Palliative Care and Hospice

Palliative care is an approach to caring for patients with life-threatening illnesses and their families with the goal of improving quality of life. Hospice is a subset of palliative care focused on caring for patients at the end of life, with nuances in the pediatric and young adult population. Both palliative and hospice care are interdisciplinary in nature. Palliative care can be provided by all providers through primary palliative care skills as it is most effective in the context of a trusted, long-term patient-provider relationship. Advance care plans should be discussed early and often, with various documents in existence to formalize decisions or wishes regarding future care. There are special considerations for adults with chronic childhood illnesses, including adjustments in medication dosing and increased use of chronic mechanical support devices. Communication and decision-making ability and preference should be ascertained and increased support should be provided to assist with both patient and caregiver coping. Curricula and other educational offerings are being created to cross-train both adult and pediatric palliative care teams in the care of this unique population.