronic Liver Disease and What Is the Evidence for Palliative Care Delivery to Those Affected by It? - p. 357 65. 44. What Do We Know About the Symptoms and Palliative Care Needs of People Affected by Liver Disease? - p. 371 66. Section D: Brain Function - p. 380 67. 45. What Is the Role of Palliative Care in Stroke? - p. 381 68. 46. What Special Considerations Are Needed for Individuals with Amyotrophic Lateral Sclerosis, Parkinson’s Disease, and Multiple Sclerosis? - p. 387 69. Section E: Heart Failure - p. 404 70. 47. What Is the Clinical Course of Advanced Heart Failure and How Do Implanted Cardiac Devices Alter This Course? - p. 405 71. Section F: Chronic Critical Illness - p. 413 72. 48. What Is Chronic Critical Illness and What Outcomes Can Be Expected - p. 414 73. Section G: Head and Neck Cancer - p. 424 74. 49. What Special Considerations Are Needed in Patients With Head and Neck Cancer? - p. 425 75. Section H: End-Stage Renal Disease - p. 432 76. 50. What Special Considerations Are Needed in Treating Symptoms in Patients With End-Stage Renal Disease, and How Should Patients Who Stop Dialysis Be Managed? - p. 433 77. 51. What Are Palliative Alternatives to Renal Replacement Therapy for People With Advanced Kidney Failure? - p. 444 78. Section I: Pulmonary - p. 447 79. 52. What Special Considerations Are Needed for Patients With Advanced Lung Disease? - p. 448 80. Section J: Geriatrics - p. 459 81. 53. What Are the Special Needs of Older Adults With Serious Illness? - p. 460 82. 54. What Are Multimorbidity and Frailty and How Do They Affect the Care of Older Adults? - p. 469 83. Section K: Pediatrics - p. 476 84. 55. What Are Special Considerations for Pediatric Palliative Care? - p. 477 85. 56. What Are Special Considerations for Dosing Medications in Pediatric Populations? - p. 489 86. 57. How Are Children With Developmental Diseases and Delays Best Managed in Palliative Care? - p. 494 87. 58. What Are Special Considerations for Perinatal Palliative Care? - p. 507 88. 59. What Are Special Considerations for Patients With Cystic Fibrosis? - p. 515 89. Part IV: Special Topics - p. 523 90. Section A: Palliative Care Emergencies - p. 523 91. 60. What Are the Signs, Symptoms, and Treatments of Spinal Cord Compression? - p. 524 92. 61. What Framework Can Be Used to Address Uncontrolled Symptoms at the End of Life? - p. 533 93. Section B: Financial Aspects of Palliative Care - p. 540 94. 62. What Are the Arguments That Show That Palliative Care Is Beneficial to Hospitals? - p. 541 95. 63. What Are the Arguments That Show That Outpatient Palliative Care Is Beneficial to Medical Systems? - p. 550 96. Section C: Caregivers - p. 556 97. 64. How Does Serious Illness Impact Family Caregivers? - p. 557 98. 65. What Can Be Done to Improve Outcomes for Caregivers of People With Serious Illness? - p. 566 99. 66. What Is Prolonged Grief Disorder and How Can Its Likelihood Be Reduced? - p. 574 100. Section D: Settings for Palliative Care Delivery - p. 581 101. 67. What Are Models for Delivering Palliative Care in Hospitals? - p. 582 102. 68. What Models Exist for Delivering Palliative Care and Hospice in Nursing Homes? - p. 590 103. 69. What Are the Models for Delivering Palliative Care in the Ambulatory Practice Setting? - p. 602 104. 70. What Are the Models for Delivering Palliative Care in the Home? - p. 611 105. 71. What Are the Models for Delivering Palliative Care in Rural Areas? - p. 619 106. 72. How Is Palliative Care Best Integrated Into Surgical Services? - p. 630 107. 73. What Models Exist to Deliver Palliative Care via Telemedicine? - p. 637 108. 74. What Are National Strategies and Frameworks for Palliative Care? - p. 644 109. 75. What Are Sources of Spiritual and Existential Suffering for Patients With Advanced Illness? - p. 653 110. 76. What Are the Racial and Ethnic Health Disparities That Exist in Palliative Care? - p. 659 111. 77. What Are the Palliative Care Needs of LGBTQ+ People? - p. 668 112. 78. What Is the Evidence for Integrative and Alternative Therapies in Palliative Care? - p. 678 113. 79. What Is the Evidence Supporting the Use of Mobile Health Technologies in Palliative Care? - p. 684 114. 80. How Can Clinician Well-Being Be Improved and Sustained in Palliative Care? - p. 690 115. Index - p. 699
Using a practical, question-and-answer approach, Evidence-Based Practice of Palliative Medicine, 2nd Edition, helps you provide optimal care for patients and families who are dealing with serious illness. This unique reference focuses on patient and family/caregiver-centered care, highlighting the benefits of palliative care and best practices for delivery. The highly practical, user-friendly format sets it apart from other texts in the field, with concise, readable chapters organized around clinical questions that you’re most likely to encounter in everyday care.
