Pediatric Palliative Care
This chapter includes the demographics of children who would benefit from palliative care, description of pediatric palliative care, the barriers why pediatric palliative care has not been fully accepted and implemented, as well as discussion of death wit
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Pediatric Palliative Care Shu-Ming Wang, Paul B. Yost, and Leonard Sender
Introduction Many people confuse palliative care with hospice care. However, the two approaches are very different. Hospice care specifically is end-of-life care. The World Health Organization (WHO) defines palliative care and pediatric palliative care in the following way: Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems: physical, psychosocial, and spiritual. Palliative care: • • • • • •
Provides relief from pain and other distressing symptoms Affirms life and regards dying as a normal process Intends neither to hasten or postpone death Integrates the psychological and spiritual aspects of patient care Offers a support system to help patients live as actively as possible until death Offers a support system to help the family cope during the patient’s illness and in their own bereavement
S.-M. Wang, M.D. (*) Department of Anesthesiology and Perioperative Care, University of California, Irvine School of Medicine, Irvine, CA, USA e-mail: [email protected]; [email protected] P.B. Yost, M.D., F.A.A.P. Department of Anesthesiology, St. Joseph’s of Orange, Orange, CA, USA L. Sender, M.D. Department of Medicine, University of California, Irvine School of Medicine, Irvine, CA, USA N. Vadivelu et al. (eds.), Essentials of Palliative Care, DOI 10.1007/978-1-4614-5164-8_25, © Springer Science+Business Media New York 2013
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• Uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated • Will enhance quality of life, and may also positively influence the course of illness • Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications
WHO Definition of Palliative Care for Children Palliative care for children represents a special, albeit closely related field to adult palliative care. WHO’s definition of palliative care appropriate for children and their families is as follows; the principles apply to other pediatric chronic disorders [1]: • Palliative care for children is the active total care of the child’s body, mind, and spirit, and also involves giving support to the family. • It begins when illness is diagnosed and continues regardless of whether or not a child receives treatment directed at the disease. • Health providers must evaluate and alleviate a child’s physical, psychological, and social distress. • Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources ar
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