Frequently Asked Questions

1. What is Palliative Care?
2. When should palliative care begin?
3. Is it true that children feel pain less intensely than adults?
4. Do children fare worse than adults in receiving palliative care?
5. Are doctors and medical staff receiving adequate training in palliative care?

1. What is Palliative Care?

According to the American Academy of Hospice and Palliative Medicine, palliative care is comprehensive, specialized care provided by an interdisciplinary team to patients and families living with a life-threatening or severe advanced illness expected to progress toward dying and where care is particularly focused on alleviating suffering and promoting quality of life. Major concerns are pain and symptom management, information sharing and advanced care planning, psychosocial and spiritual support, and coordination of care.

2. When should palliative care begin?

The Circle of Life Children’s Center and the American Academy of Pediatrics support an integrated model of palliative care which is offered at diagnosis of illness or medical condition and continues throughout the course of illness, whether or not a cure is attained. Palliative (comfort) care should not be reserved strictly for children who are dying, as other patients who might benefit would then not receive this care. If only children who are at or near end-of-life are offered palliative care, some children might die without having the benefits of this form of treatment.

3. Is it true that children feel pain less intensely than adults?

This belief was widely accepted as true at one time, but has since been proven to be false.

4. Do children fare worse than adults in receiving palliative care?

Yes, in a 2000 study by Wolfe et al, published in the New England Journal of Medicine, parents of children who died reported that even in the last days of life pain was inadequately controlled in more than 30-40% of the children. Doctors tend to be more focused on curing the disease rather than on treating associated pain. Many doctors have little training or experience in caring for dying children, especially, as with cancer patients, about 75% of children today are cured. Symptoms may also be overlooked, as goals for treatment often shift from cure to comfort only after curative measures have failed. In those cases both doctors and parents are reluctant to institute treatments that symbolize the abandonment of hope.

5. Are doctors and medical staff receiving adequate training in palliative care?

Symptom management to date has not been a high priority in medical training. Efforts are underway to bring about change in this area.