1. Cover image - p. i 2. Title page - p. ii 3. Table of Contents - p. iii 4. Copyright - p. iv 5. List of Contributors - p. v 6. Preface - p. xvii 7. Foreword - p. xviii 8. Dedication - p. xix 9. Part I: Symptom Management - p. xx 10. Section A: Pain - p. 1 11. 1. How Should Opioids Be Started and Titrated? - p. 2 12. 2. What Principles Should Guide Opioid Dose Conversions? - p. 11 13. 3. How Is Patient-Controlled Analgesia Best Used to Control Pain? - p. 19 14. 4. Which Opioids Are Safest and Most Effective in Patients With Renal or Hepatic Failure? - p. 25 15. 5. How Should Methadone Be Started and Titrated in Opioid-Naïve and Opioid-Exposed Patients? - p. 38 16. 6. What Is Neuropathic Pain and How Is It Best Managed? - p. 46 17. 7. How Are Adjuvant Medications Such as Corticosteroids and NSAIDs Used for Pain Management? - p. 53 18. 8. What Are the Approaches to Pain in Skeletal Bone Disease? - p. 61 19. 9. When and How Should Radiotherapy Be Considered for Pain Management? - p. 68 20. 10. What Principles Should Guide the Prescribing of Opioids for Noncancer Pain? - p. 78 21. 11. How Does the Opioid Epidemic Impact Palliative Medicine Practice? - p. 85 22. 12. How Does One Approach the Patient With an Opioid Use Disorder? - p. 94 23. 13. When Should Epidural or Intrathecal Medications and Pumps Be Considered for Pain Management? - p. 108 24. 14. When Should Nerve Blocks Be Used for Pain Management? - p. 115 25. Section B: Dyspnea - p. 120 26. 15. What Interventions Are Effective for Managing Dyspnea in People With Cancer? - p. 121 27. 16. What Interventions Are Effective for Managing Dyspnea in COPD? - p. 131 28. 17. What Interventions Are Effective for Managing Dyspnea in Heart Failure? - p. 138 29. Section C: Gastrointestinal - p. 146 30. 18. What Medications Are Effective in Preventing and Relieving Constipation in the Setting of Opioid Use? - p. 147 31. 19. How Should Medications Be Initiated and Titrated to Reduce Acute and Delayed Nausea and Vomiting in the Setting of Chemotherapy? - p. 155 32. 20. How Should Medications Be Initiated and Titrated to Prevent and Treat Nausea and Vomiting in Clinical Situations Unrelated to Chemotherapy? - p. 163 33. 21. What Interventions Are Effective for Relieving Acute Bowel Obstruction in Cancer and Other Conditions? - p. 171 34. Section D: Anorexia/Cachexia/Feeding Difficulties - p. 178 35. 22. What Therapies Are Effective in Improving Anorexia and Weight Loss in Cancer? - p. 179 36. 23. What Therapeutic Strategies Are Effective in Improving Anorexia and Weight Loss in Nonmalignant Disease? - p. 186 37. 24. What Is the Role of Parenteral and Enteral Nutrition in Patients With Cancer and With Noncancer Illness? - p. 192 38. Section E: Psychiatric Symptoms - p. 203 39. 25. What Treatments Are Effective for Depression in Palliative Care Settings? - p. 204 40. 26. How Are Anxiety and Fear Best Treated in Patients With Serious Illness and in Those Facing the End of Life? - p. 219 41. 27. What Is the Approach to the Patient Seeking a Hastened Death? - p. 229 42. Section F: Delirium - p. 233 43. 28. What Is Delirium and How Should It Be Managed? - p. 234 44. 29. What Are Effective Pharmacological and Nonpharmacological Treatments for Delirium? - p. 243 45. Section G: Symptoms at the End of Life - p. 247 46. 30. How Do Symptoms Change for Patients in the Last Days/Hours of Life? - p. 248 47. Part II: Communication - p. 261 48. 31. How is Prognosis Estimated and Communicated for People Facing Serious Illness? - p. 262 49. 32. What Are the Key Elements to Having a Conversation About Communicating Serious News and Setting Goals? - p. 269 50. 33. What Are the Elements of Advance Care Planning and What Is the Evidence That Advance Care Planning Changes Patient Outcomes? - p. 278 51. 34. What Are the Special Communication Issues Involved in Caring for Pediatric Patients? - p. 284 52. Part III: Disease-Specific Topics - p. 293 53. Section A: Cancer - p. 293 54. 35. What Is the Role for Palliative Care in Patients With Advanced Solid-Tumor Malignancies? - p. 294 55. 36. What Is the Clinical Course of Advanced Solid-Tumor Cancers? - p. 300 56. 37. What Is the Role for Palliative Care in Patients With Advanced Hematologic Malignancies? - p. 308 57. 38. What Is the Clinical Course of Hematologic Malignancies? - p. 316 58. 39. What Is the Role for Palliative Care in Children With Cancer? - p. 321 59. 40. What Is the Clinical Course of Pediatric Cancers? - p. 333 60. Section B: Dementia - p. 344 61. 