A recent blog on Pallimed (A Hospice Palliative Medicine Blog) looks at the difficult question that often concerns practitioners dealing with very sick children in an inpatient setting – when and how do you start? Author of the blog, Allie Shukraft, a paediatric palliative care social worker for Carolinas Healthcare System in Charlotte, NC, describes how her team strives to build a relationship of trust with young patients that will allow the asking of tough questions and discussion on uncomfortable topics.
Their first step is to introduce themselves and explain that palliative care is “an extra layer of support” helping families dealing with serious illness or conditions. Next they talk about specific roles of team members and how they overlap. In order to ‘humanize’ the patient, they ask the child and family members how the experience has been for them thus far and also ask to see pictures from before the child’s hospitalisation.
Finally they try to offer a specific way that they can help the family and patient. This could be as simple as offering to “be the bad guy” with visitors who overstay their welcome.
Once they have a ‘foot in the door’ it takes two more elements to connect with families: observation and timing. Regular communication between team members assists in assessing how the patient and families are coping. They watch body language, grooming and changes in habits that may indicate how they are coping on that day.
Click here to access the full blog.
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