5.3 Settings of Care
Download Word version
Download PDF version
Most children with advanced cancer and their families prefer to be at home if at all possible, but understand the need for outpatient visits and hospitalizations when necessary. However, as the child’s disease and care needs progress, alternate settings of care such as hospital or hospice may be preferred. Any setting can be adapted to the individual child and family’s situation.
Consider consultation with a pediatric palliative care team when caregivers are familiar with caring for children but unfamiliar with provision of care to the dying, or where there is familiarity with provision of care for the dying but not for children or adolescents. The pediatric palliative care team can add experience in symptom management, communication and ethical issues which arise at end of life.
Home
As end of life approaches, the local team will need to ensure re-evaluation of the physical set-up of the home to accommodate the changing care needs of the child and to seek supports to meet these needs (i.e., palliative nursing, personal support workers, physiotherapy, occupational therapy, social work, POGO Interlink Nurse). Regular contact with care providers in person, by phone or using technology will be necessary to ensure the family continues to feel supported. Clinician home visits and 24/7 access to telephone advice is often necessary for optimal comfort and symptom management.
Hospice
In some areas, care in a hospice setting may be available and allow increased supports to the family in a more home-like setting than a hospital. Discussion with a local hospice to discuss types of care available should include family members. Specialized pediatric hospices are available in some areas, and some children and families may already be familiar with their services.
Hospital
Families whose children continue on intensive therapy or with need for frequent transfusions and/or infusions may choose to remain in hospital. Sometimes less intensive chemotherapy allows outpatient-based care which may be facilitated at home or at a hospital closer to home. However, some families just prefer the additional support and reassurance that comes with the hospital setting for their child’s end-of-life care.
Primary author Dr. Christina Vandeboncoeur, Children’s Hospital of Eastern Ontario, Ottawa. This guidance document was developed based on the references in Sub-Section 5.8 References. Reviewed by the POGO Satellite Manual Palliative Care Working Group, 2016.
Disclaimer: Source Accuracy
You are welcome to download and save a local copy of this document in the Word and/or PDF formats provided. As the POGO Satellite Manual is subject to ongoing revisions and updates by POGO, we recommend you regularly check the online version posted at https://www.pogo.ca/satellite-manual/ to ensure you have the most up-to-date content. In the event of any inconsistency between the content of a local copy and the online version of the POGO Satellite Manual, the content of the online version shall be considered correct. Please see also the POGO Satellite Manual Disclaimer.
Record of Updates
| Version Number | Date of Effect | Summary of Revisions |
| 1 | 8/24/2021 | Original version posted. |