A. Communication Issues
1. Initiating End-of-Life Discussions with Seriously Ill Patients: Addressing the "Elephant in the Room"
2. Beyond Advance Directives: Importance of Communication Skills for Care at the End of Life
3. Decision Making at a Time of Crisis Near the End of Life
4. Dealing With Conflict in Caring for the Seriously Ill: "It Was Just Out of the Question"
B. Symptom Management
5. Managing an Acute Pain Crisis in a Patient With Advanced Cancer: "This Is as Much of a Crisis as a Code"
6. Management of Dyspnea in Patients With Far-advanced Lung Disease: "Once I Lose It, It's Kind of Hard to Catch It…"
7. Management of Intractable Nausea and Vomiting in Patients at the End of Life: "I Was Feeling Nauseous All of the Time…Nothing Was Working"
8. Palliative Care for Frail Older Adults: "There are Things I Can't Do Anymore That I Wish I Could…"
9. Palliative Management of Fatigue at the Close of Life: "It Feels Like My Body Is Just Worn Out"
10. Spinal Cord Compression in Patients With Advanced Metastatic Cancer: "All I Care About Is Walking and Living My Life"
11. Agitation and Delirium at the End of Life: "We Couldn't Manage Him"
C. Disease Management
12. Alzheimer Disease: "It's OK, Mama, If You Want to Go, It's OK"
13. Practical Considerations in Dialysis Withdrawal: "To Have That Option Is a Blessing"
14. Overcoming the False Dichotomy of Curative vs Palliative Care for Late-Stage HIV/AIDS: "Let Me Live the Way I Want to Live, Until I Can't"
15. Palliative Care for Patients with Heart Failure
16. Integrating Palliative Care for Liver Transplant Candidates: "Too Well for Transplant, Too Sick for Life"
17. Palliative Care for Patients with Amyotrophic Lateral Sclerosis: "Prepare for the Worst and Hope for the Best"
18. Palliative Care for Patients With Head and Neck Cancer: "I Would Like a Quick Return to a Normal Lifestyle"
D. Other Patient Management Issues
19. Complexities in Prognostication in Advanced Cancer: "To Help Them Live Their Lives the Way They Want"
20. Caring for the Child with Cancer at the Close of Life: "There are People Who Make It, and I'm Hoping I'm One of Them"
21. Sudden Traumatic Death in Children: "We Did Everything, but Your Child Didn't Survive"
22. The Role of Chemotherapy at the End of Life: "When is Enough, Enough?"
23. Palliative Care in the Final Days of Life: "They Were Expecting It At Any Time"
E. Psychological, Social, and Spiritual Issues
24. Psychological Considerations, Growth, and Transcendence at the End of Life: The Art of the Possible
25. Caring for Bereaved Patients: "All the Doctors Just Suddenly Go"
26. Adolescent Grief: "It Never Really Hit Me…Until It Actually Happened"
27. Dignity-conserving Care-A New Model for Palliative Care: Helping the Patient Feel Valued
28. Supporting Family Caregivers at the End of Life: "They Don't Know What They Don't Know"
29. Spiritual Issues in the Care of Dying Patients: "…It's OK Between Me and God"
F. Ethical Issues
30. Responding to Requests for Physician-assisted Suicide: "These Are Uncharted Waters for Both of Us…"
31. Palliative Sedation in Dying Patients: "We Turn to It When Everything Else Hasn't Worked"
G. Cross-Cultural and Special Populations Issues
32. Negotiating Cross-cultural Issues at the End of Life: "You Got to Go Where He Lives"
33. Palliative Care for Latino Patients and Their Families: "Whenever We Prayed, She Wept"
34. End-of-life Care for Homeless Patients: "She Says She Is There to Help Me in Any Situation"
35. Palliative Care for Prison Inmates: "Don't Let Me Die in Prison"
H. Settings of Care (Structural Issues)
36. The Role of Hospice and Other Services: Serving Patients Who May Die Soon and Their Families
37. Secondary and Tertiary Palliative Care in Hospitals
38. Withdrawal of Life Support: Intensive Caring at the End of Life.
39. Meeting Palliative Care Needs in Post-Acute Care Settings: "To Help Them Live Until They Die"
40. Referring a Patient and Family to High-quality Palliative Care at the Close of Life: "We Met a New Personality…With This Level of Compassion and Empathy"
I. Clinician Self-Care
41. Care of the Dying Doctor: On the Other End of the Stethoscope
42. Self-care of Physicians Caring for Patients at the End of Life: "Being Connected…A Key to My Survival"
Answers to Chapter Questions