Publication
Blended Pediatric/Adult Palliative Care for Young Adult With Autism and Pancreatic Cancer
Adelmann M, Davidoff K, Kiser S, Ritchie C · Journal of Pain & Symptom Management · 2025
Pediatric and adult palliative care clinicians can learn valuable lessons from each other.(1-3) However, pediatric and adult teams tend to function separately, and feel unprepared to care for the other population.(4) Many patients across the age spectrum, especially adolescents and young adults, would benefit from blended adult and pediatric palliative care approaches. Objectives 1) Use a case-based approach to analyze the commonalities, and the opportunities for greater exchange, between adult and pediatric palliative care; 2) Propose a framework for integrating adult and pediatric palliative care approaches and demonstrate how this framework can be taught to interprofessional trainees. Case MM is a 25 year old woman with autism spectrum disorder and metastatic pancreatic cancer who is admitted to an adult palliative care unit with worsening hypoxemia due to lung metastases. She has expressed to her oncologist that she wishes to “know everything.” Her parents request that the team protect her from discouraging news including prognostic information. The palliative care team and primary oncologist met first with MM's parents, and subsequently with MM and her family. With support from her family, MM made the decision to start chemotherapy. Code status was discussed separately with her parents. Multiple members of the interprofessional team expressed distress about their lack of experience caring for a young person with autism spectrum disorder. A palliative care social worker and pediatrics-trained physician supported the team in blending adult and pediatric approaches to communication, decision-making, and psychosocial support. Conclusion Based on this experience and on interviews with interprofessional palliative care fellows (n = 16), we developed a framework for integrating adult and pediatric palliative care approaches. The framework identifies differences and similarities in symptom management, decision-making, communication, psychosocial support, healthcare systems, and clinician experience. It facilitates clinicians “borrowing” practices from adult or pediatric colleagues when they encounter a case like MM.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.