Paraneoplastic syndromes in advanced malignancy
Georgina Gerrard
pp 51-53
A paraneoplastic syndrome (PS) is a remote effect of malignancy not directly due to the primary tumour or its metastases. It may be caused by tumour-induced protein secretion of a hormone-like substance such as parathyroid hormone related peptide (PTHrP) in hypercalcaemia, or antibody production (the Eaton–Lambert syndrome, for example). The usual treatment for a PS is to treat the underlying tumour.
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Discomfort and pain associated with paratonia
Heather Sanders and Libby Smales
pp 54-55
Experience at Cranford Hospice, New Zealand, over the past 12 years has made us aware that certain patients demonstrate uncomfortable/painful increased tone, often accompanied by twitches and jerks, in their last days of life. This increased tone is usually preceded by tension, restlessness, confusion and/or agitation. It is distressing and, if untreated, becomes more pronounced as death approaches.
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Clinical hypnosis in palliative care
Christina Liossi and Kyriaki Mystakidou
pp 56-58
Palliative care is not concerned with striving for a cure, nor does it involve the application of dramatic life-saving treatments. It integrates the physical, psychological and spiritual aspects of patient care and offers a support system to help the patient live as actively as possible until death.
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Promoting self-worth in the terminally ill
Elaine Stevens
pp 60-64
A well-balanced, patient-centred rehabilitation programme can promote the continuance not just of life but of a good quality of life for terminally ill patients in a hospice day care unit.
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Hospital referrals of the terminally ill for hospice care
Mark Foulkes
pp 65-67
The growth of the hospice movement and the corresponding increase in hospice beds in the UK has come about partly as an acknowledgement of the shortcomings of palliative and terminal care in hospitals.
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The impact of NHS reforms on UK palliative care services
Helen Malson, David Clark, Neil Small and Karen Mallett
pp 68-71
Since the late 1980s major structural and organisational changes have taken place in the UK’s National Health Service (NHS). Widely referred to as the ‘NHS reforms’, these radical changes aimed at separating the functions of purchasing and providing healthcare, ushering in a regulated market of healthcare and designating NHS Trusts, as well as private and non-profit-making organisations, as providers.
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Supporting the dying in myth and reality
Danièle Deschamps
pp 72-74
In this scientific age where everything is rushed, over-efficient and precise, is there still time to sit with and comfort those who are giving birth or dying? The desire to give birth or die ‘at home’ is surely just a mad Utopian dream, given the risks and the absence of state-of-the-art equipment and techniques. Surely it is simply nostalgia for a lost era, beautiful but only a myth?
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Symbolic death as grief therapy: Part II
Jean Monbourquette
pp 75-79
Though Schutzenberger deals with the whole question of transgenerational transmission of a programme of family traits, the point I want to deal with is more limited: why bereaved people are often programmed to want to die like their loved ones.
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Helping children work through their grief
Regina Millard
pp 80-83
The Caritas Christi and Order of Malta Hospice Home Care programme, established in 1993, is a unique partnership between a publicly funded hospice, under the care of the Sisters of Charity (Caritas Christi Hospice), and a community-based charitable organisation (the Order of Malta). Both organisations have a long and rich tradition of caring for the sick.
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