Pediatric Palliative Care C C E E N N L L E E Fatigue Subjective, multidimensional experience of exhaustion Commonly associated with many diseases Impacts.

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Presentation transcript:

Pediatric Palliative Care C C E E N N L L E E Fatigue Subjective, multidimensional experience of exhaustion Commonly associated with many diseases Impacts all dimensions of quality of life

Pediatric Palliative Care C C E E N N L L E E Causes of Fatigue Disease related Psychological Treatment related

Pediatric Palliative Care C C E E N N L L E E Assessment of Fatigue Subjective Objective Laboratory data

Pediatric Palliative Care C C E E N N L L E E Treatment of Fatigue Pharmacologic Non-pharmacologic  Rest  Energy conservation  PT/OT Anderson et al., 2010; Davies et al., 2002; Erickson, 2004; Hellsten & Medellin, 2010; Yennurajalingam & Bruera, 2010

Pediatric Palliative Care C C E E N N L L E E Neonates and Fatigue Limit number/amount of feedings Provide supportive environment

Pediatric Palliative Care C C E E N N L L E E Anemia / Bleeding Symptoms Causes Assessment Treatment

Pediatric Palliative Care C C E E N N L L E E Depression Manifestations in children may differ from adults Ranges from sadness to suicidal Chronic and terminally ill children are at risk Children tend to react to distress and emotions of adults closest to them.

Pediatric Palliative Care C C E E N N L L E E Causes of Depression Disease related Psychological Treatment related Other

Pediatric Palliative Care C C E E N N L L E E Assessment of Depression Situational factors Presence of risk factors Previous psychiatric history/treatment

Pediatric Palliative Care C C E E N N L L E E Treatment of Depression Antidepressants Stimulants Promote autonomy Grief/psychiatric counseling Draw on strengths Therapy

Pediatric Palliative Care C C E E N N L L E E Sisterly Love

Pediatric Palliative Care C C E E N N L L E E Anxiety Subjective feeling of apprehension Often without specific cause Categories of mild, moderate, severe

Pediatric Palliative Care C C E E N N L L E E Assessment of Anxiety Physical symptoms Cognitive symptoms Assess for presence of uncontrolled symptoms/fears

Pediatric Palliative Care C C E E N N L L E E Treatment of Anxiety Medications Empathetic listening Assurance and support Maximize symptom management Relaxation/imagery

Pediatric Palliative Care C C E E N N L L E E Palliative Caring

Pediatric Palliative Care C C E E N N L L E E Conclusion Multiple symptoms common Coordination of care with physicians and others Use drug and non-drug treatment Child/family teaching and support

Pediatric Palliative Care C C E E N N L L E E As Life Slips Away