Palliative Adult Network Guidelines (Fourth Edition)

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Gauvain-Piquard A, Rodary C, Rezvani A, Serbouti S (June 1999). "The development of the DEGR(R): A scale to assess pain in young children with cancer". European Journal of Pain. 3 (2): 165–176. doi: 10.1053/eujp.1999.0118. PMID 10700346. S2CID 14580922.

Savedra MC, Tesler MD, Holzemer WL, Wilkie DJ, Ward JA (October 1989). "Pain location: validity and reliability of body outline markings by hospitalized children and adolescents". Research in Nursing & Health. 12 (5): 307–314. doi: 10.1002/nur.4770120506. PMID 2798951. Each year an estimated56.8 millionpeople are in need of palliative care,mostof whom live in low- and middle-income countries. For children, 98% of those needing palliative care live in low- and middle-income countries with almost half of them living in Africa. Cross SH, et al. (2019). Trends in place of death for individuals with cardiovascular disease in the United States. David Bowie's son shares powerful letter". 18 January 2016. Archived from the original on 28 December 2021 . Retrieved 30 December 2021.Identify and assess symptoms through history taking (focusing on location, quality, time course, as well as exacerbating and mitigating stimuli). Symptoms assessment in children is uniquely challenging due to communication barriers depending on the child's ability to identify and communicate about symptoms. Thus, both the child and caregivers should provide the clinical history. With this said, children as young as four years of age can indicate the location and severity of pain through visual mapping techniques and metaphors. [62] Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. a b Sepúlveda C, Marlin A, Yoshida T, Ullrich A (August 2002). "Palliative Care: the World Health Organization's global perspective". Journal of Pain and Symptom Management. 24 (2): 91–96. doi: 10.1016/S0885-3924(02)00440-2. PMID 12231124. Palliative care is appropriate for individuals with serious illnesses across the age spectrum and can be provided as the main goal of care or in tandem with curative treatment. It is provided by an interdisciplinary team which can include physicians, nurses, occupational and physical therapists, psychologists, social workers, chaplains, and dietitians. Palliative care can be provided in a variety of contexts, including hospitals, outpatient, skilled-nursing, and home settings. Although an important part of end-of-life care, palliative care is not limited to individuals near the end of life. [1] Palliative care can be an option for many conditions. Some of the most common conditions where palliative care can be especially helpful are:

If someone is thought to be in their last year of life, they may start to have end of life care instead.a b Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991). "The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients". Journal of Palliative Care. 7 (2): 6–9. doi: 10.1177/082585979100700202. PMID 1714502. S2CID 26165154. a b Cassell EJ (2004). The nature of suffering and the goals of medicine (2nded.). New York: Oxford University Press. ISBN 1-60256-743-3. OCLC 173843216. The first step in receiving palliative care is to ask a doctor or healthcare professional about it. The doctor who treats your illness should refer you to a palliative care provider. Wolfe J, Grier HE, Klar N, Levin SB, Ellenbogen JM, Salem-Schatz S, etal. (February 2000). "Symptoms and suffering at the end of life in children with cancer". The New England Journal of Medicine. 342 (5): 326–333. doi: 10.1056/NEJM200002033420506. PMID 10655532.

In 2021 the UK's National Palliative and End of Life Care Partnership published their six ambitions for 2021–26. These include fair access to end of life care for everyone regardless of who they are, where they live or their circumstances, and the need to maximise comfort and wellbeing. Informed and timely conversations are also highlighted. [106] Acceptance and access [ edit ] Most spiritual interventions are subjective and complex. [54] [49] Many have not been well evaluated for their effectiveness, however tools can be used to measure and implement effective spiritual care. [49] [53] [55] Nausea and vomiting [ edit ] a b Zhukovsky D (2019). Primer of Palliative Care. American Association of Hospice and Palliative Medicine. ISBN 9781889296081. a b c Hinds PS (September 2004). "The hopes and wishes of adolescents with cancer and the nursing care that helps". Oncology Nursing Forum. 31 (5): 927–934. doi: 10.1188/04.ONF.927-934. PMID 15378093. S2CID 46005587.WHO Definition of Palliative Care". WHO. Archived from the original on 4 October 2003 . Retrieved 4 December 2019. a b "Hospice Facts & Figures". NHPCO. Archived from the original on 21 June 2020 . Retrieved 12 May 2020.

Palliative care can be initiated in a variety of care settings, including emergency rooms, hospitals, hospice facilities, or at home. [14] For some severe disease processes, medical specialty professional organizations recommend initiating palliative care at the time of diagnosis or when disease-directed options would not improve a patient's prognosis. For example, the American Society of Clinical Oncology recommends that patients with advanced cancer should be "referred to interdisciplinary palliative care teams that provide inpatient and outpatient care early in the course of disease, alongside active treatment of their cancer" within eight weeks of diagnosis. [9]Dy SM, Apostol C, Martinez KA, Aslakson RA (April 2013). "Continuity, coordination, and transitions of care for patients with serious and advanced illness: a systematic review of interventions". Journal of Palliative Medicine. 16 (4): 436–445. doi: 10.1089/jpm.2012.0317. hdl: 2027.42/140114. PMID 23488450. One instrument used in palliative care is the Edmonton Symptom Assessment Scale (ESAS), which consists of eight visual analog scales (VAS) ranging from 0–10, indicating the levels of pain, activity, nausea, depression, anxiety, drowsiness, appetite, sensation of well-being, and sometimes shortness of breath. [33] [34] A score of 0 indicates absence of the symptom, and a score of 10 indicates the worst possible severity. [33] The instrument can be completed by the patient, with or without assistance, or by nurses and relatives. [34] Interventions [ edit ] You can also access treatment aimed at curing your condition while taking advantage of palliative care treatment designed to improve your quality of life and level of comfort.