Dying at Home: A Family Guide for Caregiving

Dying at Home: A Family Guide for Caregiving

Dying at Home: A Family Guide for Caregiving

Dying at Home: A Family Guide for Caregiving

Paperback(third edition)

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Overview

"A growing number of people choose to live their final weeks or months at home. For patients who cannot benefit from acute care in the hospital, home care offers an alternative to a nursing home or hospice. Advances in medical technology and pharmacology allow even those with serious illnesses to remain at home relatively free of pain and symptoms, and professional services are increasingly available to assist family caregivers with work that is often physically and emotionally exhausting."--BOOK JACKET.

"First published in 1991, Dying at Home examined the reasons behind this trend and offered practical advice about assuming as much control as possible over the process of dying. In this thoroughly updated edition, medical anthropologist and gerontologist Andrea Sankar keeps her focus on the patient and loved ones while providing the latest information on hospice home care teams, pain medications, HIV and AIDS, legislation on death with dignity, physician-assisted suicide, and sources of information and support for patients and families."--BOOK JACKET.


Product Details

ISBN-13: 9781421447735
Publisher: Johns Hopkins University Press
Publication date: 02/20/2024
Series: A Johns Hopkins Press Health Book
Edition description: third edition
Pages: 488
Sales rank: 956,698
Product dimensions: 6.12(w) x 9.25(h) x 1.25(d)

About the Author

Andrea Sankar is a professor of medical anthropology at Wayne State University, where she is also the co-founder and co-director of the Social Work and Anthropology doctoral program. The former editor of Medical Anthropology Quarterly, Sankar was named Michiganian of the Year in 1995 for her work on HIV/AIDS.

Table of Contents

List of Illustrations and Tablesxiii
Preface to the Revised Editionxv
Acknowledgmentsxix
Some Who Died at Homexxi
Introduction1
Home Death: A Return to Tradition1
The Term Caregiver2
Factors Contributing to the Trend3
The Desire for Control3
The Hospice Movement4
The Limitations of Medical Science4
Advances in Home-based Technology and Pharmacology4
Change in Insurance Reimbursement5
Problems of Caregiving5
The Dying Person5
Intimacy6
The Caregiver's Responsibility7
Physical and Emotional Stamina10
Expenses10
Deciding Whether to Become a Caregiver11
The Research for This Book13
The Method13
The Informants14
How to Read This Book15
1.Taking the Patient Home to Die17
Participating in Hospital Care17
The Appropriateness of Treatment18
Procedures19
Bedside Nursing19
Communicating with the Hospital Staff21
The Decision to Discharge the Patient25
Discharge Options26
Planning the Discharge27
The Transfer Home34
Rehospitalization35
Reasons for Readmission35
Considering Readmission39
2.Strangers in the Home: The Use of Formal Support42
The Functions of Formal Support42
To Provide Respite42
To Provide Skilled Care43
To Supply Information and Reassurance44
To Offer Spiritual Support46
Deciding to Use Formal Support47
Assessing the Need for Services50
Types of Agencies53
Hospice53
Home Care58
Health Maintenance Organization58
Professionals Who Work in the Home59
Physicians60
Nurses62
Home Health Aides63
Other Professionals64
Gaining Access to the Formal System65
Access through Discharge from the Hospital65
Access without Prior Hospitalization68
Contacting an Agency69
Preparations69
Questions to Ask69
Finding the Right People73
Maintaining Privacy: Establishing Boundaries76
3.Caregiving79
The Caregiver's Role79
Problem Solving80
Decision Making83
Ethical Dilemmas85
Conflicts87
The Dignity and Autonomy of the Dying Person92
Becoming an Expert94
The Patient Log94
The Quality of Life98
4.Social Support101
The Meaning of Social Support102
Types of Support103
Support for the Dying Person104
Support for the Caregiver106
Spiritual Support108
How the Support System Works110
Decision Making110
Integrating Support into the Caregiving Routine111
Reciprocity112
Organizing a Support System113
The Inclusion of Children115
Problems in the Support System118
When Support Doesn't Work118
Lack of Social Support120
5.The Well-being of the Caregiver125
Day to Day125
The Physical Drain128
The Emotional Strain131
Grief131
Lack of Control132
Anger134
Fear of Death136
Responsibilities to Others138
Coping140
Taking Breaks141
Social Support142
Support Groups and Therapy143
Laughter144
Making Life Easier145
Work146
Spiritual Support148
What Enabled Caregivers to Care and What It Meant to Them148
6.Demystifying Death152
Signs of Approaching Death153
Immediately after Death154
Emergency Medical Services (EMS)154
Removing the Body156
Children156
Suicide157
Some Who Died at Home159
Alice Clark159
Jim DeMott161
Lisa Knott164
Elizabeth Krolick165
Al Martin168
Joyce Smith170
Dorothy Stead172
David Steiner174
Herbert Wolf175
John Wright177
7.After Death182
The Funeral182
Grief188
Practical Concerns194
Before Death194
After Death195
Settling Financial Matters196
Documents Needed197
Conclusion: Living while Dying198
Appendix ATasks and Problems of Caregiving201
General Care202
Appearance202
Hygiene202
Skin Care203
Sexuality207
Health Care208
Nutrition208
Elimination215
Mobility and Falls218
Transfers220
Eye Care222
Sleep222
Cognitive Impairment224
Agitation225
Administering Medication226
Breathing Problems230
Oxygen230
Seizures231
Control of Pain231
Assessment233
Appendix BAdditional Resources238
General238
Control of Pain238
Living Wills240
Caregiving at Home240
Nursing Homes241
Suicide242
Grief242
Appendix CPain Medications245
Appendix DSample Letters248
Appendix ECaregiving and HIV250
Introduction250
Helping the Caregiver Cope251
Infection Control Precautions for the Home Setting254
Home Health Care Needs of Adults with HIV256
Pain257
Rights of HIV Infected Patients258
End-of-Life Decisions260
Appendix FMichigan Dignified Death Act262
Glossary275
Bibliography285
Index289
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