CASE-BASED PALLIATIVE CARE: A Clinical Guide to Symptom Management, Serious Illness Communication, and End-of-Life Decision-Making

When symptoms persist and treatment choices become difficult, knowing the options is only the beginning. Understanding how to choose—and when to reconsider—is essential.

A patient’s breathlessness improves, but returning home remains difficult. Pain treatment provides relief, yet adverse effects create new concerns. A family asks what comes next when recovery is uncertain. These are the moments when clinical knowledge, careful judgment, and compassionate communication must work together. Case-Based Palliative Care connects the principles of adult palliative medicine with the decisions clinicians face throughout serious illness. Through evolving patient cases, clinical explanations, and purposeful visuals, readers follow the reasoning from initial assessment to treatment selection, difficult conversations, and reassessment.

Each case explores how symptoms, function, organ impairment, caregiver capacity, and patient preferences influence the care plan—and why that plan may need to change.

Inside, readers will explore:

• Symptom management and safe therapeutics: Pain, opioid prescribing, breathlessness, gastrointestinal symptoms, delirium, psychological distress, and everyday comfort.
• Communication and shared decisions: Serious news, prognosis, goals of care, capacity, advance care planning, and family disagreement.
• Disease-specific care: Cancer, heart failure, respiratory illness, kidney and liver disease, neurologic conditions, dementia, and frailty.
• Care across settings and transitions: Hospital, intensive care, outpatient services, home care, hospice, and caregiver support.
• Crises and end-of-life care: Urgent deterioration, refractory suffering, the final days, and bereavement.

Clinical diagrams, decision pathways, focused callouts, and chapter-end questions with explanations support understanding and application. Throughout, attention to comfort, dignity, and family needs accompanies the clinical teaching. Designed primarily for residents and early-career physicians, this textbook also supports advanced practice clinicians, nurses, and medical students seeking a structured approach to adult palliative care.

Explore the cases, examine the choices, and build a clearer understanding of how to adapt care as serious illness evolves.