Hospice and Non-Hospice Models of Palliative Care Delivery in Long-Term Care (327)

Abstract

medicine provider. Some of the most difficult of these cases are those at occur at the extremes of childhood. This session will discuss medical decision-making in four cases, including an unborn with life-limiting pathology, a terminally ill neonate in the NICU, an adolescent with advanced cancer and no parental support, and a previously independent 19-year-old who is suddenly ventilator-dependent with a devastating neurologic condition. These illustrative cases will demonstrate surrogate decision-making for the not-yet-competent individual, principles of assent versus consent, continuation of pregnancy against medical advice, adolescent parents as surrogates, loss of recently acquired adult maturation, withdrawal of medical therapies in children, and other unique aspects of medical decision-making with and for vulnerable child patients. Components of good pediatric palliative decision-making will become evident to the participant via interaction with the presenters. Tools to facilitate good pediatric medical decisionmaking will be presented. Application of principles of pediatric palliative care learned in four geographic, cultural, academic, and clinically diverse care settings will be shared by multidisciplinary, multispecialty faculty. AAHPM Pediatric Special Interest Group members suggested this presentation as most likely to be helpful to the Annual Assembly attendee as well as the pediatric palliative care provider. Exposure to these cases of pediatric medical decision-making at the extremes of life will build skills and enhance the participants comfort in the practice of palliative care.