A Safer Death Multidisciplinary Aspects of Terminal Care
A Safer Death Multidisciplinary Aspects of Terminal Care Edited by Anne Gilmore Prince and Princess of Wales Hospice Glasgow, Scotland and Stan Gilmore Stirling University Stirling, Scotland Plenum Press New York and London
Library of Congress Cataloging in Publication Data International Conference of the Prince and Princess of Wales Hospice on Multidisciplinary Aspects of Terminal Care (1st: 1987: Glasgow, Strathclyde) A safer death. "Proceedings of the First International Conference of the Prince and Princess of Wales Hospice on Multidisciplinary Aspects of Terminal Care, held September 8-10, 1987, in Glasgow, Scotland"-T.p. verso. I. Terminal care-congresses. 2. Terminal care-psychological aspects-congresses. I. Gilmore, Anne. II. Gilmore, Stan. III. Title. R726.8.l56 1987 362.1'75 88-12414 ISBN-13: 978-1-4615-8361-5 e-isbn-13: 978-1-4615-8359-2 001: 10.1007/978-1-4615-8359-2 Proceedings of the First International Conference of the Prince and Princess of Wales Hospice on Multidisciplinary Aspects of Terminal Care, held September 8-10, 1987, in Glasgow, Scotland. 1988 Plenum Press, New York Softcover reprint of the hardcover 1 st ed ition 1988 A Division of Plenum Publishing Corporation 233 Spring Street, New York, N.Y. 10013 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher
PREFACE During the past two decades professional interest in Terminal Care has increased dramatically. It is always difficult to trace the origins of a change of emphasis in medical and nursing care but it is likely that three influences have contributed to bring this about. Firstly, the rise of the modern hospice movement with its recognition that dying and mourning are normal life events and that the lay person has a role in these events no less important than the health professional; secondly, the development of sophisticated and successful techniques of palliative care and pain control; and lastly, the increasing expectations of the populace in advanced countries for a comprehensive and sensitive service for patients, family and care givers at the terminal phase of illness. It is significant that these developments in the care and management of the terminally ill are not confined either to one country or the sole prerogative of a single discipline. This is reflected in the papers collected in this volume which were originally presented at the International Conference on Multidisciplinary Aspects of Terminal Care organised by The Prince and Princess of Wales Hospice in Glasgow, Scotland, U.K. The cross-fertilisation of ideas, experiences, and assessments provided by the contributors in a multicultural and multidisciplinary context presented in this volume will be found stimulating and inspirational for both the professional and the lay person in the care of the dying. Michael Bond Vice Principal and Professor of Psychological Medicine University of Glasgow Scotland, U.K. 1988 v
CONTENTS Part One - Problems of Death and Dying Robert Kastenbaum Michael Murphy Raymond I1lsley "Safe Death" in the Postmodern World The Inner Web Terminal Care: from a Sociological Perspective 3 15 19 Ren~e Sebag-Lanoe The Problems of Death and Dying from a Psychoanalytic Perspective 23 Jorn Beckmann and Henrik Olesen Anssi Perakyla Katsuya Inoue Ruth Richardson Elspeth Brewis Clifton Lowther Ann Bowling Robyn Shapiro The Anxiety of the Unknown - Dying in a Psycho-Existential Perspective Four Frames of Death in Modern Hospital Various Environments Surrounding Death Among the Japanese Elderly The Nest-Egg and the Funeral - Fear of Death on the Parish Among the Elderly Terminal Care in Children Terminal Care in the Old Risk Factors with Mortality Among the Elderly Bereaved Ethical Implications of Use of the Living Will in Care of the Terminally III 31 41 47 53 59 65 69 75 Part Two - Varieties of Caring Responses Anneli Vainio Richard Schilling and Peter Millard Richard Feinmann and Audrey Pointon Pain Treatment and Terminal Care in Finnish Hospitals Special Equipment for the Severely Disabled Setting Up A District Health Authority Terminal Care Support Team 83 93 99 vii
David Frampton Patricia F10riet Milly Jolley Francesco Campione and Nadia Crotti Nicky James Marilyn Re1f and Ann Could rick Sharon Frierdich, Andrea Urban, Peggy Possin and Jan Lehman A Creative Response to Multiple Losses Jusqu'a 1a Mort, Accompagner 1a Vie Self Help and the Role of Psychosocial Support and Therapy Short-Term Psychotherapy and Crisis Intervention in Bereavement A Family and A Team - Nurses' Roles in In-Patient Terminal Care Bereavement Support - The Relationship Between Professionals and Volunteers The Development of a Program to Assist Schoo1age Children in Coping with the Death of a Classmate 103 109 113 119 125 133 139 Part Three - Evaluation Mary Vachon Battle Fatigue in Hospice/Palliative Care 149 G.B. Humphrey, W.A. Kamps, E. de Bruin, H. Bosma and A. Kingma C.M. McKee and G. Rajartnam Nicole De1vaux, Darius Razavi, Christine Farvacques and Edmond Robaye F.W. Gunz and I. Reynolds G. Morasso, F. Cianfriglia, N. Crotti, F. DeFalco and M. Tamburrini Irene Higginson, Angela Wade and Mark McCarthy Contributors Index Terminal Care of the Child with Cancer: An Analysis of Parent/Child Attitudes Evaluation of the Use of Terminal Care Services in an Inner City District The Effectiveness of a Psychological Training Designed for Health Care Professionals Dealing with Terminal Cancer Patients Health Services Used by Cancer Patients During the Terminal Three Months Physician's Attitudes in the Management of Terminally III Patients A Comparison of Four Outcome Measures of Terminal Care 161 167 171 185 191 205 213 217 viii