Integrative medicine in paediatric palliative care

Abstract

This chapter will familiarize the reader with the wide range of modalities referred to as complementary and alternative medicine (CAM) therapies, and most recently contained under the concept of integrative medicine . Given the diverse nature and history of the field, it is impossible to mention all known disciplines worldwide, but an effort has been made to address those most commonly encountered in practice by western medical physicians and nurses. Experience, as well as some research evidence, suggests that there are potential benefits and occasionally risks when using complementary therapies in children. By their very nature it has often been difficult to demonstrate the benefit of complementary therapies using conventional western methods of research. However, all but the most cynical clinician will recognize that the absence of proof may not represent the absence of efficacy, but rather imperfect tools of inquiry.There are few robust measures of quality of life in children which are sensitive enough to tease out subtle changes in mood, although an attentive parent will readily detect these differences. More powerful tools for evaluating these subjective outcomes should be developed, so that further convincing evidence can be sought regarding the place and timing of complementary interventions in advanced stages of disease. The case histories in this chapter illustrate how CAM therapy can encourage a sense of well-being, a reduction in distressing tsymptoms, and feelings of being safe, cared for, and nurtured, resulting in exactly the improvement in quality of life that is the aim of palliative care. Healthcare professionals are encouraged to talk with their patients about their interest in and use of complementary medicine, to explore the options available in their local communities, and to establish a dialogue with practitioners in various non-allopathic fi elds who can serve as resources when families ask for complementary therapies.