Oxford American Handbook of Hospice and Palliative Medicine and Supportive Care

529 Pages·2016·3.29 MB·English

by  Sriram Yennurajalingam, Eduardo Bruera

Oxford American Handbook of
Hospice and
Palliative Medicine
and Supportive Care
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Oxford American
Handbook of 
Hospice and
Palliative
Medicine and
Supportive Care
Second Edition
Edited by
Sriram Yennurajalingam, MD
Associate Professor of Palliative Care & Rehabilitation
Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas
Eduardo Bruera, MD
Professor and Chair of Palliative Care & Rehabilitation
Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas
1
1
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Published in the United States of America by Oxford University Press
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© Oxford University Press 206
First Edition published in 20
Second Edition published in 206
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Library of Congress Cataloging-i n- Publication Data
Oxford American handbook of hospice and palliative medicine
Oxford American handbook of hospice and palliative medicine and supportive care /
edited by Sriram Yennurajalingam, Eduardo Bruera. — Second edition.
p. ; cm. — (Oxford American handbooks)
Handbook of hospice and palliative medicine and supportive care
Preceded by Oxford American handbook of hospice and palliative medicine /
edited by Eduardo Bruera, Sriram Yennurajalingam. 20.
Includes bibliographical references and index.
ISBN 978-0-9-937530- (alk. paper)
I. Yennurajalingam, Sriram, editor. II. Bruera, Eduardo, editor. III. Title.
IV. Title: Handbook of hospice and palliative medicine and supportive care.
V. Series: Oxford American handbooks.
[DNLM: . Palliative Care—Handbooks. 2. Hospice Care—Handbooks.
3. Hospices—Handbooks. WB 39]
R726.8
362.7′56—dc23
205032794
9 8 7 6 5 4 3 2 
Printed by Webcom, Canada
This material is not intended to be, and should not be considered, a substitute for medical
or other professional advice. Treatment for the conditions described in this material is
highly dependent on the individual circumstances. And, while this material is designed to
offer accurate information with respect to the subject matter covered and to be current
as of the time it was written, research and knowledge about medical and health issues
is constantly evolving and dose schedules for medications are being revised continually,
with new side effects recognized and accounted for regularly. Readers must therefore
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make no representations or warranties as to the accuracy or efficacy of the drug dosages
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disclaim, any responsibility for any liability, loss or risk that may be claimed or incurred as a
consequence of the use and/or application of any of the contents of this material.
v
Preface
In the United States, hospice and palliative medicine has emerged as a
new subspecialty recently recognized by the American Board of Medical
Specialties. During the last 0 years there has been a very significant
increase in the number of inpatient and outpatient palliative care programs,
as well as a major increase in the number of patients who access hospice
for end- of- life care.
Unfortunately, educational efforts are lagging behind, and the vast major-
ity of medical students, residents, and even fellows receive minimal palliative
medicine education in the United States. However, these junior physicians,
along with a number of busy clinical specialists, are exposed to patients with
progressive incurable illnesses and their families on a daily basis.
The purpose of this handbook is to provide up- to- date, practical, and
concise information to healthcare professionals delivering care to patients
requiring hospice and palliative care in the United States. This includes phy-
sicians, nurse practitioners, fellows, residents, and students.
All the chapters are primarily aimed at the clinical and administrative
arrangements within the American healthcare system, including the hospice
Medicare benefit.
We believe this book will provide rapid access to most of the daily
bedside clinical and administrative needs, and it will hopefully help our col-
leagues in the delivery of excellent palliative and hospice care.
We would like to acknowledge the authors of each of the chapters for
having committed their time and effort to our joint project. We would also
like to acknowledge the commitment to excellence by Oxford University
Press and in particular Andrea Knobloch, our Senior Editor, for the excellent
work in coordinating our book. Finally, we would like to acknowledge the
daily effort of healthcare professionals who have contributed by their daily
clinical work, education, and research to the development of the extraor-
dinary body of knowledge that we have had the privilege to synthesize in
this book.
Sriram Yennurajalingam, MD
Eduardo Bruera, MD
Houston, June 205

vii
Contents
Contributors  xi
 Definitions and Key Elements in Palliative
and Supportive Care  
Sriram Yennurajalingam and Eduardo Bruera
2 Symptom Assessment  5
Marvin Omar Delgado Guay
3 Clinical Decision- Making  2
Eduardo Bruera
4 Pain Assessment and Management  27
Angelique Wong and Suresh K. Reddy
5 Fatigue  69
Sriram Yennurajalingam
6 Cachexia  83
Egidio Del Fabbro
7 Dehydration  93
Shalini Dalal
8 Anxiety and Depression  0
Paul W. Walker and Anis Rashid
9 Sleep Disturbance  3
Marvin Omar Delgado Guay
and Sriram Yennurajalingam
0 Chronic Nausea and Vomiting  25
Shalini Dalal
viii CONTENTS
 Constipation and Bowel Obstruction  37
Joseph A. Arthur
2 Delirium  53
Shirley H. Bush
3 Clinical Issues Related to Palliative Sedation  67
Shirley H. Bush
4 Breathlessness  7
Jeff Myers and Deborah Dudgeon
5 Emergencies in Palliative Care  85
Meiko Kuriya and Rony Dev
6 Other Symptoms: Xerostomia, Hiccups, Pruritis,
Pressure Ulcers and Wound Care, Lymphedema,
and Myoclonus  95
Paul W. Walker
7 Management of Cancer Treatment–R elated
Adverse Effects  207
David Hui
8 Radiotherapy and Palliative Care  223
Elizabeth A. Barnes
9 Hospice Approach to Palliative Care  23
Joan K. Harrold and Charles F. von Gunten
20 Psychosocial and Cultural Considerations
in Palliative Care  245
V. S. Periyakoil
2 Spiritual Issues in Palliative Care  257
Christina M. Puchalski, Betty R. Ferrell,
and Edward O’Donnell
CONTENTS ix
22 The Palliative Care Team  273
Eduardo Bruera
23 Family Conference: Role in Palliative Care  279
Margaret Isaac and J. Randall Curtis
24 Ethical Aspects of Palliative Medicine  287
James D. Duffy
25 Prognostication in Palliative Care  309
David Hui
26 Frequent Pharmacological Interactions
in Palliative Care  323
Mary Lynn McPherson and Kashelle Lockman
27 Pediatric Palliative Care  345
Donna S. Zhukovsky and Rhonda Robert
28 Palliative Care in Older Adults  36
Brook A. Calton and Christine S. Ritchie
29 Palliative Care in End- Stage Heart Failure  375
José L. Ramos and Marieberta Vidal
30 Palliative Care in End- Stage Liver Disease  385
Valentina Medici and Frederick J. Meyers
3 Kidney Palliative Care  397
Sara Davison and David Hui
32 Palliative Care in Patients with AIDS  407
Kirsten Wentlandt and Camilla Zimmermann
33 Palliative Care in End- Stage Neurological Disease  49
Tobias Walbert