the doctor is in: The role of child psychiatrists in pediatric palliative care

Abstract

Objectives * Define a collaborative model between pediatric palliative care teams and child psychiatry. * Demonstrate knowledge of psychotropic medication use in children with advanced illness. * Recognize when the involvement of child psychiatry is warranted in specific pediatric palliative care cases. Prioritizing quality of life (QOL) and decreasing suffering in children and adolescents with life-limiting illness are necessary components of pediatric palliative care (PPC). Care teams are increasingly interdisciplinary, yet what is often missing is the presence of a consulting child psychiatrist. Suffering is often viewed in terms of physical symptoms, but the psychological needs of children with advanced illness often require the specific expertise of child/adolescent psychiatrists. Collaborative models are rare; rarer still are PPC teams with dedicated psychiatrists available to guide assessment, diagnosis, and treatment in this unique pediatric population. Few child psychiatrists are specifically trained to manage children with advanced illness or end-of-life symptoms, while many may feel ill-equipped to do so. Through a combination of didactic presentation, case based discussion, and interactive audience participation, attendees will achieve a new and deeper understanding of psychiatric issues and management challenges facing PPC patients/families and care teams. The presentation will include an overview of a model of collaboration between child psychiatry and palliative care teams; discuss a range of psychotropic medications used in children/adolescents with advanced illness; and review cases where child psychiatry consultation proved essential to patient management. Participants will gain familiarity with the vital role of the child psychiatrist in palliative care cases; review psychopharmacologic interventions for symptoms in PPC; and appreciate the range of circumstances faced by PPC teams that may be best managed through consultation with psychiatry.