International Association for Hospice & Palliative Care

International Association for Hospice & Palliative Care

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Promoting Hospice & Palliative Care Worldwide


2008; Volume 9, No 3, March

Roger Woodruff, MD


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Hospice Palliative Care Book Reviews &
The Palliative Care Book of the Month

Roger Woodruff, MD

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Book of the Month

Core Skills and Clinical Competencies

Linda L. Emanuel and S. Lawrence Librach (eds)
Elsevier Saunders, 2007
ISBN 978-1-4160-2597-9
RRP $US 79.00, £46.99

This book sets out to provide the core knowledge and skills necessary to provide good palliative care that is effective, comprehensive and compassionate. The more than sixty contributors include many leaders in the field.

The book is comprehensive in scope. The Table of Contents is reproduced with this review listed in the Bookshop on the IAHPC website and I encourage you to look at it. (The Table of Contents on the publisher’s website looks like an incomplete early draft.) The first section is about core skills. After some introduction on the essence of palliative care, there are chapters on assessment, communication and negotiating the goals of care. Then there are chapters on the management of pain and other symptoms, both physical and psychological. This is followed by a very interesting group of chapters covering such issues as loss, cultural differences, advance care planning, euthanasia and physician-assisted suicide, withholding and withdrawing life-sustaining therapies, and the last hours of living. The second main section has chapters about palliative care for various illnesses including HIV/AIDS, heart failure, lung disease, renal failure, and neurodegenerative disease. There is a strong undercurrent for the involvement of palliative care in the management of all advanced diseases. The third section is about service delivery with chapters on the interdisciplinary team and the various members of it as well as the different types of services and the integration of care. The final section deals with the social context: the economic burden of end-of-life illness and palliative care in developing countries. This last chapter was written by Liliana de Lima and several members of the IAHPC Board, but sadly IAHPC is not listed in the Resources appendix.

The lay-out is appealing. Each chapter starts with an outline and ends with a summary. The liberal use of headings invites browsing and makes finding specific information easier. Each chapter also has a pair of lists: Pearls and Pitfalls.
So what’s different about this book? First is the emphasis on whole-person care, with practical guidance as to how to go about it. Second is the belief in the wider applicability of the principles and practices of palliative care—“Palliative care comprises at least half of medicine.”

Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
(February 2008)



Book Reviews

Hospice in America

Josefina B. Magno
iUniverse, Inc., 2007
129 pp
ISBN 978-0-595-45651-2
RRP $US14.95

The Annual Assembly of the Academy of Hospice Physicians was always something to be looked forward to.   The welcoming atmosphere, meeting other people enthusiastic about hospice and palliative care, and learning more about quality end-of-life care were among the highlights.  But, at the centre of it all would be mother Josefina, quietly encouraging and empowering her flock.  The hundreds, if not thousands, of physicians whom she encouraged to pursue palliative care are one of her legacies, and I count myself as fortunate to have been among them.  IAHPC, with its focus on palliative care world-wide, is another. 

Dr. Josefina B. Magno was a remarkable woman.  She had great vision, a lot of quiet determination, and was a charismatic leader.  Hospice in America is her memoir and includes stories from her childhood, marriage, becoming a widow and surviving breast cancer—all steps leading her to becoming a hospice physician.  After that, her life’s work was a crusade to develop palliative care and to educate health care professionals about it, not only in North America but also in her native Philippines.  I commend this book to anyone interested in the history of modern palliative care and to all of you who had the good fortune to know her.



Second edition

David Oliver, Gian Domenico Borasio and Declan Walsh (Eds)
Oxford University Press, 2006
ISBN 019-857048-1
RRP $US57.50  £29.95

The management of patients with amyotrophic lateral sclerosis (ALS), and their families, provides many challenges for those who work in palliative care. This updated and expanded second edition brings together information on all aspects of that care—psychosocial as well as physical. The need for a multidisciplinary approach and the roles of different members of the team are clearly outlined. The chapter on end of life care will be particularly useful for inpatient palliative care services that may first see ALS patients when they are already terminally ill. There are new chapters on decision-making, spiritual care, nursing care, and ethical issues.

This book is an excellent resource for any health care professionals who are involved in the care of patients with ALS. For those of us who see patients with ALS relatively infrequently, access to a reference such as this is invaluable, which makes this book a must for the library shelf of any palliative care unit managing these patients. It also represents good value—despite the addition of an extra 150 pages, the price has come down 40%.



Fairview Hospice
Fairview Press, 1999
192 pp
ISBN 1-57749-090-8
RRP $US14.95

This book is for family caregivers of patients with life-threatening illnesses, who are often thrust into the role of both caregiver and decision-maker. It is the collective efforts of the team members at Fairview Hospice in Minneapolis, with the help of writer Karen Hess. Chapters cover the concept of hospice care, coping with a terminal illness, being a caregiver, pain and symptom management, nutrition, financial and legal issues, the final days, and grief and bereavement. It is clearly written with the use of a lot of lists, giving straightforward practical advice about how to deal with the physical and emotional problems that occur. There are checklists of things to do or that should be done. The text also includes a number of brief but meaningful quotations. This book strikes a nice balance—it provides a lot of useful information, but manages to keep it simple and understandable. I think it would be a most useful resource for family caregivers.



Pat Schofield (Ed)
Wiley, 2007
213 pp
ISBN 978-0-470-03349-4
RRP £21.99, $US45.00,  $AUD60.95.

Voltaire said ‘…old age and pain sneak up on us…’ Increasing aches and discomforts are one of the vicissitudes of increasing age, but the problem of significant pain in the older generation is probably under recognised and inadequately treated. This book is an introduction to the significant problems associated with pain in older people for nurses whose practice brings them into contact with the older population and those learning about it.

The book opens with a useful chapter on the neurophysiology of pain, although the section about differences in perception of pain in older people deals more with psychosocial matters than with neurophysiological changes. The chapter on what older people think about their aches and pains is illuminating. The chapter on pain assessment includes a good description of how to assess pain in persons with cognitive impairment and dementia. The chapters on treatment were a little short on medical detail but provide a good basis for a nursing approach. The text includes summaries, boxed learning points and questions and seems well referenced. A critique of the available quality of life tools would have been a plus.

As an introductory text, as an invitation to reflect and to read more, I think this book achieves its goal.  


Person-centred dialogues

Richard Bryant-Jefferies
Radcliffe Publishing, 2006
183 pp
ISBN 978-1-84619-079-7
RRP £19.95, $US38.00.

In counselling circles, the Patient Centred Approach refers to a particular form of counselling and therapeutic relationship attributed to Carl Rogers.  Bryant-Jefferies presents the annotated dialogues of the counselling sessions of two patients managed by such technique—Billy mourning the death of his father and Barbara facing the threat of advanced breast cancer.  The sessions of the therapist with his supervisor are also recorded.  This book will be of interest to both student and experienced counsellors.



Ellen Csikai and Barbara Jones (Eds)
Lyceum Books, 2007
324 pp
ISBN 978-1-933478-10-4
RRP $US33.95

This compendium of teaching resources includes a review of available textbooks, clinical assessment tools, reflective exercises and details of a number of bachelors’, masters’ and specialty social work courses.  This book will be a useful resource for anyone, not just social workers, planning courses in end-of-life care, palliative care, and grief and bereavement.

Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
(February 2008)

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