Reflections on Palliative Care

Palliative care seems set to continue its rapid development into the early years of the 21st century. From its origins in the modern hospice movement, the new multidisciplinary specialty of palliative care has expanded into a variety of settings. Palliative care services are now being provided in the home, in hospital and in nursing homes. There are moves to extend palliative care beyond its traditional constituency of people with cancer. Efforts are being made to provide a wide range of palliative therapies to patients at an early stage of their disease progression. The evidence-base of palliative care is growing, with more research, evaluation and audit, along with specialist programmes of education. Palliative care appears to be coming of age. On the other hand, numbers of challenges still exist. Much service development has been unplanned and unregulated. Palliative care providers must continue to adapt to changing patterns of commissioning and funding services. The voluntary hospice movement may feel its values threatened by a new professionalism and policies which require its greater integration within mainstream services. There are concerns about the re-medicalization of palliative care, about how an evidence-based approach to practice can be developed, and about the extent to which its methods are transferring across diseases and settings. Beyond these preoccupations lie wider societal issues about the organization of death and dying in late modern culture. To what extent have notions of death as a contemporary taboo been superseded? How can we characterize the nature of suffering? What factors are involved in the debate surrounding end of life care ethics and euthanasia? David Clark and Jane Seymour, drawing on a wide range of sources, as well as their own empirical studies, offer a set of reflections on the development of palliative care and its place within a wider social context. Their book will be essential reading to any practitioner, policy maker, teacher or student involved in palliative care or concerned about death, dying and life-limiting illness.

ISBN 0335194540   Pages 224 ISBN13 9780335194544 (What's this?)   Volumes 1 Publisher Open University Press   Weight (grammes) 360 Imprint Open University Press   Published in Milton Keynes Format Paperback   Series editor Clark, David Publication date 01 Dec 1998   Series title Facing Death Non-book description 224   Height (mm) 228 Library of Congress R726.8.C54   Width (mm) 154 DEWEY 362.175   Spine width (mm) 15 DEWEY edition DC21   Academic level General

		Series editor's preface
		Notes on the authors
		Acknowledgements
		Introduction		1
Pt. I		Death in society		3
1		The social meaning of death and suffering		8
2		Ageing, dying and grieving		24
3		The ethics of dying		47
Pt. II		The philosophy and practice of palliative care		59
4		History and development		65
5		Definitions, components, meanings		79
6		Routinization and medicalization		104
Pt. III		Policy issues		125
7		Policy development and palliative care		131
8		The delivery of palliative care services		151
Pt. IV		Conclusions		173
9		The future for palliative care		176
		References		188
		Index		211

"Those wishing to acquire an overview of history, policy, and practice will not find a better combination of comprehensiveness and accessibility...a timely well-written and accessible volume." - The Health Service Journal. "This is an excellent book written by credible and respected academics who have had considerable influence on the way in which residential care for older people is understood." - Community Care. "...a comprehensive history of residential care...impeccably referenced." - Nursing Times. "...a very important book." - BASEline "...an excellent review of research and findings in residential care - The Trainers' Professional Voice. "...presents a really useful summary of the history and state of residential care." - Health Matters "This book raises essential questions about the meaning of residential care - for its residents, its work-force, relatives and for policy-makers." - Ageing and Society. "...this is an excellent review that covers a great deal of ground in a stimulating and thorough way. It will be of use to both researchers wanting a baselineon current research and teachers looking for a text to recommend for courses on gerontology and community care" - Journal of Social Policy.

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