Psychological care in the palliative phase

When cancer is no longer curable, the treatment plan changes to care aimed at prolonging life and improving quality of life. Medical treatments may still be offered, such as radiotherapy for pain management or chemotherapy to slow disease progression.

Most children who die eventually pass away at home. Psychosocial care can support parents in living day to day, in caring for their ill child, and in supporting brothers and sisters. For many parents, it is difficult to talk with their child about death and the fears associated with it. Support from the Children’s Comfort Team, palliative home care services, or a grief and loss counselor can help parents with this. How children think about death and the extent to which they understand it depends on their age and developmental stage.

If the child’s school is informed about the approaching death, it is important that teachers, classmates, and school leadership receive appropriate guidance. For the child, distraction through participation in school activities can be a welcome break from being ill. This requires flexibility from both parents and teachers, so the child can participate as much as possible.

Brothers and sisters, often referred to as siblings, who attend the same school also need appropriate support. Their emotions and school performance may be affected by the situation of their ill brother or sister. Each sibling responds differently to the palliative phase, and it is important that parents pay attention to their well-being if they are struggling. Attention to their emotions helps them adapt better in the long term. For siblings, school can also be a welcome distraction, allowing them some time away from the illness of their brother or sister.

Literature

• Van Broeck, N. (1993). Behandeling van zieke kinderen. Houten:Bohn Stafleu van Loghum.

• Grootenhuis, M.A., Aarsen, F., & Van den Bergh, E. (2001). Pscyhologische behandeling bij kinderen met kanker. In S. Duijts, R. Sanderman, M. Schroevers, & T. Vos (Eds.), Psychologische patiëntenzorg in de oncologie (pp. 323-334). Uitgeverij Van Gorcum.

• Houtzager, B. A., Grootenhuis, M. A., Hoekstra-Weebers, J. E.H.C., & Last, B. F. (2003). Kwaliteit van Leven en coping bij broers en zussen van kinderen met kanker. Tijdschrift voor kindergeneeskunde, 71(3), 188-198. https://doi.org/10.1007/bf03061455

• Longbottom, S., & Slaughter, V. (2018). Sources of children's knowledge about death and dying. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 373(1754), 20170267. https://doi.org/10.1098/rstb.2017.0267

• Martel, D., Bussières, J. F., Théorêt, Y., Lebel, D., Kish, S., Moghrabi, A., & Laurier, C. (2005). Use of alternative and complementary therapies in children with cancer. Pediatric blood & cancer, 44(7), 660–668. https://doi.org/10.1002/pbc.20205

• Valdimarsdóttir, U., Kreicbergs, U., Hauksdóttir, A., Hunt, H., Onelöv, E., Henter, J. I., & Steineck, G. (2007). Parents' intellectual and emotional awareness of their child's impending death to cancer: a population-based long-term follow-up study. The Lancet. Oncology, 8(8), 706–714. https://doi.org/10.1016/S1470-2045(07)70209-7

• Verhostadt-Denève, L.G., van Geert, P., & Vyt, A. (2003). Handboek ontwikkelingspsychologie: grondslagen en theorieën. Bohn Stafleu van Loghum.