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Symptomatic palliative care for children with neurodisability
Authors:Lizzie Bendle  Joanna Laddie
Abstract:Paediatric palliative care and neurodisability are two relatively new, evolving paediatric sub-specialities that have increasing relevance in the current paediatric landscape. For many people palliative care has been synonymous with end of life care, but in paediatrics it encompasses much more and is for all children with life-threatening or life-limiting conditions, from the point of diagnosis. This breadth of focus is demonstrated well through the interface between paediatric palliative care and paediatric neurodisability. In this article we explore this unique interface through the three domains of complex symptom management, advanced care planning and end of life care. We describe the practicalities involved in all three areas and highlight the importance of early referral and the process of “dual” or “parallel” planning. We cover in more depth the specific management of the symptoms: dystonia/abnormalities of muscle tone, seizures, pain, agitation, secretions, respiratory failure, and gut failure.
Keywords:advance care planning  agitation  dystonia  end of life care  gut failure  life-limiting condition  neurodisability  paediatric palliative care  pain  parallel planning  respiratory failure  secretions  seizure  symptom management
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