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    Palliative and end-of-life pearls / John E. Heffner, Ira R. Byock.

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    • Title:Palliative and end-of-life pearls / John E. Heffner, Ira R. Byock.
    •    
    • Author/Creator:Heffner, John E.
    • Other Contributors/Collections:Byock, Ira.
    • Published/Created:Philadelphia, PA : Hanley & Belfus, ©2002.

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    • Library of Congress Subjects:Palliative treatment--Case studies.
      Terminal care--Case studies.
      Terminally ill--Case studies.
      Death--Case studies.
    • Medical Subjects: Palliative Care--Problems and Exercises.
      Terminal Care--Problems and Exercises.
      Hospice Care--Problems and Exercises.
      Pain, Intractable--therapy--Problems and Exercises.
      Terminally Ill--psychology--Problems and Exercises.
      Attitude to Death--ethnology--Problems and Exercises.
      Right to Die--Problems and Exercises.
      Case Report.
    • Genre/Form:Case studies.
    • Description:xvi, 232 pages ; 26 cm.
    • Series:Pearls series.
    • Notes:Includes bibliographical references and index.
    • ISBN:1560535008 (alk. paper)
    • Contents:1. 78-year-old man with a ruptured aortic aneurysm and unfinished business
      2. 62-year-old man with lymphoma who develops respiratory failure, renal failure, and hypotension after bone marrow transplantation
      3. 14-year-old boy with cystic fibrosis
      4. 78-year-old woman with severe pain at the end of life
      5. 67-year-old man with terminal cancer and a DNR order who needs a surgical procedure
      6. 55-year-old man with recurrent metastatic esophageal cancer who wants to "just go to sleep" until death occurs
      7. 10-year-old child on mechanical ventilation and pharmacologic paralysis whose parents request discontinuation of ventilator support
      8. 56-year-old ventilator-dependent man with a previously expressed wish to avoid prolonged mechanical ventilation
      9. 77-year-old woman who expresses a need to discuss her end-of-life care during a routine office visit
      10. 74-year-old man with non-small cell carcinoma who requests physician-assisted suicide
      11. 34-year-old woman with end-stage adenocarcinoma of the cervix with intractable neuropathic pain
      12. 62-year-old woman with a second cancer who has abandoned a belief in God
      13. 82-year-old woman is dying in the ICU and the team does not know how to withdraw curative care for her
      14. 75-year-old Aboriginal woman in the ICU with a large, protective family
      15. 60-year-old woman on chronic dialysis who cries out "Lord, please take me"
      16. 44-year-old woman who is coping with the death of her husband from pancreatic cancer
      17. 54-year-old man with amyotrophic lateral sclerosis and progressive shortness of breath
      18. 32-year-old male medical student with a large yolk sac tumor in his chest requests assistance in dying if his suffering becomes unbearable in the future
      19. 28-year-old woman dying with acute respiratory distress syndrome who needs palliative care in the ICU
      20. 65-year-old man with metastatic lung cancer and decreasing oral fluid intake during home hospice care
      21. 73-year-old woman with ovarian cancer who asks "Why me?"
      22. 78-year-old African-American man who is experiencing uncontrolled pain at the end of life
      23. 75-year-old man with a DNR order who requires transport to the radiology department for a procedure
      24. 64-year-old man with COPD and disabling dyspnea enters pulmonary rehabilitation contemplating euthanasia
      25. 89-year-old woman with advanced dementia, recurrent aspiration pneumonia, and weight loss needs a feeding tube?
