Paediatric Palliative Care
Module LBR6247 Paediatric Palliative care
A Critical Review of Literature regarding Parental choices in End of Life Care and the Development of A Rapid Discharge Pathway
Sarah Bundy
Student Number: 10701221
Total Words:2850
According to the Department of health (2008) ’End of life care focuses on preparing for an anticipated death and managing the end stage of a terminal condition from the point of recognition that the end of life is approaching. This includes care during and around the time of death – and for the family immediately afterwards. It enables the supportive and palliative care needs of both child and the family to be identified and met throughout the last phase of life into bereavement’. Some children and young people will die very suddenly whether that’s through illness or accident, while for other children with palliative care needs, this process may happen over a period of many years. End of life care on a paediatric intensive care unit has undergone enormous change in recent years. In most western countries today the death of a child is a rare phenomenon but when it does occur it is often after a period of intensive and complex medical interventions (Matthews et al 2006). Improving the quality of end of life care has become a national priority (Paediatric Intensive Care Society 2002). Each year, many children die in PICU often following the withdrawal of life-sustaining treatment (McCallum et al 2000, Street et al, 2000). The majority of deaths can often be anticipated, offering health professionals the opportunity to share decision-making with families and manage end of life accordingly. There is a growing emphasis on incorporating the views and wishes of parents (Mayer et al, 2002). The aim of this assignment is to critically review literature around parental choices in PICU when their child is for end of life care and how this has led to the recent
A Critical Review of Literature regarding Parental choices in End of Life Care and the Development of A Rapid Discharge Pathway
Sarah Bundy
Student Number: 10701221
Total Words:2850
According to the Department of health (2008) ’End of life care focuses on preparing for an anticipated death and managing the end stage of a terminal condition from the point of recognition that the end of life is approaching. This includes care during and around the time of death – and for the family immediately afterwards. It enables the supportive and palliative care needs of both child and the family to be identified and met throughout the last phase of life into bereavement’. Some children and young people will die very suddenly whether that’s through illness or accident, while for other children with palliative care needs, this process may happen over a period of many years. End of life care on a paediatric intensive care unit has undergone enormous change in recent years. In most western countries today the death of a child is a rare phenomenon but when it does occur it is often after a period of intensive and complex medical interventions (Matthews et al 2006). Improving the quality of end of life care has become a national priority (Paediatric Intensive Care Society 2002). Each year, many children die in PICU often following the withdrawal of life-sustaining treatment (McCallum et al 2000, Street et al, 2000). The majority of deaths can often be anticipated, offering health professionals the opportunity to share decision-making with families and manage end of life accordingly. There is a growing emphasis on incorporating the views and wishes of parents (Mayer et al, 2002). The aim of this assignment is to critically review literature around parental choices in PICU when their child is for end of life care and how this has led to the recent
References: ACT (2004) A Framework for the Development of Integrated Multi-Agency Care Pathways for children with Life-Threatening and Life Limiting Conditions. ACT Bristol. Department of Health (2008). Better Care: Better Lives. London: Department of Health. Fitzmaurice (1997) Equipment Cases for palliative care. Paediatric Nursing 1997 July;9(6)18-9. Gillis (1997) When life-saving treatment in children is not the answer. British Medical Journal; 315:1246-1247 Lauer et al (1989) Long-term follow up of parental adjustment following a child’s death at home or hospital Longden (2007) Family involvement in end-of-life care in a paediatric intensive care unit. Nursing in Critical Care;12:181-187. Matthews et al (2006) Developing the Liverpool Care Pathway for The Dying Child. Paediatric Nursing vol 18, No 1, Feb McCallum DE, Byrne P, Bruera E (2000) How children die in hospital Meert et al (2008) Parental perspectives on physician-parent communication near the time of a child’s death in the pediatric intensive care unit. Pediatric Critical Care Medicine;9:2-7. Meyer et al (2006) Improving the quality of end-of-life care in the pediatric intensive care unit: parents priorities and recommendations. Pediatrics;117: 649-657. Meyer et al (2002) Parental perspectives on end-of-life care in the pediatric intensive care unit. Critical Care Medicine;30:226-231. Miles et al (1989) The pediatric intensive care unit as a source of stress for parents. Maternal Child Health Journal;18:199-206. Paediatric Intensive care Society (2002). Standards for Bereavement Care. Sheffield, UK: Paediatric Intensive Care Society. Ryder-Lewis (2005). Going home from ICU to die: a celebration of life. Nursing in Critical Care;10:116-122. Solomon MZ, Browning D, (2005). Pediatric palliative care: relationships matter and so does pain control. Journal of Clinical Oncology;23:9055-9057.