End Of Life Care Essay

A child’s death is the ‘ultimate loss’ (CITE), a devastating event described by parent as unique, complicated, stressful, dramatic, profound and disruptive. Parental grief can be influenced by inherent attributes such as a parent’s personality and resilience, cognitive skills, social support systems, religious beliefs, and their own physical health. Some situational factors cannot be altered, such as the suddenness of a child’s death; however, extrinsic factors such as the accessibility, compassion and communication skills of health professionals working with the families of dying children can be optimized and it is important that all involved have an understanding of parental needs. End-of-life care on pediatric intensive care units (PICU)

Technological advances and extensive research into patient outcomes have provided increasing abilities to prolong life. However, life ultimately has a natural end and the continuation of enhanced therapeutic interventions is not always appropriate, and the question then arises whether or not it is in the child’s best interests to provide further treatment. The traditional paradigm that once separated intensive care and palliative care no longer exists (CITE) and as health professionals we are faced with the challenge of providing systems of care that meets the needs of dying children and their families. Improving the quality of end-of-life care has become a national priority (Pediatric Intensive Care Society, 2002) and as part of this, there is a growing emphasis on incorporating the views and wishes of the parents (CITE). Reported influences that shape parental decision making and, if the child dies, impact parents’ end-of-life and bereavement experiences include: physician recommendations, communication with health care professionals, faith, time, predictions of survival and quality of life, intuition, trust of health care professionals, and feeling a sense of caring from health care professionals. These data show the important influence that