Since the publication of the first edition of The Medical Care of Terminally Ill Patients, the field of palliative care has progressed significantly, both socially and scientifically. In this new edition, Dr. Robert Enck reviews the results of clinical studies devoted to the care of dying patients. Special attention is given to pain management, management of symptoms, care of advanced cancer patients, and care of patients with nonmalignant diseases. More than 100 new references, a new list of abbreviations, and tables with new drugs and dosages provides valuable information. Dr. Enck places great emphasis on enhancing the quality of life while addressing the most common symptoms of terminal illness. Praise for the first edition: ''How can we do a better job of caring for our patients at the end of life? A good start would be to buy and read Robert Enck's Medical Care of Terminally Ill Patients. This concise, easy-to-read book tells you what you need to know. The first chapter estimates duration of survival in patients with cancer, Alzheimer disease, and motor neuron diseases and is alone almost worth the price of the book, but the text holds so much more.''Annals of Internal Medicine ''An excellent book for any hospice to have for the volunteers, social workers, and physicians. For those who have taken it upon themselves to give home care, this would be an invaluable book.''AIDS Book Review Journal ''Dr. Enck does an excellent job of summarizing the relevant research. . . The author clearly has wide experience in dealing with terminal care and gives a sensitive and thorough review of the complex medical care issues involved in producing a humane death.''Family Medicine ''It is an excellent introduction for those internists, family physicians, and others unfamiliar with management of the terminally ill. It serves as a quick reference for hospice physicians, oncologists, and nursing personnel.''Hospice Journal ''The author concisely suggests treatments of commonly encountered symptoms. The book can be easily used as a quick reference, and be useful to nurses, pharmacists, and physicians in the care of patients with advanced disease.''Journal of Pharmaceutical Care in Pain and Symptom Control
Contents:
Preface to the Second Edition List of Abbreviations
1. The Prognostication of Survival Cancer Dementia Motor Neuron Disease Acquired Immunodeficiency Syndrome (AIDS) Central Nervous System Anoxia Advanced Pulmonary Disease Heart Disease Summary
I. The Management of Symptoms Common Among Dying Patients
2. General Symtoms of Dying Patients Pain Gastrointestinal Symptoms Nausea and Vomiting Anorexia and Cachexia nutritional Probllmes Hydration Constipation
Central Nervous System Symptoms Delirium Depression
3. Other Problems of Patients with Cancer Malignant Intestinal Obstruction Malignant Dysphagia Neuromuscular Dysfunction Malignant Ulceration Summary
4. Other Problems of Patients with Nonmalignant Diseases Dementia Motor Neuron Disease Acquired Immunodeficiency Syndrom (AIDS) Chronic Vegetative State Advanced Pulmonary Disease Heart Disease Summary
5. Palliative Surgery Principles of Preoperative Care Principles of Operating for Advanced Cancer Principles of Postoperative Care Indications for Surgery Summary
II. The Management of Pain
6. An Overview of Pain Management Principles of Pain Management The Ladder Approach Managing the Complications of Pain Treatment Summary
7. Opioids Oral Morphine Parenteral Opioids Alternative Routes of Administration Summary
9. Complications of Pharmacologic Therapy Opioids Nonsteroidal Anti-inflammatory Drugs Summary
10. Bone Pain Pathopysiolgoy Radiation Therapy Pharmacotherapy Summary References Index 11. Surgery and Other Nonpharmacologic Interventions to Manage PainSurgery Acupuncture Transcutaneous Electrical Nerve Stimulation Relaxation Techniqu eComplimentary/Alternative Medicine Summary III. The Management of Symptoms During the Last Few Days 12. The Final Moments Terminal Symptoms and Their Managment Drug-Induced Terminal Sedation Summary 13. Issues Concerning the Sustaining of Life Do Not Resuscitate Advance Directives Physician-Assisted Suicide and Euthanasi aSummary References Index
""We can congratulate and thank [Dr. Enck] for adding to the comfort and care of a great many of our fellow human beings as death draws near.""
