Palliative care for the pediatrician

Abstract

A multitude of diagnoses can limit the lives of children. Palliative care represents a branch of care with a distinct, family-centered approach. Symptoms can be far-ranging and include grief, anxiety, and existential concerns, in addition to somatic complaints, such as pain, dyspnea, and nausea. Therefore, a multidisciplinary approach best benefits the family and patient. Despite the varied underlying diagnoses, many of the symptoms will be common and amenable to a thoughtful, basic approach. Key to managing all of the symptoms in the palliative and hospice settings is communication. It is essential to understand the family's goals, fears, and wishes, and to integrate therapy into that superstructure. Fortunately, the primary care physician is in the perfect position to appreciate the basis for the child and family's goals The primary care physician's rapport with the family will facilitate communication and decision-making in what maybe a very stressful journey for the child and family. Palliative and end of life care extend to parents and siblings, who should be monitored for extreme reactions to the death of a loved one and supported as they heal after death has claimed a child. © 2008 Humana Press.