Even though Americans are living longer, they are also living with more chronic diseases. Over time, patients become more debilitated and dependent as a result. Repeated hospitalizations and prolonged recovery cause physical and psychological stresses on patients and psychosocial burdens for families. As the inevitable downward course of their chronic illnesses progress, they need more than what science and technology can offer to extend life. They need physical symptoms relieved, their psychological burdens unloaded, social difficulties addressed, and spiritual turmoil lifted in order to live life. A multidisciplinary team of physicians, nurses, case managers, social workers, and clergy must form a coordinated team to care for the whole patients. Skills in team coordination, communication, symptoms management, and psychosocial support are required for effective palliative and hospice care.
SHM’s Palliative Care Special Interest Group compiled resources and tools to expand the knowledge and skills of practicing hospitalists as well as other members of the team. With the understanding that adults are not the only ones in need of Palliative Care, the group also included information related to Pediatric Palliative Care. Pediatric Palliative Care is both a philosophy of care and an organized, structured system of delivering care to children living with life threatening conditions and their families. The goal of Pediatric Palliative Care is to prevent and relieve suffering and to maximize quality of life for children of all ages, and their family members/support systems. This family centered approach to care is provided by an interdisciplinary team of professionals including medicine, nursing, social work, chaplaincy, nutrition, pharmacy, therapists and other health care professionals. Pediatric Palliative Care can be delivered concurrently with life-prolonging care or as the main focus of care and is treatment that should be started early in the trajectory of the condition. It preserves the integrity of the family during the condition progression, addressing anticipatory grief and bereavement support following the death.