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Children 2018, 5(3), 37; https://doi.org/10.3390/children5030037

Interdisciplinary Pediatric Palliative Care Team Involvement in Compassionate Extubation at Home: From Shared Decision-Making to Bereavement

1
Pain Medicine, Palliative Care and Integrative Medicine Program, Children’s Hospitals and Clinics of Minnesota, 2525 Chicago Avenue South, Minneapolis, MN 55404, USA
2
Department of Pediatrics, University of Minnesota, Minneapolis, MN 55404, USA
3
School of Social Work, University of Minnesota, Saint Paul, MN 55404, USA
*
Author to whom correspondence should be addressed.
Received: 19 January 2018 / Revised: 2 March 2018 / Accepted: 5 March 2018 / Published: 7 March 2018
(This article belongs to the Special Issue Pediatric Palliative Care)
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Abstract

Little is known about the role of pediatric palliative care (PPC) programs in providing support for home compassionate extubation (HCE) when families choose to spend their child’s end of life at home. Two cases are presented that highlight the ways in which the involvement of PPC teams can help to make the option available, help ensure continuity of family-centered care between hospital and home, and promote the availability of psychosocial support for the child and their entire family, health care team members, and community. Though several challenges to realizing the option of HCE exist, early consultation with a PPC team in the hospital, the development of strategic community partnerships, early referral to home based care resources, and timely discussion of family preferences may help to make this option a realistic one for more families. The cases presented here demonstrate how families’ wishes with respect to how and where their child dies can be offered, even in the face of challenges. By joining together when sustaining life support may not be in the child’s best interest, PPC teams can pull together hospital and community resources to empower families to make decisions about when and where their child dies. View Full-Text
Keywords: compassionate extubation; psychosocial care; children; palliative care; advance care planning; terminal care; end of life compassionate extubation; psychosocial care; children; palliative care; advance care planning; terminal care; end of life
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Postier, A.; Catrine, K.; Remke, S. Interdisciplinary Pediatric Palliative Care Team Involvement in Compassionate Extubation at Home: From Shared Decision-Making to Bereavement. Children 2018, 5, 37.

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