×

Uh-oh, it looks like your Internet Explorer is out of date.

For a better shopping experience, please upgrade now.

The Medical Care of Terminally Ill Patients
     

The Medical Care of Terminally Ill Patients

by Robert E. Enck
 

See All Formats & Editions

Since the publication of the first edition of The Medical Care of Terminally Ill Patients, the field of palliative care has progressed significantly, both socially and scientifically. In this new edition, Dr. Robert Enck reviews the results of clinical studies devoted to the care of dying patients. Special attention is given to pain management, management of

Overview

Since the publication of the first edition of The Medical Care of Terminally Ill Patients, the field of palliative care has progressed significantly, both socially and scientifically. In this new edition, Dr. Robert Enck reviews the results of clinical studies devoted to the care of dying patients. Special attention is given to pain management, management of symptoms, care of advanced cancer patients, and care of patients with nonmalignant diseases. More than 100 new references, a new list of abbreviations, and tables with new drugs and dosages provides valuable information.

Dr. Enck places great emphasis on enhancing the quality of life while addressing the most common symptoms of terminal illness.

Editorial Reviews

Doody's Review Service
Reviewer: Linda L Emanuel, MD, PhD (Northwestern University Feinberg School of Medicine)
Description: This book provides a valuable set of concise and accurate summaries of major research papers, and the author presents them in a logical fashion that both traces the historical development of the field in some of its key aspects and provides a clear set of clinically relevant answers for clinicians.
Purpose: Too many people with serious illness suffer needlessly with their symptoms. The author's purpose is to provide a concise guide to reliable literature on symptom management and the clinical guidance it offers. If all we do by having this book at our fingertips is improve symptom management and understand the research that undergirds the recommended practices, these will be great strides forward. We can congratulate and thank the author for adding to the comfort and care of a great many of our fellow human beings as death draws near. The author has, however, made one choice with which most in the palliative care field would disagree — he has focused almost entirely on symptom management. Had the title of his book been The Symptom Management..., instead of The Medical Care..., then no disagreement would exist. However, although relief of symptoms is a sine qua non of care, the full medical care of people with a life-shortening condition involves a good deal more than symptom management.
Audience: The author writes for all clinicians who care for patients who die, and that is most if not all clinicians. The content is limited to the skill sets needed by nonpalliative care specialists. Fortunately, the author's positive contribution to the field now has a comprehensive companion, the American Society of Clinical Oncology's 2001 publication Optimizing Cancer Care: The Importance of Symptom Management. Readers of this book who need more than the core set of skills can turn to this fine set of materials for more advanced palliative care specialty-level skills. Much of the clinical wisdom in the ASCO curriculum is also applicable to the care of noncancer terminal conditions.
Features: In a sea of accurate, useful information, one can always find points of difference. A little more information on the use of the somatostatin, octreotide for patients with bowel obstruction could have been added. Some more guidance on management of terminal delirium would have been helpful, as would the management of sleep cycle disturbances. The place of methylphpenidate for rapid antidepressant action among patients for whom little time remains or for whom depression has become unbearable could also have had more discussion. A chapter on the aspects of care that people with illness find important would help. People with illness care about their changing family relationships, the burden of care placed on caregivers, financial matters, dignity, and existential concerns. If a clinician is unaware that existential anxiety can be manifest as intractable physical pain, patients may be treated with escalating doses of opioids instead of visits from their pastor or other spiritual mentor. If the clinician is unaware that a patient is fighting for life because he or she cannot face the idea of leaving this life without resolving a personal discord, the patient may end up asking for what seems to be futile technical intervention rather than face time with the relevant people. Toward the end of filling out the scope of core skills needed in caring for people with terminal conditions, the author will likely wish to include sections on whole person assessment, on goals of care, on futility, on advance care planning, on interdisciplinary teams, on existential pain, on care of the family caregiver, and perhaps more. Possibly the author would have been pressed in his earlier edition to find the rigorous empirical studies on which the current book is based. But a number of good studies do now exist. Defining a narrower scope for the book or expanding the content to match the title are now necessary.
Assessment: This is a useful, concise guide to current norms of practice, and the research that supports it, in core aspects of symptom management for the nonpalliative care clinician.
Inside GCM
A very well thought out and organized professional book... A thorough book for physicians.

— Carolyn Whitman, M.S., R.N.

International Association for Hospice and Palliative Care Newsletter
This Second Edition demonstrates the enormous advances that have been made in the understanding of the treatment of the terminally ill. It provides the clinician with a clear, readable and practical guide to managing clinical problems at the end of life.

— Roger Woodruff

Annals of Internal Medicine

How can we do a better job of caring for our patients at the end of life? A good start would be to buy and read Robert Enck's Medical Care of Terminally Ill Patients. This concise, easy-to-read book tells you what you need to know. The first chapter estimates duration of survival in patients with cancer, Alzheimer disease, and motor neuron diseases and is alone almost worth the price of the book, but the text holds so much more

AIDS Book Review Journal

An excellent book for any hospice to have for the volunteers, social workers, and physicians. For those who have taken it upon themselves to give home care, this would be an invaluable book.

