Pediatric End of Life Care Flashcards
Greater than (blank) children struggle with life-threatening condtions.
100,000
Approx (blank) children in the US die every year
50,000
What are these: Trauma Congenital and perinatal conditions Extreme prematurity Heritable disorders Acquired illness, neoplasms
common ways children die
How do most children die?
proressive diseases (app. 2,300 die of cancer)
Are end of life decisions common?
yes (DNR, withdrawal of support, agreesive symptom management only)
Are the deaths of children usually anticipated?
yes
Is pallative care the same as end-of-life or hospice care?
no
Can you use adult pallative care guidelines for children?
no (because it is hard to predict time of death and diseases for children are different than adults)
HOw does pallative care work for children?
you are comforting them but constantly looking for a cure :) (some kids even live)
When is pallative care offered for children?
at diagnosis and continued throughout course of illness.
What is the goal of pallative care?
to enhance quality of life of a child and their family in the face of an ultimately terminal condition
Includes: control of pain and other symptoms, addresses the developmental, psycholoical, social, or spiritual problems of the child (and their families)
What is the Americans Academy of Pediatrics promoting?
welfare of infants and children with equitable and effective support
What is this:
Child’s preferences concerning testing, monitoring, and treatment.
Attending to the family’s needs both during the illness and after the child’s death.
Respect for the Dignity of patients and families
What is this:
Access to therapies that are likely to improve the child’s quality of life
Education, grief and family counseling, peer support, music therapy, child-life intervention, spiritual support for both parents and siblings, and appropriate respite care.
access to competent compassionate palliative care
What is this:
Partnership
Child, family, parents’ employers, teachers, school staff, health care professionals, nurses, chaplains, bereavement counselors, social workers, primary care physicians, and consultants.
What are they addressing?
palliative care team
Physical, emotional, psychosocial and spiritual domains
Children should be encouraged to do what?
talk about feelings, express themselves through art or music therapy
What do you need to do for a child who is passing away?
acknowledge childs own recognition of dieing and have them communicate thir wishes and plan for the child’s death
What should be involved in the discussion of death with the child?
disease experience
developmental level of child
childs understanding and prior experience with death
family religious and cultural beliefs about death
the childs usual patterns of coping with pain and safness
thee expected circumstances of death
being open and honest
What should you do for the parents of the dying children?
provide realistic prognosis
range of time until death
support emotional expression
What is respite care?
provision of care to an ill child by qualified caregivers other than family members
T or F
palliative care does not end when death occurs
T
An important role of the palliative care team is to provide support for the family after the death of a child.
Parents must be able to do what before and after the child’s death?
to hold them
Does forgoing life-sustaining treatment equal intent or choice to hasten the death of ac hild?
no it does not
What is the goal of giving pallative care without hastening death?
optimize the quality for the childres experience rather than hasten death
Studies have shown that many clinicians give inadequate pain medications out of fear of (blank)
hastening death
What is the doctrine of double effec?
distinguishes between effects that are intended from those that are foreseen but unintended
T or F
It is important to remember that the child’s progressive deterioration and death may be attributed to the disease process and not the medication.
T
What is the goal of pain relief at end of life care?
dying with dignity and without pain or distress is the primary goal
What are some ways to support caregivers through institutional support?
paid funeral leave
routine counseling
remembrance ceremonies
T or F
physicians and nurses experience grief differently
T
How does death effect medical students?
evokes strong emotional responses and often get a lack of support from supervising residents, fellows, and attendings
How can you establish closrure?
stay connected to bereave parents, send cards, meet with family, attend funeral, or written thoughts of reflections of condolences
A pediatric palliative care interdisciplinary team is more than end-of-life symptom management.
T or F
T
“The goal is to add life to the child’s years, not simply years to the child’s life.”
