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Unit 6 Life and MedicinePage 137Issues to be coverednVarious models of end-of-life care and the commonalities(共性)and differences between themnVaried opinions on end-of-life care and euthanasia（安乐死）from various stakeholders（利益相关者）,namely（也就是，即）,physicians,patients and patient family members or friends nPalliative care（姑息疗法）,hospice care（临终关怀）,comfort care,and the similarities and difference between themnInfertility treatments,particularly IVF,its pioneers,ethical dispute,and social impacts（不孕不育治疗,尤其是体外受精,其先锋,伦理争议,和社会影响）Page 137-166Text AnFinding Care at the End of Life qNational Institute on AgingPage 138Warm-up ListeningHospice Care临终关怀How has the end-of-life care changed over time?(Pre.1)Page 139,P1Pre 1.How has the end-of-life changed over time?Page 136In the pastDied at homeAt presentStay in hospitals or nursing homes at the end of lifeThere is no“right”place to die.nThings to consider when choosing the right place to die:qThe most sensible type of careqAvailability of such care qAvailability of support systemqManagement of the costPage 139,P 2What is said about George?(Pre.2)Age:sixty-fourPast history:congestive heart failureRequirements about medical services:get all medical care available to extend lifeChoice of medical services:HOSPITALPage 139,P 2Language Focuses nGeorge and those closest to him had previously decided that,no matter what,the doctor should try to do everything medically possible to extend Georges life.qWhat is interesting to you in the sentence?Page 139,P2Language Focuses nGeorge and those closest to him had previously decided that,no matter what,the doctor should try to do everything medically possible to extend Georges life.Page 139,P2Language Focuses nSo,when George needed care,he went to a hospital,where doctors and nurses are available around-the-clock.qWhat is interesting to you in the sentence?Page 139,P2Language Focuses nSo,when George needed care,he went to a hospital,where doctors and nurses are available around-the-clock.qWhat is interesting to you in the sentence?Page 139,P2What advantages does a hospital have over a nursing home for end-of-life care?(Pre.3)nAvailability of medical resources,including doctors,nurses and facility around the clocknAnything else you can add to that?nAdvantages of Nursing HomeqPrearranged plans for end-of-life careqEstablishment of a relationship between the staff and familyqMore personalized careqPrivacy arrangement:time alonePage 139,P4英语短语 Congestive heart failure充血性心衰Extend life延长生命Available around-the-clock24小时随叫随到Coronary Care Unit冠心病监护室Page 83英语短语 Not responding to treatment治疗无效Hospital setting医院环境Nursing home养老院Skilled nursing facility专业护理机构Page 83Whats the role of family and friends when the patient is cared at home?(Pre.4)nTaking on a job which is big physically,emotionally,and financially；nHiring a home nurse for additional help;nArranging for services(such as visiting nurses)and special equipment(like a hospital bed or bedside commode)Page 140 P 6-8What needs to be considered to make comfort care available at home?(Pre.5)nHealth insurancenPlanning by a professional,such as a hospital discharge planner or a social workernHelp from local governmental agenciesnDoctor supervision at homePage 140 P6-8英语短语 Come and go freely来去自由Take on a job承担工作Comfort care舒适护理Health insurance医疗保险英语短语 弥留之际at the end of life临终者/弥留之际的人the dying person临终看护end-of-life care根据需要/按需as neededHow has the meaning of palliative care changed?(Pre.6)Page 140,P9-10only symptom carecomprehensive:lquality of life lfamily includedlmultidisciplinary：doctors,nurses,therapists,counselors,social workers,others as neededlmedical,social,emotionallplaces:hospital,nursing homes,outpatient clinics,specialized clinics,at homeclose to hospice care21Knowledge of the subject matter Page 141,P11Knowledge of the subject matter Page 141,P11Knowledge of the subject matter Page 141,P11Knowledge of the subject matter Page 141,P11Knowledge of the subject matter Page 141,P12Knowledge of the subject matter Page 141,P12Knowledge of the subject matter Page 141,P12Knowledge of the subject matter Page 141,P12Knowledge of the subject matter Page 141,P13Knowledge of the subject matter Page 141,P13英语短语 Symptom care症状护理Palliative care姑息疗法Multidisciplinary health care team多学科医疗团队Fatal illness/Terminal disease绝症英语短语 Chronic obstructive pulmonary disease慢性阻塞性肺病Experimental treatments实验性治疗As the disease progressed随着疾病发展Jack as a case in point/a typical example nDiagnosed with chronic obstructive pulmonary disease at age seventynMore difficult breathing as the disease progressed nAble to receive the comfort care and emotional support through the palliative care provided by the Veterans Health Administration 退伍军人事务部,while receiving treatment for his pulmonary diseasenThe palliative care program around the house and other support for Jacks wife,making it easier for her to care for Jack at home34Where does hospice care come in?nNo more curative medical treatmentnThe illness not responding to medical attempts to cure it or to slow the diseases progress.35What might be one of the misconceptions about choosing hospice?