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12 - Practical aspects of home care

Published online by Cambridge University Press:  04 August 2010

Anna Wreath Taube
Affiliation:
University of Alberta, Edmonton
Michael J. Fisch
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Eduardo Bruera
Affiliation:
University of Texas, M. D. Anderson Cancer Center
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Summary

Introduction

Palliative care of a cancer patient at home can be one of the most meaningful and rewarding life experiences possible for both the relatives or significant others in the patient's life and for involved professionals. In many poorer parts of the world, of course, there never has been an alternative care setting, but the custom of home care of the advanced cancer patient declined sharply after the mid-twentieth century in much of the industrialized world. In recent years, both patient quality of life issues and government attempts to download costlier acute care medical services to the less costly community setting have encouraged reconsideration of home care of advanced cancer patients as a viable alternative to hospital, or even hospice, care in the Western world.

For family or other lay caregivers, despite the desire to do so, the task is often challenging, emotionally and physically exhausting, and potentially financially costly. Given the exponential advances in palliative medical/radiation oncology and palliative medicine, the terminal phase of many cancer illnesses is now considerably prolonged and families face extended periods of much more complicated cancer home care than in earlier eras. The specifics of home care in any given community may obviously vary considerably, depending on local medical practices and socioeconomic, political, and cultural factors. The following considerations are offered as general suggestions for approaches and resources to facilitate home care of the advanced cancer patient.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2003

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References

Doyle D. Domicillary palliative care. In Oxford Textbook of Palliative Medicine, 2nd edn, ed. D Doyle, G Hanks, N MacDonald, pp. 957–73. Oxford: Oxford University Press, 1998
Macmillan K, Peden J, Hopkinson J, Hycha D. A Caregivers's Guide: a Handbook about End of Life Care. Edmonton: The Palliative Care Association of Alberta, 2000
Mount B M. The ACP Home Care Guide for Advanced Cancer. American College of Physicians. Web site: www.acponline.org/public/h_care/contents.htm

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