What is palliative care?

Palliative care is care for terminally ill patients and their families. If children have an advanced illness that can’t be cured, palliative care makes them as comfortable as possible, by treating their pain and other distressing symptoms. In addition, palliative care provides psychological, social and spiritual support for the children and their families.

What influences pain in advanced illness?

In the so-called bio-psycho-social model, pain develops due to dynamically interacting biological, psychological, and social factors unique to each individual.  One physical or biological (bio-) factor is the underlying disease that may affect inner organs such as the brain, the heart, lungs, kidneys, the liver, and the gut, or the nerves, muscles and joints. Other biological factors might include how the body deals with and processes this pain. Psychological (psycho-) factors comprise a child’s mood and emotions. Social factors include how the child and his or her family can deal with the circumstances and stresses of the child’s illness. All factors can have positive or negative effects on pain development, persistence and experience, and pain will arise or become more intense when negative influences outweigh the positive ones.

What are signs of pain in advanced illness?

Children with life-limiting conditions have often many problems; pain is likely only one of many complications. It can be important to recognize unreported pain in these children. A child in pain may

  • avoid moving to avoid further pain in a body region.
  • protect the area that hurts.
  • become unusually quiet, frustrated, sad, depressed, anxious, worrisome, moody, irritable, or upset and
  • be mentally absent or not be able to focus or concentrate.
  • experience poor appetite and low energy.

How is pain in advanced illness treated?

Pain in children with advanced illness is likely only one of many symptoms that they will have related to their illness. Therefore, treatment of advanced illness is usually a team effort. The pediatric palliative care team, the palliative care team particularly for children, includes physicians and clinical nurse specialists. They work very closely together with the teams already involved in the care of the child, such as family physicians, pediatricians, and further specialists who look after the underlying disease. The pediatric palliative care team sees patients along the continuum of care in a variety of places including in hospital, outpatient clinics, home, and in other community settings.

The pediatric palliative care team uses a combination of medication and non-medical ways to treat the pain and other associated symptoms.

Pediatric Palliative Care in Manitoba

A request to have the Pediatric Palliative Care Team involved in the care of a child here in Manitoba needs to be made by a health care provider.

  • Urgent referrals can be made by calling HSC Paging at 204-787-2071 and asking for Pediatric Palliative Care.
  • Non-urgent referrals can be sent to the Winnipeg Regional Health Authority Palliative Care Program by faxing: 204-237-9162.