NOTES FROM A SMALL HOSPICE: A PERSONAL SUMMARY OF PALLIATIVE CARE

by Peter Kaye

This book started as an attempt to write a very short introduction for both professionals and service users, in the style of "coffeepot conversations" - imagined brief replies to common questions. It grew into a longer book but the aim remains the an informal, personal description of the most important aspects of palliative care. Each chapter is meant to be "short enough to read in the bath before the water goes cold" with plenty of stories and personal opinions.This is an informal book about a serious subject and the approach taken will interest those already working in the field as well as newcomers. The book will also appeal to patients and families, especially the chapters on What is a Good Death? ( nearly called "How to die well") End of life conversations, Bereavement and Coping in a Crisis. The book aims to capture something of the complexity and humanity of palliative care and is wide-ranging, anecdotal, idiosyncratic and not totally devoid of humour, much like palliative care itself. Consultant in Palliative Care doctor Peter Kaye (the author of several bestselling textbooks on the subject) has summarised the specialty as he now sees it, looking back on 30 years of experience. Someone famous once said "if a thing is worth saying, it is worth saying clearly". This book is both comprehensive and easy-to-read. Taking the first steps into the realm of palliative care can be anxiety-provoking for anyone. This book aims to dispel some unnecessary worrying by professionals (“what if I say the wrong thing?”) and patients (“what is going to happen?”) and relatives (“how will we cope?”).
There is a detailed contents list of all the sub-headings found in each chapter, making it easy to find your way around the digital version of the book. Chapter 1: What is Palliative Care?, discusses what patients need, and expands on the important concepts of continuity of care, caring and trust. Chapter 2: A Bit of History, summarises the development of hospices and palliative care. Chapter 3: What is a Good Death? - the most personal of the chapters - includes an ambitious section called The 8 Tasks of Dying. Chapter 4: Crisis Intervention - Ways to Help, describes a very useful theory about how to provide support without getting burnt out. Chapter 5: Effective Teamwork, is a practical look at how teams work and how to maximise our potential as team members. Chapter 6: The Mystery of Pain looks in some detail at the neurophysiology of pain and includes a section on how to control cancer pain. Chapter 7: How to Use Morphine, is about our understanding of morphine plus a detailed clinical description that includes how to teach our patients to use it well. Chapter 8, 25 Principles of Symptom Control, is a brief summary of the key messages. Chapter 9: A-Z of Common Problems is a longer chapter with brief (opinionated) discussions of common problems and symptoms to prompt thinking about each topic. Chapter 10: The Power of a Family Meeting is informed by Dr Kaye's special interest in family dynamics and encourages more use of this approach. Chapter 11: End of Life Conversations, contains some recent stories and some do's and don'ts. Chapter 12: What's So Difficult About Spiritual Care? explores the slippery question of spirituality. Chapter 13: The Art of Dying, is about the therapeutic uses of creativity. Chapter 14: Two Debates - Pushing and Pulling, discusses the ethical issues of euthanasia and resuscitation. Chapter 15: Bereavement, includes some recent research on attachment theory. Chapter 16: My Desert Island Drugs, considers the best drugs for controlling symptoms. Chapter 17: Thoughts on Prescribing, looks at the art and science of therapeutics. Chapter 18 How Drugs Work is longer than the other chapters and is a fairly detailed update on (useful) clinical pharmacology, starting from scratch, with plenty of diagrams. Chapter 19: The Future, contains some musings on the future of palliative care.

401 pages, Kindle Edition

First published July 2, 2014