Death of a child at home or in the hospital: subsequent psychological adjustment of the family

Palliative care for children with cancer--home, hospital, or hospice?

“…It is the best place to maintain normal family life with the family retaining control, and there is evidence that the long term problems of bereaved parents and siblings are reduced.7 8 It is also cheaper. On the other hand, heavy responsibility falls on the parents, as well as on the primary health care team who rarely encounter dying children and often feel ill equipped to deal with either the medical or emotional needs of the child and family.…”

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program

“…A growing body of evidence suggests that the location in which children receive palliative care has significant implications. When palliative care is provided in the home, parental satisfaction appears to be high, and subsequent adaptation and outcomes for parents and siblings improves (12)(13)(14)(15). One model for such care is Partners for Children (PFC), a pediatric palliative care program in California.…”

Pediatric Palliative Care

“…48 In a follow-up study, investigators found that parents who cared for their dying child at home had decreased feelings of helplessness, greater feelings of control, and increased opportunity for family communication. 49 This study also found that parents of patients who died in the hospital were more anxious, depressed, and defensive. They also found that siblings of patients who died in the hospital showed fewer emotions, were more withdrawn, and were more fearful.…”

“…There are many benefits to having a child receive terminal care at home. [47][48][49][50] Some of the reasons families choose to care for their dying child at home include the child's wish to be at home, easier access to family and friends, freedom from the hospital, less disruption of family life, and ease of care for the siblings as well. 47 The effect of having a child die at home has been researched, and one of the early studies examining families after a child's death in the home versus in the hospital, found that families of children who died at home had a more rapid return to normal social functioning and a decrease in parental guilt when compared to parents of children hospitalized for terminal care.…”

“…51 Some other problems encountered in caring for their dying child at home include watching the decline, fears of what would happen, the nursing responsibility, and care for the other siblings. 49 Choice and control are fundamental to parents' coping strategies, and home is generally seen as the place of choice for terminal care of the child. 52 Research examining terminal home care for children with cancer found that this was very feasible; however, this type of care requires the ability to expect and prevent symptoms, to have liaison between the hospital and the primary care team, and to have a family support nurse.…”