Dying for palliative care
Sally Derry
pp 80-82
Pioneers of the modern hospice movement have always maintained that the principles of palliative care, so successfully employed in the management of patients with cancer, can and indeed should ‘not only be facets of oncology but of geriatric medicine, neurology, general practice and throughout medicine’.
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The need for adjustable lighting in palliative care
Glenn Sweitzer
pp 83-84
Access to daylight is arguably most critical for those confined indoors, including those receiving terminal care. Of these patients, many are dependent on window and electric lighting controls used by others, such as staff or visitors. Their combined lighting needs are discussed in this article using the example of a private patient room with integral toilet and shower.
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The palliative/primary healthcare interface
Kath Defilippi
pp 86-87
According to the WHO Declaration at Alma Ata in 1978, Primary Health Care (PHC) is: ‘Essential healthcare based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part of the country’s healthcare system'.
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The benefits of home care for the terminally ill
Cathryn Watters
pp 90-92
Recent changes within the UK NHS have enabled a new approach to healthcare to emerge, and many authors have examined the impact of these changes. Eliot explains that with the implementation of the NHS Community Care Act (1991) we can aim to offer increased patient choice. This in turn can give way to intensive nursing therapy and social care at home, involving a range of multidisciplinary team members.
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A partnership in care
Pam Caddow and David Oliviere
pp 94-95
As palliative care services have developed, the integration of practice, research, teaching and writing as building blocks for excellence in service provision has been actively encouraged.
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The nurse’s role in the multidisciplinary team
Maureen Carson, Thelma Williams, Angela Everett and Stephanie Barker
pp 96-98
Nursing staff make a major contribution to the success of the interdisciplinary team, mainly because they are the continuous caregivers – the ‘nucleus’ of the team. The nursing service coordinates the diverse inputs of other healthcare professionals and services.
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Recent research into staff stress in palliative care
Mary Vachon
pp 99-103
In the early days of the hospice movement, staff stress was sometimes high and resulted from a combination of personal and organisational variables. Team conflict and communication problems with others were often more of a stressor than working with the dying. Research from the last decade shows that much of the stress in palliative care continues to come from areas apart from patient care, but there is still some stress associated with caring for patients and families, particularly if staff feel inadequately prepared for their roles.
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Psychodynamic counselling in specialist palliative care
Maggie Fisher, Mike Fitzsimmons, Helen Thorpe and George Ward
pp 105-109
An extensive literature exists on the experience of adjusting to death and dying, much of it focused on observational studies of the responses of dying people to illness. The provision of different psychological levels is viewed as a core component of specialist palliative care, but there is no recommended structure for counselling services. Most hospices employ social workers who focus on both welfare and psychological care. Many employ psychologists and/or psychiatrists on a sessional basis, but only a few employ a counsellor.
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