Homestead together: Pediatric palliative care telehealth support for rural children with cancer during home‐based end‐of‐life care

2021 ◽  
Vol 68 (4) ◽  
Author(s):  
Meaghann S. Weaver ◽  
Valerie K. Shostrom ◽  
Marie L. Neumann ◽  
Jacob E. Robinson ◽  
Pamela S. Hinds
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Rural Children ◽  
Life Care ◽  
Children With Cancer ◽  
Home Based

Predictors of Specialized Pediatric Palliative Care Involvement and Impact on Patterns of End-of-Life Care in Children With Cancer

2018 ◽  
Vol 36 (8) ◽  
pp. 801-807 ◽  
Author(s):  
Kimberley Widger ◽  
Rinku Sutradhar ◽  
Adam Rapoport ◽  
Christina Vadeboncoeur ◽  
Shayna Zelcer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Children With Cancer ◽  
The Impact

Purpose The impact of specialized pediatric palliative care (SPPC) teams on patterns of end-of-life care is unknown. We sought to determine (1) which children with cancer access SPPC and (2) the impact of accessing SPPC on the risk of experiencing high-intensity end-of-life care (intensive care unit admission, mechanical ventilation, or in-hospital death). Methods Using a provincial childhood cancer registry, we assembled a retrospective cohort of Ontario children with cancer who died between 2000 and 2012 and received care through pediatric institutions with an SPPC team. Patients were linked to population-based administrative data capturing inpatient, outpatient, and emergency visits. Children were classified as having SPPC, general palliative care, or no palliative care on the basis of SPPC clinical databases, physician billing codes, or inpatient diagnosis codes. Results Of the 572 children, 166 (29%) received care from an SPPC team for at least 30 days before death, and 100 (17.5%) received general palliative care. SPPC involvement was significantly less likely for children with hematologic cancers (OR, 0.3; 95% CI, 0.3 to 0.4), living in the lowest income areas (OR, 0.4; 95% CI, 0.2 to 0.8), and living further from the treatment center (OR, 0.5; 95% CI, 0.4 to 0.5). SPPC was associated with a five-fold decrease in odds of intensive care unit admission (OR, 0.2; 95% CI, 0.1 to 0.4), whereas general palliative care had no impact. Similar associations were seen with all secondary indicators. Conclusion When available, SPPC, but not general palliative care, is associated with lower intensity care at the end of life for children with cancer. However, access remains uneven. These results provide the strongest evidence to date supporting the creation of SPPC teams.

End-of-Life Care in Patients Exposed to Home-Based Palliative Care vs Hospice Only

2019 ◽  
Vol 67 (6) ◽  
pp. 1226-1233 ◽  
Author(s):  
Susan E. Wang ◽  
In-Lu Amy Liu ◽  
Janet S. Lee ◽  
Peter Khang ◽  
Romina Rosen ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Home Based

scholarly journals Development of a Pediatric Palliative Care Curriculum and Dissemination Model: Education in Palliative and End-of-Life Care (EPEC) Pediatrics

2019 ◽  
Vol 58 (4) ◽  
pp. 707-720.e3 ◽  
Author(s):  
Stefan J. Friedrichsdorf ◽  
Stacy Remke ◽  
Joshua Hauser ◽  
Laurie Foster ◽  
Andrea Postier ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Life Care

End-of-Life Care for Children Enrolled in a Community-Based Pediatric Palliative Care Program

2014 ◽  
Vol 17 (5) ◽  
pp. 589-591 ◽  
Author(s):  
Lisa M. Niswander ◽  
Philene Cromwell ◽  
Jeanne Chirico ◽  
Alyssa Gupton ◽  
David N. Korones
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Program ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Palliative Care Program ◽  
Community Based

Integrating palliative care into end-of-life care for children with cancer

2016 ◽  
Vol 1 (4) ◽  
pp. 289-301
Author(s):  
Amanda L. Linz ◽  
Joanna A. Lyman ◽  
Melody J. Cunningham ◽  
Justin N. Baker
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Children With Cancer

Pain therapy, pediatric palliative care and end-of-life care: training, experience, and reactions of pediatric residents in Italy

2014 ◽  
Vol 173 (9) ◽  
pp. 1201-1207 ◽  
Author(s):  
Francesca Rusalen ◽  
Anna Ferrante ◽  
Chiara Pò ◽  
Michele Salata ◽  
Caterina Agosto ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Pain Therapy ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Training Experience ◽  
Pediatric Residents ◽  
Care Training

Improving the Quality of End-of-Life Care in Pediatric Oncology Patients Through the Early Implementation of Palliative Care

2017 ◽  
Vol 34 (6) ◽  
pp. 374-380 ◽  
Author(s):  
Lauren Ranallo
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
End Of Life ◽  
Pediatric Oncology ◽  
End Of Life Care ◽  
Terminal Phase ◽  
Clear Understanding ◽  
Life Care ◽  
Oncology Patients ◽  
Children With Cancer

Providing end-of-life care to children with cancer is most ideally achieved by initiating palliative care at the time of diagnosis, advocating for supportive care throughout the treatment trajectory, and implementing hospice care during the terminal phase. The guiding principles behind offering palliative care to pediatric oncology patients are the prioritization of providing holistic care and management of disease-based symptoms. Pediatric hematology-oncology nurses and clinicians have a unique responsibility to support the patient and family unit and foster a sense of hope, while also preparing the family for the prognosis and a challenging treatment trajectory that could result in the child’s death. In order to alleviate potential suffering the child may experience, there needs to be an emphasis on supportive care and symptom management. There are barriers to implementing palliative care for children with cancer, including the need to clarify the palliative care philosophy, parental acknowledgement and acceptance of a child’s disease and uncertain future, nursing awareness of services, perception of availability, and a shortage of research guidance. It is important for nurses and clinicians to have a clear understanding of the fundamentals of palliative and end-of-life care for pediatric oncology patients to receive the best care possible.

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