Preface xi

List of Abbreviations xii

About the companion website xiv

Part 1 Introduction 1

1 Setting the scene 2
Christine Ingleton

2 Managing the needs of family caregivers 4
Philip J. Larkin

3 Principles of effective communication 6
Alison Pilsworth and Martyn Geary

4 Advance care planning 8
Christine Ingleton

5 Delivering palliative approaches in different care contexts 10
Christine Ingleton

6 Integrated care pathways 12
Christine Ingleton

Part 2 Clinical applications 15

7 Principles of symptom management 16
Philip J. Larkin

8 Best practice in pain management 18
Pat Schofield

9 Managing pain 20
Pat Schofield

10 Complex pain problems and treatment challenges 22
Pat Schofield

11 Managing nausea and vomiting 24
Jackie Robinson

12 Managing constipation 26
Philip J. Larkin

13 Understanding depression 28
Mari Lloyd-Williams

14 Understanding delirium and confusion 30
Peter Lawlor and Katie Marchington

15 Managing myoclonus, tremors and muscle spasms 32
Jackie Robinson

16 Managing lymphoedema 34
Lorna Malcolm

17 Managing hypercalcaemia of malignancy 36
Geraldine Tracey

18 Assessing and managing oral hygiene 38
Philip J. Larkin

19 Caring for people with dysphagia 40
Philip J. Larkin

20 Managing breathlessness 42
Liz Darlison

21 Cough and haemoptysis 44
Jackie Robinson

22 Explaining and exploring cachexia, anorexia and fatigue 46
Cathy Payne

23 Continual subcutaneous infusion: using a syringe pump 48
Philip J. Larkin

24 Emergencies: superior vena cava obstruction 50
Joanna De Souza

25 Emergencies: haemorrhage 52
Joanna De Souza

26 Emergencies: malignant spinal cord compression 54
Joanna De Souza

27 Chemotherapy 56
Clare Warnock

28 Radiotherapy 58
Clare Warnock

Part 3 Palliative care for all 61

29 Palliative care approaches in heart failure 62
Gill Horne and Sarah Human

30 Palliative care approaches to chronic obstructive pulmonary disease 64
Clare McVeigh

31 Palliative care approaches in motor neurone disease 66
David Oliver

32 Palliative care approaches for people receiving dialysis 68
Rachel Lewis and Helen Noble

33 Palliative care approaches for people with progressive kidney disease: a non-dialytic pathway 70
Helen Noble and Rachel Lewis

34 Care of the patient following a stroke 72
Tony Ryan

35 Principles of palliative care for older people 74
Amanda Clarke and Paula Smith

36 Care of the person with dementia 76
Tony Ryan

37 Care for people with mental illness 78
Ann Sheridan

38 Care for people with learning disabilities 80
Dorry McLaughlin

39 Care for the homeless person 82
Brian Nyatanga

40 Care for people in prison 84
Mary Turner and Marian Peacock

Part 4 Professional roles in palliative care 87

41 Understanding rehabilitation in palliative care 88
Cathy Payne

42 The social worker 90
Niamh Finucane

43 The occupational therapist 92
Deirdre Rowe

44 The physiotherapist 94
Helena Talbot-Rice

45 Complementary and supportive therapy 96
Philip J. Larkin

46 The clinical nurse specialist 98
Liz Bryan

47 The advanced nurse practitioner 100
Geraldine Tracey

48 The nurse consultant 102
Jo Hockley

49 The chaplain 104
Mark Cobb

50 The medical consultant 106
Bill Noble

Part 5 Ethical challenges in palliative care practice 109

51 Stress in palliative care nursing 110
Liz Bryan

52 Responses to euthanasia and physician-assisted suicide 112
Joanna De Souza

53 Withholding and withdrawing life-sustaining care 114
Joanna De Souza

54 Recognising and planning for the terminal phase of life 116
Pauline Ui Dhuibhir

Part 6 Managing end-of-life care 119

55 Changing goals of care at the end of life 120
Deborah Hayden

56 Managing respiratory secretions at the end of life 122
Jackie Robinson

57 Care at the moment of death 124
Michael Connolly

58 Spiritual perspectives at the end of life 126
Mark Cobb

59 Bereavement 128
Pam Firth

Index 131