CASE STUDIES IN PALLIATIVE AND END-OF-LIFE CARE

Contributor List viii
Introduction xii
• Section 1 Communication Case Studies 1
Case 1.1 Comsmunicating about a Progressive Diagnosis and Prognosis 5
Case 1.2 Diagnosis/Prognosis Uncomplicated Death at Home 12
Case 1.3 Accommodating Religiosity and Spirituality in Medical Decision-Making 18
Case 1.4 Discussing Cardiopulmonary Resuscitation When it May Be Useful 26
Case 1.5 Discussing CPR When it is a Non-Beneficial Intervention 33
Case 1.6 Discussing Brain Death, Organ Donation, and Donation after Cardiac Death 41
Case 1.7 Discussing Physiological Futility 52
Case 1.8 Wounded Families: Decision-Making in the Setting of Stressed Coping and Maladaptive Behaviors in Health Crises 60
Case 1.9 Notification of an Expected Death 68
Case 1.10 Death Notification after Unexpected Death 73
• Section 2 Symptom Management Case Studies 83
Case 2.1 Pain: Cancer in the Home 87
Case 2.2 Treating an Acute, Severe, Cancer Pain Exacerbation 98
Case 2.3 Pain and Advanced Heart Failure 104
Case 2.4 Dyspnea and Advanced COPD 110
Case 2.5 Dyspnea and Heart Failure 117
Case 2.6 Treating Dyspnea during Ventilator Withdrawal 128
Case 2.7 Cough Associated with COPD and Lung Cancer 138
Case 2.8 Hiccups and Advanced Illness 145
Case 2.9 Treating Nausea Associated with Advanced Cancer 152
Case 2.10 Nausea Associated with Bowel Obstruction 161
Case 2.11 Nausea Related to Uremia, Dialysis Cessation 168
Case 2.12 Opioid-Induced Pruritus 176
Case 2.13 Pruritus in End-Stage Renal Disease 183
Case 2.14 Opioid-Induced Constipation 190
Case 2.15 Depression in Advanced Disease 198
Case 2.16 Treating Anxiety 205
Case 2.17 Terminal Secretions 213
Case 2.18 Fungating Wounds and the Palliative Care Patient 220
Case 2.19 Pressure Ulcer Care in Palliative Care 229
Case 2.20 Treating Ascites 239
Case 2.21 Delirium Management in Palliative Care 247
• Section 3 Family Care Case Studies 257
Case 3.1 Caring for the Family Expecting a Loss 259
Case 3.2 Anticipatory Grief and the Dysfunctional Family 266
Case 3.3 Acute and Uncomplicated Grief after an Expected Death 277
Case 3.4 Bereavement after Unexpected Death 289
Case 3.5 Complicated Grief 300
Index 309

Case Studies in Palliative and End-of-Life Care uses a case-based approach to provide students and practitioners with an important learning tool to improve critical thinking skills and encourage discussion toward improving experiences for patients and their families.
The book is organized into three sections covering subjects related to communication, symptom management, and family care. Each case is presented in a consistent, logical format for ease of use, highlighting key evidence-based concepts including the case history, care setting, diagnosis and prognosis, assessment, treatment considerations, and family support.
A key reference, Case Studies in Palliative and End-of-Life Care is an invaluable resource for clinicians who provide palliative care to patients with life-limiting illnesses and those at the end of life along with their families.

Features
• Includes more than 35 cases covering a range of palliative and end-of-life care subjects
• Emphasizes care of the family as well as the patient
• Easy to follow, structured format for each case
• Written by experts in the field

Author
Margaret L. Campbell, PhD, RN, FPCN is Associate Professor – Research in the Office for Health Research at the College of Nursing at Wayne State University in Detroit, Michigan.