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Center to Advance Palliative Care Manual
http://64.85.16.230/educate/content.html

This is a very informative well organized and accessible online manual. From the website:
This "How To" manual was written to facilitate the development palliative care services in hospitals and health systems by clinicians and administrators.

Palliative care is interdisciplinary care that aims to relieve suffering and improve quality of life. Although the skills and knowledge base developed for end-of-life care, palliative care may be combined with curative or disease-modifying therapy for patients with life-threatening illnesses and their families.

Hospitals and health care systems develop programs to deliver palliative care services in a variety of ways. They are composed of a variety of components; consultation services, inpatient units, home care and hospice care are the most common. Frequently, one component develops first. ther components are added as the program matures.

A comprehensive program that meets the needs of patients, families and caregivers will provide care in all settings, either as a direct responsibility or through collaborative relationships. In fact, many new programs begin with collaboration between a hospice program and hospital or health care system.

The rationale for developing palliative care services in hospitals and health care systems is compelling. The illness experience for most serious diseases has changed over the past century. Now, the majority of people die after a chronic progressive illness that is many years in duration. Those people are frequently hospitalized. If the symptom, emotional, practical and existential issues that are manifestations and predicaments arising from the disease process re not addressed, hospital resources may be used excessively or inappropriately. By providing palliative care services, hospitals can more effectively and efficiently provide care that satisfies heir patients and their families. In addition, they can provide that care more cost effectively.

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