Pediatric Palliative Care: Where Are We Now?

Tina M. Schwartz; Stephanie Chalupka

Disclosures

Pediatr Nurs. 2019;45(5):224-230. 

In This Article

Improving Patient Outcomes

PPC aims to improve the QOL of patients and families throughout life-threatening conditions or life-limiting illnesses. Care provided to pediatric patients differs from adult care in that it involves decision-making by parents rather than patients themselves (Baker et al., 2015). The deaths of neonates are usually due to preterm birth, congenital disorders, and syndromes, thereby characterizing palliative care for them as the end of life and bereavement care.

Care for children with chronic or complex conditions is more readily ascertained. Indications are the progression of the disease, stability or instability of a child's condition, increased admissions or medical support, worsening pain, suffering, or treatment that is no longer curative (Bergstraesser, 2012). Advanced care planning is another attribute of improving the QOL of patients receiving PPC. Children regardless of their age should be able to have a voice as to their wishes surrounding their treatment. They should be included in the decision-making process. Regardless of either acute or chronic conditions, parents are looking for a knowledgeable professional to provide them with honest and realistic information to help guide them during times of uncertainty (Bergstraesser, 2012).

In evaluating a home-based program, Chong, De Castro Molina, Teo, and Tan (2018) noted that after palliative care consultation, QOL was improved in the domains of both pain and symptom management, as well as a reduction of burden among caregivers of children with life-limiting illnesses. By optimizing resources, palliative care positively serves the patient and families. It allows them to receive services in their home, thereby reducing the stress and burden of hospitalization while maintaining QOL and managing symptoms (Chong et al., 2018; Thrane, Maurer, Cohen, May, & Sereika, 2017).

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