Paediatric Palliative Notes

6 Cs (top concerns and questions that children have)

What is it called?

Can I catch it?

Did I cause it?

Can I cure it?

Who will take care of me?

How can I connect to people I care about?

3 Ws (to enhance opportunities to talk with children)

Wonders, Worries, and Wishes

Communicating with ages 0-2 years old

Aware of loss through separation, experiences the world and achieves comfort through the senses, affected by emotions of caregivers

Interventions with ages 0-2 years old

provide structure and consistency, physical contact, feeling of security

Communicating with 2-6 years old

Generally views death as a reversible event, tends to associate death with external causes, can have “magical thinking,” may feel guilty/responsible

Interventions with 2-6 years old

repetition and simple explanations, reassurance, maintain routines, puddle jumping with grief

Communicating with ages 6-12 years old

Generally understands death is permanent and may want details, may believe death only happens to others, young child: associates death with external cause; older child: aware of internal and external causesIn

Interventions with 6-12 years old

accurate and literal information, reassurance about grief reactions, opportunities to ask questionsC

Communicating with Adolescence

Understand implications of death, aware of universality of death; may withdraw and spend time alone; may feel isolated and lonely; may experience intense emotionsIn

Interventions with Adolescence

Inclusion in discussion and decisions; time alone, journal or diary; support from peers (important to fit in)

Strategies for communicating with children

Play (role play), art, story telling (journal), books, support groups, peer support