Family Medicine

Dr. Enck does an excellent job of summarizing the relevant research... The author clearly has wide experience in dealing with terminal care and gives a sensitive and thorough review of the complex medical care issues involved in producing a humane death.

Hospice Journal

It is an excellent introduction for those internists, family physicians, and others unfamiliar with management of the terminally ill. It serves as a quick reference for hospice physicians, oncologists, and nursing personnel.

Journal of Pharmaceutical Care in Pain and Symptom Control

The author concisely suggests treatments of commonly encountered symptoms. The book can be easily used as a quick reference, and be useful to nurses, pharmacists, and physicians in the care of patients with advanced disease.

Inside GCM - Carolyn Whitman

A very well thought out and organized professional book... A thorough book for physicians.

International Association for Hospice and Palliative Care Newsletter - Roger Woodruff

This Second Edition demonstrates the enormous advances that have been made in the understanding of the treatment of the terminally ill. It provides the clinician with a clear, readable and practical guide to managing clinical problems at the end of life.

Reviewer:Linda L Emanuel, MD, PhD(Northwestern University Feinberg School of Medicine)
Description:This book provides a valuable set of concise and accurate summaries of major research papers, and the author presents them in a logical fashion that both traces the historical development of the field in some of its key aspects and provides a clear set of clinically relevant answers for clinicians.
Purpose:Too many people with serious illness suffer needlessly with their symptoms. The author's purpose is to provide a concise guide to reliable literature on symptom management and the clinical guidance it offers. If all we do by having this book at our fingertips is improve symptom management and understand the research that undergirds the recommended practices, these will be great strides forward. We can congratulate and thank the author for adding to the comfort and care of a great many of our fellow human beings as death draws near. The author has, however, made one choice with which most in the palliative care field would disagree -- he has focused almost entirely on symptom management. Had the title of his book been The Symptom Management..., instead of The Medical Care..., then no disagreement would exist. However, although relief of symptoms is a sine qua non of care, the full medical care of people with a life-shortening condition involves a good deal more than symptom management.
Audience:The author writes for all clinicians who care for patients who die, and that is most if not all clinicians. The content is limited to the skill sets needed by nonpalliative care specialists. Fortunately, the author's positive contribution to the field now has a comprehensive companion, the American Society of Clinical Oncology's 2001 publication Optimizing Cancer Care: The Importance of Symptom Management. Readers of this book who need more than the core set of skills can turn to this fine set of materials for more advanced palliative care specialty-level skills. Much of the clinical wisdom in the ASCO curriculum is also applicable to the care of noncancer terminal conditions.
Features:In a sea of accurate, useful information, one can always find points of difference. A little more information on the use of the somatostatin, octreotide for patients with bowel obstruction could have been added. Some more guidance on management of terminal delirium would have been helpful, as would the management of sleep cycle disturbances. The place of methylphpenidate for rapid antidepressant action among patients for whom little time remains or for whom depression has become unbearable could also have had more discussion. A chapter on the aspects of care that people with illness find important would help. People with illness care about their changing family relationships, the burden of care placed on caregivers, financial matters, dignity, and existential concerns. If a clinician is unaware that existential anxiety can be manifest as intractable physical pain, patients may be treated with escalating doses of opioids instead of visits from their pastor or other spiritual mentor. If the clinician is unaware that a patient is fighting for life because he or she cannot face the idea of leaving this life without resolving a personal discord, the patient may end up asking for what seems to be futile technical intervention rather than face time with the relevant people. Toward the end of filling out the scope of core skills needed in caring for people with terminal conditions, the author will likely wish to include sections on whole person assessment, on goals of care, on futility, on advance care planning, on interdisciplinary teams, on existential pain, on care of the family caregiver, and perhaps more. Possibly the author would have been pressed in his earlier edition to find the rigorous empirical studies on which the current book is based. But a number of good studies do now exist. Defining a narrower scope for the book or expanding the content to match the title are now necessary.
Assessment:This is a useful, concise guide to current norms of practice, and the research that supports it, in core aspects of symptom management for the nonpalliative care clinician.
Booknews
Doctors like to heal people; they would rather not deal with people who are not going to get well. The hospice movement has brought them to task, and Enck (medicine, Ohio State U.) provides a handbook for health professionals to dealing with pain and symptom control in dying patients. He emphasizes the care of cancer patients, but also describes nonmalignant diseases such as dementia and AIDS. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Product Details

ISBN-13:
9780801867668
Publisher:
Johns Hopkins University Press
Publication date:
11/28/2001
Series:
The Johns Hopkins Series in Hematology/Oncology
Edition description:
second edition
Pages:
226
Product dimensions:
6.00(w) x 9.00(h) x 0.56(d)

Meet the Author

Robert E. Enck, M.D., is a clinical associate professor in the Department of Medicine at The University of Pennsylvania School of Medicine and editor-in-chief of the American Journal of Hospice and Palliative Care.

Customer Reviews

Average Review:

Post to your social network

     

Most Helpful Customer Reviews

See all customer reviews