41. What Is the Clinical Course of Advanced Dementia? - p. 345 62. 42. What Are Appropriate Palliative Interventions for Patients With Advanced Dementia? - p. 350 63. Section C: Advanced Liver Disease - p. 356 64. 43. What Are the Causes and Complications of Chronic Liver Disease and What Is the Evidence for Palliative Care Delivery to Those Affected by It? - p. 357 65. 44. What Do We Know About the Symptoms and Palliative Care Needs of People Affected by Liver Disease? - p. 371 66. Section D: Brain Function - p. 380 67. 45. What Is the Role of Palliative Care in Stroke? - p. 381 68. 46. What Special Considerations Are Needed for Individuals with Amyotrophic Lateral Sclerosis, Parkinson’s Disease, and Multiple Sclerosis? - p. 387 69. Section E: Heart Failure - p. 404 70. 47. What Is the Clinical Course of Advanced Heart Failure and How Do Implanted Cardiac Devices Alter This Course? - p. 405 71. Section F: Chronic Critical Illness - p. 413 72. 48. What Is Chronic Critical Illness and What Outcomes Can Be Expected - p. 414 73. Section G: Head and Neck Cancer - p. 424 74. 49. What Special Considerations Are Needed in Patients With Head and Neck Cancer? - p. 425 75. Section H: End-Stage Renal Disease - p. 432 76. 50. What Special Considerations Are Needed in Treating Symptoms in Patients With End-Stage Renal Disease, and How Should Patients Who Stop Dialysis Be Managed? - p. 433 77. 51. What Are Palliative Alternatives to Renal Replacement Therapy for People With Advanced Kidney Failure? - p. 444 78. Section I: Pulmonary - p. 447 79. 52. What Special Considerations Are Needed for Patients With Advanced Lung Disease? - p. 448 80. Section J: Geriatrics - p. 459 81. 53. What Are the Special Needs of Older Adults With Serious Illness? - p. 460 82. 54. What Are Multimorbidity and Frailty and How Do They Affect the Care of Older Adults? - p. 469 83. Section K: Pediatrics - p. 476 84. 55. What Are Special Considerations for Pediatric Palliative Care? - p. 477 85. 56. What Are Special Considerations for Dosing Medications in Pediatric Populations? - p. 489 86. 57. How Are Children With Developmental Diseases and Delays Best Managed in Palliative Care? - p. 494 87. 58. What Are Special Considerations for Perinatal Palliative Care? - p. 507 88. 59. What Are Special Considerations for Patients With Cystic Fibrosis? - p. 515 89. Part IV: Special Topics - p. 523 90. Section A: Palliative Care Emergencies - p. 523 91. 60. What Are the Signs, Symptoms, and Treatments of Spinal Cord Compression? - p. 524 92. 61. What Framework Can Be Used to Address Uncontrolled Symptoms at the End of Life? - p. 533 93. Section B: Financial Aspects of Palliative Care - p. 540 94. 62. What Are the Arguments That Show That Palliative Care Is Beneficial to Hospitals? - p. 541 95. 63. What Are the Arguments That Show That Outpatient Palliative Care Is Beneficial to Medical Systems? - p. 550 96. Section C: Caregivers - p. 556 97. 64. How Does Serious Illness Impact Family Caregivers? - p. 557 98. 65. What Can Be Done to Improve Outcomes for Caregivers of People With Serious Illness? - p. 566 99. 66. What Is Prolonged Grief Disorder and How Can Its Likelihood Be Reduced? - p. 574 100. Section D: Settings for Palliative Care Delivery - p. 581 101. 67. What Are Models for Delivering Palliative Care in Hospitals? - p. 582 102. 68. What Models Exist for Delivering Palliative Care and Hospice in Nursing Homes? - p. 590 103. 69. What Are the Models for Delivering Palliative Care in the Ambulatory Practice Setting? - p. 602 104. 70. What Are the Models for Delivering Palliative Care in the Home? - p. 611 105. 71. What Are the Models for Delivering Palliative Care in Rural Areas? - p. 619 106. 72. How Is Palliative Care Best Integrated Into Surgical Services? - p. 630 107. 73. What Models Exist to Deliver Palliative Care via Telemedicine? - p. 637 108. 74. What Are National Strategies and Frameworks for Palliative Care? - p. 644 109. 75. What Are Sources of Spiritual and Existential Suffering for Patients With Advanced Illness? - p. 653 110. 76. What Are the Racial and Ethnic Health Disparities That Exist in Palliative Care? - p. 659 111. 77. What Are the Palliative Care Needs of LGBTQ+ People? - p. 668 112. 78. What Is the Evidence for Integrative and Alternative Therapies in Palliative Care? - p. 678 113. 79. What Is the Evidence Supporting the Use of Mobile Health Technologies in Palliative Care? - p. 684 114. 80. How Can Clinician Well-Being Be Improved and Sustained in Palliative Care? - p. 690 115. Index - p. 699
