Palliative care for children represents a special, albeit closely related field to adult palliative care.
- Palliative care for children is the active total care of the child's body, mind; and spirit; it also involves giving support to the family.
- It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.
- Health providers must evaluate and alleviate a child's physical, psychological, and social distress.
- Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources are limited.
- It can be provided in tertiary care facilities, in community health centers, and even in children's homes.
Palliative care should be offered from diagnosis of a life-limiting condition or from determination that curative treatment for a life-threatening condition is not an option; however, each child is different and care should be tailored to the individual.
There are considered to be the 4 groups of children for whom palliative care is needed:
1. Children with life-threatening conditions for which curative treatment may be possible but may fail. Palliative care may be necessary during periods when prognosis is uncertain and when treatment fails. Children who have had successful curative treatment or who are in long-term remission are not included.
2. Children with conditions where there may be long periods of intensive treatment aimed at prolonging life and allowing participation in normal childhood activities but where death could still occur.
3. Children with progressive conditions, without the possibility of a cure. Palliative care of these children may be for many years.
4. Children with conditions not usually considered progressive, but which may cause weakness and make children more vulnerable to complications. These children may deteriorate unpredictably.