Models of Pediatric Palliative Care

Multiple models of pediatric palliative care exist nationally (Carter et al. 2006; Duncan et al. 2007; Friedrichsdorf et al. 2007; Rushton et al. 2006;

Ward-Smith et al. 2007) and internationally (Friedrichsdorf et al. 2005; Monterosso and Krist-janson 2008). Differences lie primarily in the composition of the care teams rather than in the overall approach to care. Most programs include, at a minimum, a physician, often serving as medical director, and a nurse. In addition, dedicated support staff, such as a social worker, child life specialist, psychologist and/or psychiatrist, and chaplain, may be integrated into the core team. However, some palliative care programs utilize existing ancillary services, collaborating with the primary medical team already involved in the patient's care.

Consistent across the models is the provision of care throughout the illness continuum, from initial diagnosis and treatment to recurrence to end-of-life care and family bereavement follow-up. Continuity of care across treatment settings is emphasized, and when possible, palliative care teams provide children and their families with both inpatient and outpatient services, in addition to coordinating with community providers involved in the care. Clinical consultation is provided to primary medical teams

15-19 years

10-14 years 7%

5-9 years

15-19 years

10-14 years 7%

5-9 years

Under 1 year 53%

Figure 16-2. Percentage of total childhood deaths by age group (2004).

Source. Data from Minono et al. 2007.

and families around issues such as adjusting analgesia and sedation; managing withdrawal from life-sustaining measures; helping families with medical decision making, home care needs, sibling support, grief, and bereavement; and providing staff support. Palliative care services may participate in residency education, monthly palliative care rounds, patient care conferences to facilitate communication and planning, and/or bereavement debriefing (Rushton et al. 2006).

Self Improvement Fast Track

Self Improvement Fast Track

Surefire Ways To Put Your Self Improvement On The Fast Track. This Book Is One Of The Most Valuable Resources In The World When It Comes To Accelerated Learning Techniques For People New To Personal Development.

Get My Free Ebook


Post a comment