Case Studies in Palliative and End-of-Life Care

Margaret L. Campbell, PhD, RN, FPCN is Associate Professor – Research in the Office for Health Research at the College of Nursing at Wayne State University in Detroit, Michigan.

• Contributor List viiiIntroduction xiiMargaret L. CampbellSection 1 Communication Case Studies 1Case 1.1 Comsmunicating about a Progressive Diagnosis and Prognosis 5Julia A. WalchCase 1.2 Diagnosis/Prognosis Uncomplicated Death at Home 12Constance DahlinCase 1.3 Accommodating Religiosity and Spirituality in Medical Decision-Making 18Jennifer GentryCase 1.4 Discussing Cardiopulmonary Resuscitation When it May Be Useful 26Kelli GershonCase 1.5 Discussing CPR When it is a Non-Beneficial Intervention 33Judy PassagliaCase 1.6 Discussing Brain Death, Organ Donation, and Donation after Cardiac Death 41Christine Westphal and Rebecca WilliamsCase 1.7 Discussing Physiological Futility 52Judy C. WheelerCase 1.8 Wounded Families: Decision-Making in the Setting of Stressed Coping and Maladaptive Behaviors in Health Crises 60Kerstin McSteenCase 1.9 Notification of an Expected Death 68Peg NelsonCase 1.10 Death Notification after Unexpected Death 73Garrett K. ChanSection 2 Symptom Management Case Studies 83Case 2.1 Pain: Cancer in the Home 87Constance DahlinCase 2.2 Treating an Acute, Severe, Cancer Pain Exacerbation 98Patrick J. CoyneCase 2.3 Pain and Advanced Heart Failure 104Margaret L. CampbellCase 2.4 Dyspnea and Advanced COPD 110Margaret L. CampbellCase 2.5 Dyspnea and Heart Failure 117Garrett K. ChanCase 2.6 Treating Dyspnea during Ventilator Withdrawal 128Margaret L. CampbellCase 2.7 Cough Associated with COPD and Lung Cancer 138Peg NelsonCase 2.8 Hiccups and Advanced Illness 145Marian GrantCase 2.9 Treating Nausea Associated with Advanced Cancer 152Judy C. WheelerCase 2.10 Nausea Associated with Bowel Obstruction 161Terri L. MaxwellCase 2.11 Nausea Related to Uremia, Dialysis Cessation 168Linda M. GormanCase 2.12 Opioid-Induced Pruritus 176Richelle Nugent HooperCase 2.13 Pruritus in End-Stage Renal Disease 183Linda M. GormanCase 2.14 Opioid-Induced Constipation 190Grace Cullen OligarioCase 2.15 Depression in Advanced Disease 198Todd HultmanCase 2.16 Treating Anxiety 205Darrell OwensCase 2.17 Terminal Secretions 213Terri L. MaxwellCase 2.18 Fungating Wounds and the Palliative Care Patient 220Laura C. HarmonCase 2.19 Pressure Ulcer Care in Palliative Care 229Laura C. HarmonCase 2.20 Treating Ascites 239Darrell OwensCase 2.21 Delirium Management in Palliative Care 247Kerstin McSteenSection 3 Family Care Case Studies 257Case 3.1 Caring for the Family Expecting a Loss 259Patricia A. Murphy and David M. PriceCase 3.2 Anticipatory Grief and the Dysfunctional Family 266Rita J. DiBiaseCase 3.3 Acute and Uncomplicated Grief after an Expected Death 277Rita J. DiBiaseCase 3.4 Bereavement after Unexpected Death 289Garrett K. ChanCase 3.5 Complicated Grief 300Rita J. DiBiaseIndex 309