The opportunity for psychiatry in palliative care

Psychiatry Programs, The Institute for Palliative Medicine at San Diego Hospice, San Diego, California 92103, USA.
Canadian journal of psychiatry. Revue canadienne de psychiatrie (Impact Factor: 2.55). 12/2008; 53(11):713-24.
Source: PubMed

ABSTRACT The need for psychiatrists to work with patients and families living with chronic life-threatening illnesses has never been greater. Further, psychiatrists may find exciting work within the relatively new field of palliative care, which is devoted to the prevention and relief of all suffering. Increasingly, individuals are living longer with multiple issues that cause suffering, interfere with their lives, and often lead to psychosocial sequelae. To ensure state-of-the-art care for patients and families throughout an illness and any ensuing bereavement period, many experienced psychiatrists are needed as consultants to, and as members of, interdisciplinary palliative care teams. This need presents limitless opportunities for psychiatrists to care for patients, provide education, and engage in research. The potential to make a difference is great.

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    • "First a more thorough assessment of the target audience is needed. Clinicians will vary in their knowledge and skills about the assessment, diagnosis , and management of psychiatric issues as they relate to patients with life-threatening illnesses (Irwin & Ferris, 2008). Nonpalliative-care physicians and other members of the general health care team will need to achieve and maintain basic core competencies in the psychiatric aspects of palliative medicine. "
    Palliative and Supportive Care 04/2009; 7(1):3-6. DOI:10.1017/S1478951509000029 · 0.98 Impact Factor
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    ABSTRACT: Patients with advanced illness and their caregivers are intimately familiar with the experience of grief and loss. Being diagnosed with a serious illness is often the beginning of emotional and physical losses that may end with the patient's death. Along the difficult journey through illness, patients and caregivers may develop varying degrees and types of emotional distress. Depression, severe grief reactions, and demoralization are common types of disorders experienced by patients and caregivers in the palliative care setting. While commonly recognized as separate diagnostic entities, these disorders share many symptoms, making their differentiation challenging. Accurate diagnosis is crucial because of its treatment implications. This article reviews the characteristic features of these disorders in the context of palliative and end-of-life care. Assessment and non-pharmacologic treatment modalities are presented.
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    ABSTRACT: How we die is increasingly becoming a matter of law and public policy. We grapple with issues of patient autonomy, the proper parameters of doctor-patient discussions on the end of life, the right to hasten death, and the right to control our own medical treatment. But it is physicians and patients, not judges and legislators, who are the principal actors in events at the end of life. Palliative medicine is just beginning to probe the multi-dimensional totality of suffering in dying and seriously ill patients. What we learn will influence our options at the end of life and tell us why different approaches benefit different individuals. Before we invite the lawyers and the policy makers to our bedsides, it is important that we understand the dying process, and how doctors and patients can more effectively collaborate in the pursuit of a better death.
    SSRN Electronic Journal 09/2009; DOI:10.2139/ssrn.1475348
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