Paediatric palliative care indeed differs significantly from adult palliative care in several ways. Here are some key distinctions:
- Family-Centered Approach: Paediatric palliative care places a strong emphasis on the family unit. Children are usually dependent on their families for care, so support extends to parents, siblings, and other caregivers. The whole family’s well-being is considered in the care plan.
- Developmental Considerations: Children’s understanding of illness and death varies greatly depending on their age and developmental stage. Palliative care teams must adapt their communication and support strategies accordingly, ensuring age-appropriate information and emotional support.
- Longer Illness Trajectories: Many children with life-limiting conditions may have longer illness trajectories compared to adults. This means that paediatric palliative care often involves complex and ongoing management over extended periods of time, which requires continuity of care and support.
- Interdisciplinary Approach: Like adult palliative care, paediatric palliative care involves a multidisciplinary team including doctors, nurses, social workers, psychologists, and others. However, in paediatrics, this team often includes specialists in child development and education to address the unique needs of children and adolescents.
- Ethical and Legal Considerations: There are specific ethical and legal considerations in paediatric palliative care, such as decision-making capacity (often involving parents or legal guardians), consent issues, and discussions around withdrawing or withholding treatments.
- Focus on Quality of Life: The primary goal of paediatric palliative care is to enhance the quality of life for both the child and the family. This involves not only managing symptoms and pain but also supporting emotional, spiritual, and social needs.
- Transitioning from Curative to Palliative Care: In paediatrics, the transition from curative to palliative care can be particularly challenging for families and healthcare providers. It requires sensitive communication and careful planning to ensure that families understand and are supported through this transition.
In essence, paediatric palliative care is a specialised field that recognises the unique needs of children facing life-threatening conditions and their families. It combines medical expertise with a holistic approach that considers developmental, emotional, and familial dynamics to provide compassionate care and support.
Another important distinction between paediatric palliative care and adult palliative care is that children often don’t follow a straightforward downward trajectory the way adults do. At our Emily’s House children’s hospice in Toronto, Canada, children may move between hospice, hospital and home for years before requiring advanced palliative care. This means that quality of life programming, respite care, accessible adaptable recreation, peer group programming, supports for caregivers/child siblings, and other considerations become vitally important for the child’s wellbeing as well as for improved outcomes for the family.
With thanks.
I enjoy your ehospice articles very much.
I consider it is necessary that the message reaches to all the pediatricians through their Association,e.g. Indian Association of Pediatricians. IAPC may also consider to approach State Medical and Nursing Councils for the same, suggesting online trainings and credit points for attending these.