[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Paediatric nursing](https://durgical.com/en/nursing/areas/pediatric/) › Palliative and end-of-life care for children and their families # Palliative and end-of-life care for children and their families - Fundamental Palliative care for children starts at diagnosis, runs alongside treatment, relieves suffering and supports the whole family, siblings and grief included. Updated Nov 13, 2026 ## Key points - Starts at diagnosis and continues alongside disease-directed treatment; it is not a last resort. - Care covers the child, parents, siblings and other close people, and continues into bereavement. - Interdisciplinary team; available wherever the child is, including at home. - Pain relief is a right; restrictive rules on controlled medicines are a major barrier worldwide. - With grieving children, use the word 'death', not euphemisms such as 'gone to sleep'. ## What it is Paediatric palliative care aims to give the child and family the best possible quality of life from diagnosis onward, whatever the outcome of treatment. It prevents and relieves pain and other physical, psychological, social and spiritual problems, runs alongside disease-directed treatment and continues into bereavement. It is delivered by an interdisciplinary team wherever the child is, including at home. Most children who need it live in low- and middle-income countries, where access, including to pain medicines, is often limited. The nurse is at the centre of symptom control, communication and family support. ## Key points - WHO: palliative care relieves physical, psychosocial and spiritual suffering and supports caregivers and bereavement. - Children may not understand that death is permanent until preschool age or later. - Grief in children can show as anger, regression, sleep changes, school problems or withdrawal. - The death of a child is a risk factor for complicated grief in parents; grandparents' grief is often overlooked. - Advance care planning is a core principle of paediatric palliative care. ## Components - Symptom control: pain, breathlessness, nausea, fatigue, anxiety. - Communication: honest, at the child's developmental level, with time and presence. - Family support: parents, siblings, grandparents; practical and financial needs. - Spiritual and cultural care, and rituals the family values. - Bereavement support and care for the staff. ## What it is for - Improves quality of life for the child and family, whatever the course of the disease. - Keeps the family's goals and wishes at the centre of decisions. - Reduces the risk of complicated grief through support before and after death. ## In nursing practice - Assess pain and use non-drug measures (raising the bed or a fan for breathlessness, small room-temperature meals for nausea) alongside prescribed treatment. - Ask the child and family about their goals of care, with open questions and active listening; answer honestly. - Use play as the child's language to explore fears and feelings. - Include siblings and grandparents in the support the team offers. - Facilitate the family's religious or cultural practices and refer to chaplains or counsellors when asked. - Look after the team: repeated exposure to a child's suffering and death can cause distress and burnout. ## Common mistakes - Waiting until the last days to involve palliative care. - Using euphemisms with children ('gone away'), which confuse them. - Forgetting the siblings and grandparents. - Undertreating pain for fear of medicines; follow the prescription and protocol and report uncontrolled symptoms. ## Test yourself Think of the answer, then tap the question to see it. ## When should paediatric palliative care begin? From diagnosis of a life-threatening illness, alongside disease-directed treatment. ## Who does paediatric palliative care support? The child, parents, siblings and other significant people, including after the death. ## Why avoid saying a dead person has 'gone to sleep' to a child? Euphemisms confuse children; using the word 'death' is clearer and supports their grief. ## What is a major global barrier to pain relief in children's palliative care? Restrictive regulation of, and poor access to, opioid medicines. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/palliative-and-end-of-life-care-for-children-and-their-families/) ## Connections ## Related 3 - [Nursing care of the dying patient](https://durgical.com/en/nursing/nursing-care-of-the-dying-patient/) - [Supporting the family and grief](https://durgical.com/en/nursing/supporting-the-family-and-grief/) - [Symptoms at the end of life: pain, breathlessness, secretions, delirium and mouth care](https://durgical.com/en/nursing/symptoms-at-the-end-of-life-pain-breathlessness-secretions-delirium-and-mouth-ca/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Paediatric palliative care in cancer (ecancermedicalscience 18:1823)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11959118/) (ecancermedicalscience (open access, CC BY 4.0, PMC11959118), 2024); [Palliative care (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/palliative-care) (World Health Organization, 2020); [Nursing Fundamentals, 17.2 Basic Concepts (grief and loss) (Open RN, CC BY 4.0)](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/17%3A_Grief_and_Loss/17.02%3A_Basic_Concepts) (Open Resources for Nursing (Open RN) / LibreTexts, 2021); [Nursing Fundamentals, 17.4 Palliative Care Management (Open RN, CC BY 4.0)](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/17%3A_Grief_and_Loss/17.04%3A_Palliative_Care_Management) (Open Resources for Nursing (Open RN) / LibreTexts, 2021). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/palliative-and-end-of-life-care-for-children-and-their-families/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/palliative-and-end-of-life-care-for-children-and-their-families/