Opening doors
Jean Gaffin
pp 6-7
The National Council for Hospice and Specialist Palliative Care Services (NCHSPCS) was set up in December 1991 to represent hospice and specialist palliative care services in England, Northern Ireland and Wales. Its membership includes professional organisations, national charities concerned with palliative care, an elected National Health Service (NHS) representative and 16 elected regional representatives from a range of disciplines, both in the NHS and in voluntary hospice and specialist palliative care services.
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The role of nebulised drugs in palliating respiratory symptoms of malignant disease
Carol Davis
pp 9-15
Inhalation is the preferred method of administration for many drugs used in the management of chronic, non-malignant lung disease. Inhaled drugs have traditionally been most widely used in patients with chronic obstructive pulmonary disease (COPD) and asthma, but they are also an important part of the management of patients with cystic fibrosis and bronchiectasis. More recently, nebulised antibiotics have been successfully employed in the prophylaxis and treatment of opportunistic infection in patients with HIV infection and AIDS.
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Helen House: a model of children’s hospice care
Jacqueline Worswick
pp 17-20
Helen House opened in Oxford in November 1982. It is a small, eight-bedded, purpose-built unit set in a beautiful garden. The hospice provides day-to-day love and care for children with life limiting illness as well as support for their families. Since it opened, 307 children from all over the UK have come for respite and/or terminal care. Of these, more than 50% have come from within a 50 mile radius, but some have travelled considerably further – 17% from over 100 miles away.
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Family care – new principles
Martine Hannicq
pp 21-24
The special role of home palliative care nurses brings them into daily contact with the reality of the problems in this situation. They are made aware of what the relatives are going through – their suffering, how they are affected by death and how, on a 24- hour basis, sometimes for months on end, they give time, energy and love to someone close to them.
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Saying goodbye
atinka Maus-Bielders
pp 25-28
In the minutes, hours and days following the death of a loved one, various moments and stages must be lived through. There is the moment when someone closes the deceased’s eyes. Who should make the first move? A member of the family? A nurse? When? What does this gesture mean? When should the drip or the alternating mattress be turned off?
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The crisis of dying
Maurice Abiven
pp 29-32
In psychology, ‘crisis’ describes an abrupt change in an individual’s behaviour. The change may be due to internal causes – a physiological development or a serious illness – or to external ones, such as redundancy or a broken relationship. Some of these are designated as such in everyday language. It is common to hear about the crisis of the menopause (the mid-life crisis).
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Burnout – what is at stake?
Alexis Burger
pp 33-34
The concept of burnout first appeared in the literature more than 20 years ago when Freudenberger invented the expression. While initial interest developed in the USA, Europe followed suit from the beginning of the 1980s. In a noteworthy study, Maslach defined it as ‘a syndrome of physical and emotional exhaustion, including the development of negative self-assessment and professional attitudes as well as the loss of feeling for and involvement with the client.’
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Spiritual components in palliative care
Stuart Coates
pp 37-39
Kallenberg and Brakenhielm have highlighted five different headings under they observe the experience of suffering in palliative care (physical pain, compassion, guilt, loss and anxiety/fear of death). These experiences appear to be considered predominantly from the perspective of carers, with the apparent exception of the first (ie, in relation to physical pain).
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