Neonatologists’ Perspectives of Palliative and End-of-Life Care in the Neonatal Intensive Care Unit (SA506-C)

Abstract

2. Examine the characteristics of death in the hospital among the young adult cancer population at a single academic institution. 3. Describe escalations in care at the end of life that occur in the young adult population. Background. While evidence suggests nonelderly adults with cancer are likely to receive aggressive treatment in their last month of life (chemotherapy, intensive care admission, cardiopulmonary resuscitation, mechanical ventilation), and less likely to receive palliative and/ or hospice services, these indicators have not been studied in the young adult population (age 20-39 years). Little is known about the characteristics of end-of-life experiences among young adults with cancer. Research Objectives. This descriptive, pilot study explored the characteristics of death among young adults with cancer (those diagnosed between the ages of 20-39 years) in a tertiary academic hospital setting to describe the end-of-life experiences that may be unique to this young adult age group. Method. The authors conducted a retrospective chart review of hospitalized young adults who were diagnosed and died with cancer within a 10-year period. Study variables were abstracted for quantification and qualitative content analysis. Result. Preliminary analysis of 60 records indicates that young adults commonly received cancer treatment within 1 week of death and that do-not-resuscitate orders were frequently written only when death appeared imminent. Palliative care teams were consulted for management of physical symptoms, but often within days of death. Additionally, the trajectory from diagnosis to death was extremely short. Conclusion. This study highlights the need for further inquiry into end-of-life care for young adults with cancer so that interventions can be developed to meet the physical, emotional, social, and spiritual needs of this unique group of patients, their families, and friends. Implications for Research, Policy, or Practice. Describing characteristics of end-oflife experiences for young adults who die of cancer is a necessary first step to develop and implement palliative care interventions to improve care for this population. In addition, study findings may reveal policy implications related to coverage and reimbursement of palliative care and hospice services for these patients. Neonatologists’ Perspectives of Palliative and End-of-Life Care in the Neonatal Intensive Care Unit (SA506-C) Donna Maria Cortezzo, MD, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, CT. Marilyn Sanders, MD, Connecticut Children’s Medical Center, Hartford, CT. Elizabeth Brownell, PhD, Connecticut Children’s Medical Center, Hartford, CT. Kerry Moss, MD, Connecticut Children’s Medical Center, Hartford, CT. (All authors listed above had no relevant financial relationships to disclose.)