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PEDIATRIC PALLIATIVE CARE

PEDIATRIC PALLIATIVE CARE. Hanna Lotocka-Reysner 26 November 2004. PALLIATIVE CARE – PRIMARY GOALS. Provide comfort Minimize suffering Preserve dignity and integrity of the child and the family Achieve the best quality of life possible that is consistent with patient’s and family values.

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PEDIATRIC PALLIATIVE CARE

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  1. PEDIATRIC PALLIATIVE CARE HannaLotocka-Reysner 26 November 2004

  2. PALLIATIVE CARE – PRIMARY GOALS • Provide comfort • Minimize suffering • Preserve dignity and integrity of the child and the family • Achieve the best quality of life possible that is consistent with patient’s and family values

  3. > 6500 death among Canadians under age of 20 (2001)

  4. Where do children with cancer die? • Factors influencing palliative care and place of death among children with cancer in British Columbia

  5. Children with cancer in BC – place of death • Total 145 • Home 41 • Hospital 66 • Hospice 26 • Other 12

  6. 1998 Total 27 Home 7 Hospital 14 Hospice 1 Other 5 1999 Total 33 Home 14 Hospital 13 Hospice 4 Other 2

  7. 2000 Total 27 Home 8 Hospital 11 Hospice 6 Other 2 2001 Total 31 Home 5 Hospital 15 Hospice 9 Other 2

  8. 2002 • Total 27 • Home 7 • Hospital13 • Hospice 6 • Other 1

  9. Children with cancer – place of death - hospital

  10. BRAIN TUMOR – 38 patients Home 32% Hospital 42% Hospice 21% Other 5% LEUKEMIA – 31 patients Home 16% Hospital 61% Hospice 20% Other 3%

  11. NEUROBLASTOMA – 13 patients Home 23% Hospital 54% Hospice 15% Other 8% ES – 11 patients Home 46% Hospital 18% Hospice 36%

  12. OS – 9 patients Home 56% Hospital 22% Hospice 22% LYMPHOMA – 9 patients Home 11% Hospital 45% Hospice 22% Other 22%

  13. Are we meeting our patients and their families wishes when they enter end of life pathway ?

  14. Some families and patients wish to remain in hospital. In this case discussion and decisions should center on creating an environment that meets the needs of the family and patient

  15. If the family and/or the patient wishes to receive end of life care in their own home and required care can be mobilized outside of the hospital – it should be arranged

  16. GOALS OF MEDICINE TO CURE TO HEAL PERSON DISEASE Investigations Diagnosis Treatment Wholeness Relationships Quality of life

  17. STEPS IN PROCESS • Identify eligible patients • Communicate effectively • Understand the illness experience • Establish prognosis • Establish goals of care • Establish advanced illness care plan

  18. PEACE – it does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of all those things and still be calm in your heart. (Anonymous)

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