Pediatric End of Life Care

Question 1

Greater than (blank) children struggle with life-threatening condtions.

Answer 1

100,000

Question 2

Approx (blank) children in the US die every year

Answer 2

50,000

Question 3

What are these:
Trauma
Congenital and perinatal conditions
Extreme prematurity
Heritable disorders
Acquired illness, neoplasms

Answer 3

common ways children die

Question 4

How do most children die?

Answer 4

proressive diseases (app. 2,300 die of cancer)

Question 5

Are end of life decisions common?

Answer 5

yes (DNR, withdrawal of support, agreesive symptom management only)

Question 6

Are the deaths of children usually anticipated?

Answer 6

yes

Question 7

Is pallative care the same as end-of-life or hospice care?

Answer 7

no

Question 8

Can you use adult pallative care guidelines for children?

Answer 8

no (because it is hard to predict time of death and diseases for children are different than adults)

Question 9

HOw does pallative care work for children?

Answer 9

you are comforting them but constantly looking for a cure :) (some kids even live)

Question 10

When is pallative care offered for children?

Answer 10

at diagnosis and continued throughout course of illness.

Question 11

What is the goal of pallative care?

Answer 11

to enhance quality of life of a child and their family in the face of an ultimately terminal condition
Includes: control of pain and other symptoms, addresses the developmental, psycholoical, social, or spiritual problems of the child (and their families)

Question 12

What is the Americans Academy of Pediatrics promoting?

Answer 12

welfare of infants and children with equitable and effective support

Question 13

What is this:
Child’s preferences concerning testing, monitoring, and treatment.
Attending to the family’s needs both during the illness and after the child’s death.

Answer 13

Respect for the Dignity of patients and families

Question 14

What is this:
Access to therapies that are likely to improve the child’s quality of life
Education, grief and family counseling, peer support, music therapy, child-life intervention, spiritual support for both parents and siblings, and appropriate respite care.

Answer 14

access to competent compassionate palliative care

Question 15

What is this:
Partnership
Child, family, parents’ employers, teachers, school staff, health care professionals, nurses, chaplains, bereavement counselors, social workers, primary care physicians, and consultants.
What are they addressing?

Answer 15

palliative care team

Physical, emotional, psychosocial and spiritual domains

Question 16

Children should be encouraged to do what?

Answer 16

talk about feelings, express themselves through art or music therapy

Question 17

What do you need to do for a child who is passing away?

Answer 17

acknowledge childs own recognition of dieing and have them communicate thir wishes and plan for the child’s death

Question 18

What should be involved in the discussion of death with the child?

Answer 18

disease experience
developmental level of child
childs understanding and prior experience with death
family religious and cultural beliefs about death
the childs usual patterns of coping with pain and safness
thee expected circumstances of death
being open and honest

Question 19

What should you do for the parents of the dying children?

Answer 19

provide realistic prognosis
range of time until death
support emotional expression

Question 20

What is respite care?

Answer 20

provision of care to an ill child by qualified caregivers other than family members

Question 21

T or F

palliative care does not end when death occurs

Answer 21

T

An important role of the palliative care team is to provide support for the family after the death of a child.

Question 22

Parents must be able to do what before and after the child’s death?

Answer 22

to hold them

Question 23

Does forgoing life-sustaining treatment equal intent or choice to hasten the death of ac hild?

Answer 23

no it does not

Question 24

What is the goal of giving pallative care without hastening death?

Answer 24

optimize the quality for the childres experience rather than hasten death

Question 25

Studies have shown that many clinicians give inadequate pain medications out of fear of (blank)

Answer 25

hastening death

Question 26

What is the doctrine of double effec?

Answer 26

distinguishes between effects that are intended from those that are foreseen but unintended

Question 27

T or F
It is important to remember that the child’s progressive deterioration and death may be attributed to the disease process and not the medication.

Answer 27

T

Question 28

What is the goal of pain relief at end of life care?

Answer 28

dying with dignity and without pain or distress is the primary goal

Question 29

What are some ways to support caregivers through institutional support?

Answer 29

paid funeral leave
routine counseling
remembrance ceremonies

Question 30

T or F

physicians and nurses experience grief differently

Answer 30

T

Question 31

How does death effect medical students?

Answer 31

evokes strong emotional responses and often get a lack of support from supervising residents, fellows, and attendings

Question 32

How can you establish closrure?

Answer 32

stay connected to bereave parents, send cards, meet with family, attend funeral, or written thoughts of reflections of condolences

Question 33

A pediatric palliative care interdisciplinary team is more than end-of-life symptom management.

T or F

Answer 33

T

“The goal is to add life to the child’s years, not simply years to the child’s life.”