Maurie Markman, MD, Series Editor

Transcription

1 Palliative Care

2 Current Clinical Oncology Maurie Markman, MD, Series Editor For other titles published in this series, go to

3 Palliative Care A Ca s e-b a s e d Gu i d e Edited by Ja n e E. Lo i t m a n Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA Christian T. Sinclair Kansas City Hospice, Palliative Care, Kansas City, MO, USA Mi c h a e l J. Fi s c h Department of General Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

4 Editors Jane E. Loitman, MD, MS, FAAHPM Department of Neurology Washington University School of Medicine St. Louis, MO, USA Christian T. Sinclair, MD, FAAHPM Kansas City Hospice Palliative Care Kansas City, MO, USA Michael J. Fisch, MD, MPH, FACP Department of General Oncology The University of Texas M.D. Anderson Cancer Center Houston, TX, USA ISBN e-isbn DOI / Springer New York Dordrecht Heidelberg London Library of Congress Control Number: Springer Science+Business Media, LLC 2010 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Humana Press is a part of Springer Science+Business Media (

5 Preface A clinical case-based handbook has a role in general clinicians practice of caring for patients with serious or life-limiting illness. The explosion of the field of Hospice and Palliative Medicine impacts all physicians and healthcare providers. Fellowship trained specialists graduate in greater numbers annually. These and more seasoned specialists are now certified by the American Board of Medical Specialties as subspecialists. Research in this field is expanding in scope and quantity, and peer reviewed journals devoted to this work are multiplying. Moreover, peer reviewed journals in primary care and other subspecialties of medicine regularly include papers that focus on end-of-life care, quality of life issues, and symptom management. Overall then, access to clinical information necessary to care for patients with life-limiting illness is not only essential, but also increasingly available. This case-based clinical book aims to help with the actual practice of caring for patients with life-limiting illness. Numerous texts and journals exist to provide the data to inform care, yet there remains a need to find practical points and information about the practical application of the principles of palliative care. Thus, we hope that the cases, key points, and practical tips will help health care providers who are not experts already in palliative care in the care of patients with serious illness and challenging problems. Some chapters follow one patient through the course of an illness to highlight the applicability of palliative care throughout the disease process. Whether with one patient or with several patient examples, clinical aspects are highlighted. Some aspects of Hospice and Palliative Medicine remain in transition or relate to individual practice style. To put the data and other more global topics into perspective, the nature of these issues is addressed. Similarly, the less recipe-driven areas of care such as communication, the terminal state, and bereavement are included to provide a framework to approach these situations. Physicians and other healthcare providers crave data. Each section includes a brief list of papers or chapters from textbooks providing more substantive data. Hopefully, this handbook will help you provide care in the patient s room, home, or exam room and then provide further tools for exploration once back to your library, office, or computer. St. Louis, MO Kansas City, MO Houston, TX Jane E. Loitman Christian T. Sinclair Michael J. Fisch v

6 Contents Preface... 1 Global Palliative Care Issues... 1 Marissa Slaven 2 Palliative Care Communication Issues... 7 Joshua Hauser 3 Nutritional Palliative Care Issues Clay M. Anderson 4 Psychiatric Palliative Care Issues Jane E. Loitman and Teresa Deshields 5 Cardiac Palliative Care Issues David Wensel and Drew A. Rosielle 6 Pulmonary Palliative Care Issues Karin B. Porter-Williamson 7 GI Palliative Care Issues Eric Roeland and Gary Buckholz 8 Palliative Pain Issues Miles J. Belgrade 9 Palliative Wound and Skin Issues Cynthia A. Worley 10 Issues in the Last Hours Jane E. Loitman and Christian T. Sinclair Index v vii

7 Contributors Clay M. Anderson, MD Division of Hematology and Medical Oncology, Missouri Palliative Care Program and Department of Internal Medicine, Ellis Fischel Cancer Center, University of Missouri, Columbia, MO, USA Miles J. Belgrade, MD Pain and Palliative Care Center, Fairview Health Services, Minneapolis, MN, USA Gary Buckholz, MD The Institute for Palliative Medicine at San Diego Hospice, San Diego, CA, USA Teresa Deshields, PhD Psycho-Oncology Service, Alvin J. Siteman Cancer Center, St. Louis, MO, USA Michael J. Fisch, MD, MPH, FACP Department of General Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA Joshua Hauser, MD Department of Medicine, Buehler Center on Aging, Health and Society, Palliative Care and Home Hospice Program, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA Jane E. Loitman, MD, MS, FAAHPM Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA Karin B. Porter-Williamson, MD Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA Eric Roeland, MD Department of Hematology and Oncology, University of California San Diego, San Diego, CA, USA Drew A. Rosielle, MD Department of Medicine, Palliative Care Center, Medical College of Wisconsin, Milwaukee, WI, USA Christian T. Sinclair, MD, FAAHPM Kansas City Hospice and Palliative Care, Kansas City, MO, USA Marissa Slaven, MD Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, ON, Canada David Wensel, DO Hospice & Palliative Care, Mercy Medical Center North Iowa, Mason City, IA, USA Cynthia A. Worley, BSN, RN, CWOCN Division of Nursing, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA ix