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Paediatric palliative care in the NICU: A new era of integration
Sophie Bertaud1, Angela M Montgomery2, Finella Craig3
1Ethox Centre, Nuffield Department of Population Health, University of Oxford, UK; Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, UK; Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Hospital, London, UK.
Insights
Neonatal medicine and pediatric palliative care are integrating, offering holistic support beyond end-of-life care. This collaboration addresses infants
Area of Science:
- Neonatal Medicine
- Pediatric Palliative Care
- Healthcare Integration
Background:
- Palliative care's role is expanding beyond terminal illness in neonatal medicine.
- Increasing recognition of the need for integrated care models.
Purpose of the Study:
- To address principles of pediatric palliative care in the NICU.
- To outline key components and providers of palliative care in neonatal settings.
- To explore international standards and integration of palliative care in neonatal medicine.
Main Methods:
- Review of principles and standards in pediatric palliative care.
- Analysis of palliative care application within the NICU setting.
- Discussion on interdisciplinary collaboration between neonatal and palliative care teams.
Main Results:
- Palliative care offers proactive, holistic support addressing physical, emotional, spiritual, and social needs.
- Integration requires harmonizing skills from neonatal and palliative care teams.
- Current practices and future directions for integrated care are considered.
Conclusions:
- A new era of integration between neonatal medicine and pediatric palliative care is emerging.
- Holistic palliative care extends beyond end-of-life, benefiting infants and families.
- Successful integration necessitates a coordinated, interdisciplinary approach.
Abstract:
We are entering a new era of integration between neonatal medicine and paediatric palliative care, with increasing recognition that the role and skills of palliative care extend beyond care of only the terminally ill infant. This paper addresses the principles of paediatric palliative care and how they apply in the NICU, considers who provides palliative care in this setting and outlines the key components of care. We consider how the international standards of palliative care pertain to neonatal medicine and how a fully integrated approach to care may be realised across these two disciplines. Palliative care is so much more than end-of-life care, offering a proactive and holistic approach which addresses the physical, emotional, spiritual and social needs of the infant and family. This is a truly interdisciplinary endeavour, relying on a harmonisation of the skills from both the neonatal and palliative care teams to deliver high-quality coordinated care.
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