Palliative Care

New support for a child’s medical journey

Traditionally, treatment for children with life-threatening illnesses is targeted toward a cure through a blur of doctor visits, scans and tests.

While the quest for a cure continues, a new division in the Department of Pediatrics will take an alternate yet complementary approach to caring for these children.

Beginning in July, the Division of Pediatric Palliative Medicine will focus solely on providing the best possible quality of life for patients and their families, according to Dr. Rick Boyte, associate professor of pediatrics.

“It’s at the heart of what we’re supposed to be doing in health care,” Boyte said.

Boyte is one of only 47 pediatricians nationwide to be board certified in palliative medicine and has been instrumental in the development of the program. He and Jacqueline Carrillo, a nurse practitioner, will serve as the only full-time members of the team. Other members – child life specialists, chaplains, pharmacists, nurses and social workers – will contribute their expertise to the team in addition to their current responsibilities.

Palliative care begins at diagnosis and follows a patient and family throughout curative treatment and beyond, regardless of where their medical journey leads. According to the National Hospice and Palliative Care Organization, pediatric palliative care is both a philosophy and an organized treatment option for children with life-threatening conditions.

Central to the philosophy is the notion that pain is not just physical, but quite often psychological, spiritual or psychosocial as well, according to Boyte. “We would not only be able to help the child with that, but the family as well,” Boyte said.

Treatment of this ‘total pain,’ as it has been described, takes a holistic style and therefore, varies widely. This interdisciplinary team may be asked to manage physical discomfort or treat symptoms such as severe nausea or weight loss, but they may also be relied upon to offer support for patients and families dealing with the emotional pain of depression or changes in family dynamics.

Boyte noted that Batson Hospital staff already addresses many of these issues. “We will specialize in them, however, so hopefully, we can bring new things to the table and new ways of approaching them,” he said.

For instance, where curative treatments are exhausted or become ineffective, the palliative care team will be specially trained in addressing the complex emotional and spiritual issues surrounding a child’s impending death. Currently, there is little formal training for handling these delicate situations.

Team members will also work to improve communication between patients, families and health care professionals in an increasingly complex and fragmented health care system. The team will function as a case manager of sorts, meeting weekly to discuss patients and coordinate their care between the many different units that a child may visit for treatment. “We won’t be unit-specific,” said Carrillo. “We’ll act as the common thread between all the specialists that a child is seeing.”

Initially, the program will be consultation-based and available to patients and families in the pediatric intensive care and hematology-oncology units.

Palliative medicine is a relatively recent addition to the medical world. It began as an outgrowth of hospice care, but unlike hospice care, can be administered concurrently with curative care and regardless of whether the result is death or cure. Hospice patients have usually refused any further curative treatment and have less than six months to live.

‘The American Board of Medical Subspecialties officially recognized it as a medical subspecialty in 2006. A recent report from the Center to Advance Palliative Care and the National Palliative Care Research Center showed that in Mississippi and surrounding states, less than 40 percent of the hospitals offered access to a palliative care program.

Boyte offers an optimistic slant to the report, saying he is excited about where the program could go. Eventually, he hopes the program can become part of resident and nurse training. “We have the opportunity to create a cutting-edge program in our region,” he said.

-Jen Hospodor

2009-06-08 00:00:00 3528