(Pre.7)nStopping treatment specifically aimed at curing an illness equals discontinuing all treatmentqA good example:An older person with cancerqDiscontinuation of chemotherapy but continuation of medication for hypertension36What might be one of the misconceptions about choosing hospice?(Pre.7)nChoosing hospice is a permanent decisionqDeloresqEighty-two with failing kidneys qBeginning hospice care not wanting to go through dialysisqChanging her mind and beginning dialysis in the hopes of one day holding her first great-grandchild.37What might be one of the misconceptions about choosing hospice?(Pre.7)nChoosing hospice is a permanent decisionqArt Buchwaldqeighty-one qDecided against the kidney dialysis suggested by his doctorqBig news with stabilized conditionqLeaving hospice without threat of death38英语短语 Spiritual Advisors精神顾问Discontinue all treatment停止所有治疗Go through dialysis接受透析Further Thinking:What is the best choice for the end of life in Chinas setting?nHome?nHospital?nNursing Home?40Further ListeningHearing or LifeTask 1 OverviewPage 143Similarities Differences Palliative careHospice care42Task 1 OverviewPage 143Similarities Differences Palliative care1.Treatment of symptoms;2.Multidisciplinary service;3.Provided at home,hospitals,and specialized care centers;4.Reversible choice1.Service may be provided as long as possible;2.There is still hope for a cure.Hospice care1.Service usually provided to patients who have only 6 months to live;2.There is no hope for a cure.43Task 1 OverviewPage 143Place of end-of-life careAdvantages Disadvantages HospitalsNursing homesHomes 44Task 1 OverviewPage 143Place of end-of-life careAdvantages Disadvantages Hospitals Availability of medical resources,including doctors,nurses and facility around the clock Hospital rules Limited space Privacy issueN u r s i n g homes Closer relationship with nursing staff More personalized care L i m i t e d a c c e s s t o doctors Privacy issue Homes Familiar environment Freedom for family and friends to come and go Physical,emotional and financial burden for the caregivers45Task 1 Medical TerminologyPage 145EnglishchemotherapydisinfectioncoronarycurativedialysisanemiapalliativeMedicarepulmonarymultidisciplinaryChinese化学疗法消毒，杀菌冠状动脉的治疗的，治愈的透析贫血（症）姑息/缓和的（疗法）美国联邦医疗保险肺的多学科的，跨学科的46Task 2 Signpost Language Giving ExamplesPage 146nFor example,.nA good example of this is.nAs an illustration,.nTo give you an example,.n is a case in point.nSuch as47Task 2 Signpost LanguageCause and EffectPage 115n1.These patients also receive symptom care or palliative care.For example,in time George developed anemia along with his heart failure.Managing the anemia can improve some of the symptoms troubling George.n2.It is important to remember that stopping treatment specifically aimed at curing an illness does not mean discontinuing all treatment.A good example is an older person with cancer.n3.Choosing hospice does not have to be a permanent decision.For example,Delores was eighty-two when she learned that her kidneys were failing.n4.In order to make comfort care available at home,you will have to arrange for services(such as visiting nurses)and special equipment(like a hospital bed or bedside commode).48Task 3 Formal Englishn1.If the dying person has lived in the facility for a while,the staff and family have probably become as close as friends.n2.In a palliative care program,a health care team made up of people from different disciplines gives both the patient and family any medical,social,and emotional support so that the patient can live with a deadly disease.n3.Palliative care could change to hospice care.Even if the palliative care continued,the emphasis should be put on comfort care,not on medical treatment or a cure.n4.If you choose hospice now,you can change it later.Page 147
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