Sara Booth

Breathlessness is increasingly recognised as a common, disabling symptom of many advanced diseases and one that is very difficult to treat. There is now an understanding that a multi-disciplinary approach to management can make a significant impact on the severity of the symptom improving both the patient’s and their carers’ quality of life. Breathlessness is one of the most difficult conditions that palliative care (and other clinicians who care for patients with advanced disease) have to treat. With the improvements in pain control, it is possibly now the most difficult symptom for clinicians to manage: many feel frustrated at not being able to give their patients better care. Many patients and families are enduring terrible suffering. There has been little progress in improving the symptom, in spite of an increase in the amount of research and interest in it over the last twenty years. The Cambridge Breathlessness Intervention Service (CBIS) has been established since 2004 and is a research-based service which has being evaluated since its inception: its model of caring has been shaped by the patients and families who use it and the clinicians who refer to it. CBIS has firm evidence of its effectiveness with patients with breathlessness with both malignant and non-malignant disease. This book will help others to manage breathlessness in their day-to-day clinical practice and, if so desired, set up their own breathlessness service. There is a well-established website which can be used in conjunction with the book. The book is written to give practical help in the clinical management of breathlessness and written so that the information is easy to access in clinic, ward or home.

Hospital palliative care teams have been established in rapidly increasing numbers over the last 20 years, as it has been recognised that hospices can never transfer the philosophy and practice of palliative care into the acute sector by simply existing; they often work as 'stand alone units' and remain outside mainstream medicine. However it has become apparent that improving access to palliative care for patients in acute hospitals is not as easy as employing external palliative care specialists as consultants. Even setting up a team of professionals who work solely in a hospital will often not improve the care of the great majority of patients being treated there. Based on the extensive experience and knowledge of three clinicians in the area who have developed palliative care services in acute settings, this book provides those facing the same challenges with practical guidance and down to earth advice on a range of problems they might encounter. Using a problem focused and practical approach, Palliative Care in the Acute Hospital Setting: a practical guide is filled with case-based problems to help readers identify realistic, usable, everyday solutions. It also covers the skills and knowledge needed to help teams make progress in the hospital as well as outlining the best training to help them continue to flourish. Written in an accessible style with short and focussed chapters, this clearly laid out book helps readers find the information they need to tackle particular problems easily and with confidence. With a supportive outlook and covering the non-clinical management aspects of palliative care, this book is the ideal guide for palliative care specialists making the transfer from hospice to hospital, and for those setting up palliative care teams in the acute hospital setting.