Clinical review

ABC of palliative care: Special problems of children

The death of a child has long been acknowledged as one of the greatest tragedies that can happen to a family, and care for seriously ill children and their families is central to paediatrics. It is only recently, however, that the needs for palliative care of children with life limiting illnesses and their families have been considered as a speciality within paediatrics: the most suitable approaches to care are still being developed, and the provision of services nationally is uneven and sometimes inadequate.

	Which children need care?

	Aspects of care in children

Child development
Care at home
Assessing symptoms
Methods of assessing pain in children

Managing symptoms

	Specific problems

Pain
Children and pain

Analgesic doses

Feeding
Nausea and vomiting
Neurological problems

	Support for the family

Support that every child and family should expect

	Bereavement

Communicating with children about death

The loss of a child

Further reading

	Notes

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Relevant Articles

In search of a good death: Can children with life threatening illness and their families experience a good death?

Laura Beaune and Christine Newman
BMJ 2003 327: 222-223. [Extract] [Full Text]

Palliative care services for children must adopt a family centred approach

Linda Deeley, Paul Stallard, Mary Lewis, and Simon Lenton
BMJ 1998 317: 284. [Extract] [Full Text]

This article has been cited by other articles:

• Ware, J., Raval, H. (2007). A Qualitative Investigation of Fathers' Experiences of Looking After a Child with a Life-limiting Illness, in Process and in Retrospect. Clin Child Psychol Psychiatry 12: 549-565 [Abstract]  
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• Beaune, L., Newman, C. (2003). In search of a good death: Can children with life threatening illness and their families experience a good death?. BMJ 327: 222-223 [Full text]  
• Feudtner, C., Christakis, D. A., Zimmerman, F. J., Muldoon, J. H., Neff, J. M., Koepsell, T. D. (2002). Characteristics of Deaths Occurring in Children's Hospitals: Implications for Supportive Care Services. Pediatrics 109: 887-893 [Abstract] [Full text]  
• Enck, R. E. (2001). Pediatric pain control. AM J HOSP PALLIAT CARE 18: 365-366  
• Marples, I. L, Murray, P., Heger, S. (2000). Morphine induced allodynia in child with brain tumour. BMJ 320: 381-381 [Full text]  
• Wolfe, J., Grier, H. E., Klar, N., Levin, S. B., Ellenbogen, J. M., Salem-Schatz, S., Emanuel, E. J., Weeks, J. C. (2000). Symptoms and Suffering at the End of Life in Children with Cancer. NEJM 342: 326-333 [Abstract] [Full text]  
• Deeley, L., Stallard, P., Lewis, M., Lenton, S. (1998). Palliative care services for children must adopt a family centred approach. BMJ 317: 284a-284 [Full text]