Approaching death : improving care at the end of life / Committee on Care at the End of Life, Division of Health Care Services, Institute of Medicine ; Marilyn J. Field and Christine K. Cassel, editors.

Format:

Book

Contributor:

Field, Marilyn J. (Marilyn Jane)

Cassel, Christine K.

Institute of Medicine (U.S.). Committee on Care at the End of Life.

Language:

English

Subjects (All):

Terminal care--United States.

Terminal care.

Physical Description:

1 online resource (455 p.)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1997.

Language Note:

English

Summary:

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Contents:

Front Matter; Preface; Acknowledgments; Contents; TABLES, FIGURES, AND BOXES; Summary; 1 Introduction; 2 A Profile of Death and Dying in America; 3 Caring at the End of Life; 4 The Health Care System and the Dying Patient; 5 Accountability and Quality in End-of-Life Care; 6 Financial and Economic Issues in End-of-Life Care; 7 Legal Issues; 8 Educating Clinicians and Other Professionals; 9 Directions for Research to Improve Care at the End of Life; 10 Conclusions and Recommendations; References; A Institute of Medicine Feasibility Study on Care at the End of Life1 August 1993-February 1994

B Institute of Medicine Committee on Care at the End of Life Public MeetingsC Examples of Initiatives to Improve Care at the End of Life*; D Prognosis and Clinical Predictive Models for Critically Ill Patients; E Cultural Diversity in Decisionmaking About Care at the End of Life; F Measuring Care at the End of Life; G Excerpts from Medical Guidelines for Determining Prognosis in Selected NonCancer Diseases*; H American Board of Internal Medicine Clinical Competence in End-of-Life Care*; I Examples of Medical Education Curricula; J Committee Biographies; Index

Notes:

Description based upon print version of record.

Includes bibliographical references and index.

ISBN:

9786612082177

9780309174602

0309174600

9781282082175

1282082175

9780309518253

0309518253

9780585024271

0585024278

OCLC:

817957828