Integration of Palliative Care Practices into the Ongoing Care of Children with Cancer: Individualized Care Planning and Coordination

Abstract

Most parents of children with cancer have dual primary goals: a primary cancer-directed goal of cure and a primary comfort-related goal of lessening suffering. Early introduction of palliative care principles and practices into their child's treatment is respectful and supportive of these goals. The Individualized Care Planning and Coordination Model is designed to integrate palliative care principles and practices into the ongoing care of children with cancer. Application of the model helps clinicians to generate a comprehensive individualized care plan that is implemented through Individualized Care Coordination processes as detailed here. Clinicians' strong desire to provide compassionate, competent, and sensitive care to the seriously ill child and the child's family can be effectively translated into clinical practice through these processes.

Race Does Not Influence Do-Not-Resuscitate Status or the Number or Timing of End-of-Life Care Discussions at a Pediatric Oncology Referral Center

“…It aims to enhance communication about difficult issues by discerning patient and family values and priorities before critical decision points are reached. 23,24 This model is currently theoretical and is unproven in the research realm, but we have found it extremely useful in clinical practice.…”

Contributions of Palliative Care to Pediatric Patient Care

“…11 In short, it is evident that palliative interventions are necessary as suffering is universal for children with cancer and their families. 10 A further examination of definitional clarity, disease trajectory, and symptom management point out the unique obstacles facing PPC delivery in pediatric oncology.…”

“…10 Some known cancer-and treatment-related symptoms experienced in children with cancer include emesis, anemia, fatigue, distress, and pain. 10 These symptoms should be managed from diagnosis, supporting an integrative palliative and disease-directed approach to care; yet symptom management in pediatric oncology is not always successful.…”

“…It is suggested that palliative care be delivered within disease-focused medical treatment, regardless of curative goals. 10 …”

Integration of Palliative Surgery into the Palliative Care Delivery Team

“…In recent years, however, there has been an increased appreciation for palliative care as an area of special need and expertise, but the breadth and integration of various specialty components remains variable [3]. This is compounded by the fragmentation of healthcare in the U.S. [4,5]. Implementation of palliative surgery, in particular, as an integrated component of palliative care remains a challenge.…”