      26. very elderly woman with acute respiratory failure
      27. 10-year-old boy with unmanageable aqueductal stenosis and unremitting severe pain
      28. 72-year-old man with pleural adenocarcinoma whose family requests that "everything be done"
      29. 49-year-old woman with metastatic breast cancer and acute respiratory distress syndrome who lacks decision-making capacity and a surrogate decision-maker
      30. 72-year-old woman with nonresectable lung cancer who is living alone
      31. 60-year-old seriously ill man with impaired mentation whose family and physician disagree over treatment plans
      32. 59-year-old woman with metastatic breast carcinoma complicated by anorexia/cachexia/fatigue syndrome
      33. 48-year-old woman with colon cancer who develops profound analgesia-induced sedation
      34. 64-year-old rural rancher with end-stage lung cancer and painful metastases
      35. 64-year-old man admitted to a CCU with an acute myocardial infarction and multiple end-stage medical conditions
      36. 65-year-old man with end-stage metastatic cancer who requests discontinuation of life-sustaining medical interventions
      37. 64-year-old man with COPD who accepts intubation and mechanical ventilation, but not indefinitely
      38. 65-year-old man with advanced cancer with nausea, vomiting, dyspnea, and dysphagia who desires home care
      39. 78-year-old woman intubated for COPD and lung cancer whose family states that she never wanted to be on a ventilator
      40. 56-year-old man in need of palliative care in anticipation of end-of-life distress
      41. 73-year-old woman with multiorgan failure and a contentious, divided family
      42. 26-month-old child with severe developmental abnormalities, hydrocephalus, and recurrent ventricular shunt infections
      43. 73-year-old man with a subdural hematoma and poor prognosis based on an ICU scoring system
      44. 68-year-old woman with respiratory failure who requests in writing to "end it now"
      45. 36-year-old African-American mother with terminal AIDS
      46. 46-year-old African-American man with widely metastatic cancer who "will fight for his life till the end"
      47. 33-year-old man with active substance abuse and metastatic colon cancer who requires analgesia for pain control
      48. 500-g preterm infant born to parents who must make decisions about life-supportive care
      49. 54-year-old man with intractable heart failure who transitions to palliative care in the ICU
      50. 78-year-old man who is unconscious and ventilator-dependent after a stroke with a family that requests transfer of care
      51. 52-year-old woman with metastatic cancer who asks, "How does a Jewish person die?"
      52. 74-year-old man with acute respiratory failure who has not had prior discussions with his family about life-supportive care
      53. 4-year-old boy with fulminant hepatitis whose "terminal" course is altered by liver transplantation
      54. 58-year-old woman with ovarian cancer who requests physician-assisted suicide
      55. 38-year-old man with a secondary leukemia who needs setting of goals of care
      56. 83-year-old woman with acute respiratory failure and a do-not-intubate status whose daughter requests noninvasive ventilation
      57. 68-year-old woman with metastatic cancer and severe pain who cannot tolerate oral medications
      58. 72-year-old man with end-stage COPD and retained secretions
      59. 66-year-old Mexican man with severe dyspnea due to pulmonary fibrosis who says, "Doctor, ayudeme, que no puedo respirar"
      60. 78-year-old man with end-stage lung disease who requests aggressive, life-sustaining care
      61. 48-year-old man with metastatic cancer who has not yet recognized the terminal nature of his disease
      62. 52-year-old man whose family and physicians cannot agree on continuing life-supportive care
      63. 73-year-old man who fears suffocating yet requests withdrawal of life-supportive care
      64. 43-year-man with squamous cell carcinoma of the face causing pain that is intermittently responsive to opioids
      65. 68-year-old man with severe COPD who wishes to forego further invasive treatment but whose children wish to continue aggressive care
      66. 54-year-old woman with severe pain from metastatic cancer whose needs exceed a hospital's palliative care resources
      67. 80-year-old man in respiratory failure who repeatedly removes catheters and tubes
      68. 73-year-old man with a history of stroke, COPD, and arterial insufficiency of the leg whose son requests discussion of end-of-life care
      69. 56-year-old woman with metastatic breast cancer and new hypercalcemia admitted to a hospitalist
      70. 60-year-old man admitted to the ICU with metastatic mesothelioma whose son demands continued aggressive life-supportive care
      71. 35-year-old man with end-stage cystic fibrosis who wants to know if completing an advance directive is important.
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