Palliative care has evolved rapidly in recent years. Not only is the field dealing with an increasingly elderly and multi-morbid population, it is also addressing a wider variety of complex diagnoses such as heart failure, renal failure, advanced lung disease, frailty, and dementia. Challenging Cases in Palliative Care is unique, as it uses examples of real-world cases from palliative care practices. It also includes expert commentary to support modern clinicians in managing the messiness of clinical care, as well as the increasingly complex needs of patients today. As part of our Challenging Cases series, the cases in this book not only cover a range of physical and psychosocial problems seen in palliative care, they also reflect the core curriculum for UK speciality trainees. Each case brings together expert interpretation of the available evidence, management strategies, guidelines and best practice, while discussing complexities in clinical decision-making and controversies in approach.
1. Pain Management; Cancer-related bone pain; Cancer-related neuropathic pain; Interventional pain; Pain in people with drug dependence; Chronic non-cancer pain; 2. Management of symptoms in advanced illness; Breathlessness; Nausea, vomiting and hiccups; Cancer cachexia; Palliative bowel obstruction; Pruritis; Mouth care; Constipation; Diarrhoea; 3. Management of the dying patient; Clinical uncertainty and prognostication; De-escalation from ITU; Community patient transferred into ED/AMU - rapid assessment and decision-making; Prescribing review; Co-ordination and transfer of care; Giving remote advice to families and other professional providers; What to expect with death at home; Individualised end of life care plans; 4. Interface between palliative care and mental health; Depression in the context of life-limiting illness; Hoarding; Delirium; Dementia; Learning disabilities; Serious mental health and the palliative care patient, including patients under section; 5. Challenging physiology/physical conditions; Symptom management in organ failure (renal failure); Rigidity; Sialorrhoea; Frailty/multi-morbidity; Diabetic management at end of life; Palliative management of malignant spinal cord compression (MSCC); Seizures; 6. Personalised palliative care; Care planning and goal setting; Advance care planning; Pandemics and disaster response; Spiritual care; Cultural care; Supportive care/survivorship; Specific challenges: homelessness; Transition from childrens to adult palliative care; Developing compassionate communities; Bereavement; 7. Legal considerations; A desire for hastened death; Treatment escalation plans and CPR decisions; Withdrawal of treatment; Autonomy in children;
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