Pediatric Palliative Care for Children with Cancer
The goal of pediatric palliative care is to manage physical symptoms such as pain while also addressing the emotional, social, and spiritual needs of the child and family, with the aim of improving the quality of life of the child and family.
Pediatric palliative care is a combination of art, science, and skill. It begins at the time of diagnosis and continues through the advanced stages of illness and even during bereavement.
The foundation of clinical care for a child with cancer is the early recognition and accurate assessment of symptoms, followed by effective symptom management. A thorough assessment by a skilled team is essential for developing an appropriate diagnosis and an effective care and treatment plan.
The Role of Palliative Care in Supporting Other Family Members
Having a sick child in the family can change the roles and responsibilities of parents. These responsibilities can place significant pressure on parents and other children in the family, increasing their need for additional support.
In other words, the psychological, emotional, and physical stress associated with caring for a child with a life-threatening illness affects the entire family and may lead to conflict, family difficulties, and social isolation. Therefore, the care team should pay particular attention to the needs of the whole family.
Members of the Pediatric Palliative Care Team
Effective pediatric palliative care requires a multidisciplinary approach. The best care is achieved when it is provided by a team with different areas of expertise working toward a common goal. This team may include physicians, nurses, psychologists, social workers, spiritual care providers, volunteers, and other healthcare professionals.
Effective, high-quality care requires ongoing communication and collaboration among team members. This may take place through team meetings, individual consultations, and other appropriate methods. Regular meetings allow the care provided to be adapted to changes in the condition of the child and family.
Because pediatric palliative care is family-centered, parents are the primary caregivers and an important source of information and support for their child. They should therefore be involved in all stages of decision-making and implementation of the care plan.
When Should Palliative Care Begin for a Child?
Pediatric palliative care for a child with cancer should begin at the time of diagnosis and, in some cases, even before a definitive diagnosis is established. Supportive services should be provided both while the child is receiving cancer-directed treatment and when the disease no longer responds well to treatment, continuing throughout the course of the illness and supporting the family through its different stages.
In fact, palliative care is valuable from the early stages of illness, while the child is receiving chemotherapy, as well as when cancer-directed treatments are discontinued.
The philosophy of pediatric palliative care is the ongoing assessment and optimization of the child's and family's physical, psychological, and social well-being.
Therefore, communication with the family about the goals and need for palliative care at different stages and under different circumstances of the illness is essential.
World Health Organization (WHO) Definition of Pediatric Palliative Care
According to the World Health Organization (WHO), pediatric palliative care aims to prevent and relieve suffering associated with life-threatening illnesses in children and their families. This suffering may include physical, psychological, social, and spiritual concerns affecting the child, as well as psychological, social, and spiritual distress experienced by family members.
Pediatric Palliative Care:
- Promotes the early identification, comprehensive assessment, and treatment of problems and symptoms.
- Helps improve quality of life, maintain comfort and dignity, and may also have a positive effect on the course of illness.
- Provides ongoing support to the child and family throughout the illness.
- Should be integrated with and complement prevention, early diagnosis, and treatment of serious health conditions.
- Can be provided from the beginning of the illness alongside other life-prolonging treatments.
- Can support people living with long-term physical, psychological, social, and spiritual consequences of serious, complex, or life-limiting illnesses or treatment-related effects.
- Improves continuity of care, strengthens health systems, and contributes to universal health coverage.
Pediatric Hematologist & Oncologist
