Abstract
This book was written as a practical guide for professionals who care for patients with advanced respiratory disease and comes in a familiar format that all Oxford Handbooks are based on. Each section is a succinct summary of end-stage respiratory disease, its recognition, treatment therapies and targets. It emphasizes the role of nonrespiratory symptoms, which is often overlooked but remains of great importance to the patient. Furthermore, the book considers the ethical, legal, spiritual and cultural needs of the patient and the health care professionals involved.
This handbook excels in its explanation of nonmedical therapies to help patients with end-of-life care issues, which are often sidelined. Additionally, there is guidance on estimating prognosis, which is often challenging. It deals with recognizing when the end-of-life phase is approaching and gives practical steps on how to broach this sensitive subject with the patient and their family. The discussion of pain management is particularly useful as attention is given to the differing types of pain and the advantages and disadvantages of specific analgesics alongside their conversion and titration calculations. Interestingly, it also deals with ‘whole body pain’ or ‘morphine irrelevant pain’, which is a manifestation of the deep psychological turmoil that some of these patients experience at the end-of-life. The chapter on ‘Care in the Terminal Phase’ provides an important aid to any practitioner in managing patients, and it also focuses the reader on the support required by the carer of these often challenging groups of patients. The last third of the book is dedicated to the critical aspects of effective communication and advanced care planning. There is a concise table that outlines a basic framework on which to break bad news and execute an effective palliative care consultation that would work well in either a clinic or ward setting. The use of examples allows the reader to visualize the consultation and practice their communication skills, which is of paramount importance.
The only shortfall in this succinct but comprehensive guide is its lack of pictorial representation, which may be valuable in providing easy referencing when time is short, for example, when dealing with an emergency. Overall, I would recommend this easy-to-read and thorough practical guide to all health care professionals involved in the care of advanced and terminal respiratory disease.