Psychosocial Palliative Care

One of the most challenging roles of the psycho-oncologist is to help guide terminally-ill patients through the physical, psychological, and spiritual aspects of the dying process. Patients with cancer, AIDS, and other life-threatening illnesses are at increased risk for the development of major psychiatric complications, and have an enormous burden of both physical and psychological symptoms. Concepts of adequate palliative care must be expanded beyond the current focus on pain and physical symptom control to include the psychiatric, psychosocial, existential, and spiritual aspects of care. The psycho-oncologist, as a consultant to or member of a palliative care team, has a unique role and opportunity to fulfill this promise of competent and compassionate palliative care for those with life-threatening illnesses. Psychosocial Palliative Care guides the psycho-oncologist through the most salient aspects of effective psychiatric care of patients with advanced illnesses. This handbook reviews basic concepts and definitions of palliative care and the experience of dying, the assessment and management of major psychiatric complications of life-threatening illness, including psychopharmacologic and psychotherapeutic approaches, and covers issues such as bereavement, spirituality, cultural sensitivity, communication and psychiatric contributions to common physical symptom control. A global perspective on death and palliative care is taken throughout the text, and an Appendix provides a comprehensive list of international palliative care resources and training programs.Part I. Modern Palliative Care ; 1. Principles of Palliative Care ; 2. A Global Perspective on Death ; 3. Role of the Psycho-Oncologist in Palliative Care ; Part II. Psychiatric Disorders in the Palliative Care Setting ; 4. Anxiety Disorders in Palliative Care ; 5. Depression in Palliative Care ; 6. Suicide, Assisted Suicide, and Desire for Hastened Death ; 7. Delirium and other Cognitive Disorders in Palliative Care ; Part III. Psychosocial Issues the Palliative Care Setting ; 8. Fatigue in Palliative Care ; 9. Psychotherapy and Behavioral Interventions in Palliative Care ; 10. Psychiatric and Psychological Interventions for the Control of Selected Physical Symptoms ; 11. Spiritual and Existential Issues in the Care of the Dying ; 12. Cross Cultural Issues ; 13. Doctor-Patient Communication ; 14. Grief and Bereavement ; 15. Conclusions ; Appendix: Resources for Patients and Health-Care Professionals