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Pediatric Palliative CareCCEENNLLEE
Fatigue
Subjective, multidimensional experience of exhaustion
Commonly associated with many diseases
Impacts all dimensions of quality of life
Pediatric Palliative CareCCEENNLLEE
Causes of Fatigue
Disease related
Psychological
Treatment related
Pediatric Palliative CareCCEENNLLEE
Assessment of Fatigue
Subjective
Objective
Laboratory data
Pediatric Palliative CareCCEENNLLEE
Treatment of Fatigue
Pharmacologic
Non-pharmacologic Rest
Energy conservation
PT/OTAnderson et al., 2010; Davies et al., 2002;
Erickson, 2004; Hellsten & Medellin, 2010; Yennurajalingam & Bruera, 2010
Pediatric Palliative CareCCEENNLLEE
Neonates and Fatigue
Limit number/amount of feedings
Provide supportive environment
Pediatric Palliative CareCCEENNLLEE
Anemia / Bleeding
Symptoms Causes Assessment Treatment
Pediatric Palliative CareCCEENNLLEE
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 CareCCEENNLLEE
Causes of Depression
Disease related
Psychological
Treatment related
Other
Pediatric Palliative CareCCEENNLLEE
Assessment of Depression
Situational factors
Presence of risk factors Previous psychiatric
history/treatment
Pediatric Palliative CareCCEENNLLEE
Treatment of Depression
Antidepressants Stimulants Promote autonomy Grief/psychiatric
counseling Draw on strengths Therapy
Pediatric Palliative CareCCEENNLLEE
Sisterly Love
Pediatric Palliative CareCCEENNLLEE
Anxiety
Subjective feeling of apprehension
Often without specific cause Categories of mild, moderate, severe
Pediatric Palliative CareCCEENNLLEE
Assessment of Anxiety
Physical symptoms
Cognitive symptoms
Assess for presence of uncontrolled symptoms/fears
Pediatric Palliative CareCCEENNLLEE
Treatment of Anxiety
Medications
Empathetic listening
Assurance and support
Maximize symptom management
Relaxation/imagery
Pediatric Palliative CareCCEENNLLEE
Palliative Caring
Pediatric Palliative CareCCEENNLLEE
Conclusion
Multiple symptoms common Coordination of care with
physicians and others Use drug and non-drug
treatment Child/family teaching and
support
Pediatric Palliative CareCCEENNLLEE
As Life Slips Away
