Palliative Care in Oncology
Palliative care provides comprehensive support for severely affected patients with any life-limiting or life-threatening diagnosis. To do this effectively, it requires a disease-specific approach as the patients’ needs and clinical context will vary depen
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Palliative Care in Oncology
Bernd Alt-Epping • Friedemann Nauck Editors
Palliative Care in Oncology
Editors Bernd Alt-Epping Department of Palliative Medicine University Medical Center Göttingen Germany
Friedemann Nauck Department of Palliative Medicine University Medical Center Göttingen Germany
ISBN 978-3-662-46201-0 ISBN 978-3-662-46202-7 DOI 10.1007/978-3-662-46202-7
(eBook)
Library of Congress Control Number: 2015936042 Springer Heidelberg New York Dordrecht London © Springer-Verlag Berlin Heidelberg 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Foreword
A Palliative Care Revolution Irene, a 59-year-old patient with cancer of the breast and bone metastases at a London cancer hospital, ruminated on care, treatment, death and bereavement. She began with This is a wonderful place….they have a cure for everything
and ended with They are just going to get me through to Christmas….and then decide what to do with me. I’m worried about Bill looking after himself.
I just listened. She took just 6 min to tell me her story. Two months later, after her death, her husband, Bill, told me, She was so thin, her wedding ring fell off – that hurt. She told me it hurt to hug her … I couldn’t even hug her.
The generic palliative care skills of trust building, full attention, listening, reflecting back, open questions and well-paced interspersing of information giving and inquiry were just some of the skills used to coax out what was most worrying for Irene and later her bereaved husband. The skills are almost invisible. This is one patient’s narrative. Narrative medicine encourages us to listen and tease out patients’ stories to reach the pain in whatever dimension the patient and those close to them are experiencing it. O’Brien, quoting Elwyn and Gwyn (1999), reminds us, ‘for all the science that underpins clinical practice, practitioners and patients make sense of
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