This book is a printed edition of the Special Issue "Family Communication at the End of Life" that was published in Behavioral Sciences

Scholars contributing to this special issue on "Family Communication at the End of Life" have provided evidence that communication is vital for terminally ill individuals, family members, and healthcare/palliative care specialists. Overall, the fifteen articles in this special issue focus on five questions: First, what are the trends regarding different approaches for beginning the conversation about death and dying earlier rather than later? Second, who is making the end of life decisions and how are they made? Third, how does age and disease impact the way that families communicate at the end of life? Fourth, how does good communication (i.e., satisfying for all participants, effective for addressing needs, fulfilling goals) impact the myriad of complex issues at the end of life? Fifth, what is the significance of exploring and valuing the perspective of the family members' experiences and recollections of their communication at the end of life with their terminally ill family member as well as with the healthcare providers? Overall, the scholars emphasize that focusing on family communication at the end of life is crucial for improving medical, psychological, and relational outcomes for those dealing with the death and dying process.

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

This book examines the dialectic between fictional death as depicted in the media and real death as it is experienced in a hospital setting. Using a Terror Management theoretical lens, Davis and Crane explore the intersections of life and death, experience and fiction, to understand the relationship between them. The authors use complementary perspectives to examine what it means when we speak and think of death as it is conceived in cultural media and as it is constructed by and circulates between patients, health professionals, and supportive family members and friends. Layering analysis with evocative narrative and an intimate tone, with characters, plot, and action that reflect the voices and experiences of all project participants, including the authors’ own, Davis and Crane reflect on what it means to pass away. Their medical humanities approach bridges health communication, cultural studies, and the arts to inform medical ethics and care.

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

From Ira Byock, prominent palliative care physician and expert in end of life decisions, a lesson in Dying Well. Nobody should have to die in pain. Nobody should have to die alone. This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning. Ira Byock is also the author of The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life.

This multi-contextual approach serves to integrate current findings, expand our theoretical understanding of the end of life, prioritize the significance of competent communication for scholars and practitioners, and provide a solid foundation upon which to build pragmatic interventions to assist individuals at the end of life as well as those who care for and grieve for those who are dying.