Papers by Christy Torkildson
Welcome to the twenty-third issue of the ChiPPS electronic newsletter. This issue of our e-newsle... more Welcome to the twenty-third issue of the ChiPPS electronic newsletter. This issue of our e-newsletter offers a PDF collection of articles that explore some issues involving help and healing in relationship to bereavement perspectives. These are, of course, merely a limited number of the vast assortment of issues that arise in this broad subject area. Nevertheless, we hope this sampler will help to bring out some useful discussions and guidelines for readers of this issue. This newsletter is produced by ChiPPS (the Children’s Project on Palliative/Hospice Services), a program of the National Hospice and Palliative Care Organization and, in particular, by NHPCO’s Communications Work Group, co-chaired by Christy Torkildson and Maureen Horgan. Archived issues of this newsletter are available
Handbook of Perinatal and Neonatal Palliative Care, 2019
Journal of Pediatric Surgical Nursing, 2020
Journal of Palliative Medicine, 2018
OBJECTIVE This study examines health care provider perspectives about barriers to pediatric palli... more OBJECTIVE This study examines health care provider perspectives about barriers to pediatric palliative care for seriously ill children 15 years after an initial study within the same academic health system. METHODS Anonymous validated surveys were sent electronically to inpatient nursing unit distribution lists (n = 1315). Reminders were sent through e-mail twice over a two-month data collection period. RESULTS Response rate was 20.9% (275/1315) with 45.2% of responses from critical care units and 21.6% from hematology/oncology units. Of the participants, 58.2% (n = 160) had ≥10 years nursing experience, 58.5% (n = 161) had one to five patients die in the past 12 months, and 50.2% (n = 138) had one to five patients receiving subspecialty pediatric palliative care in the past year. Approximately one-half of the participants reported 3 of 26 barriers listed on the study survey as frequently or almost always occurring, including (1) family preference for more life-sustaining treatment than staff (n = 177, 64.8%), (2) family not ready to acknowledge incurable condition (n = 175, 64.1%), and (3) parent discomfort with possibility of hastening death (n = 146, 53.7%). Study findings were similar between 2002 and 2017, particularly in the extremes of the most and least commonly cited barriers. CONCLUSIONS Barriers to palliative care for hospitalized children persist and commonly include perceptions that families deny, prefer, or have discomfort with forgoing life-sustaining treatments. Increasingly, studies have shown that families can be simultaneously hopeful and aware of their child's worsening health. Further palliative care education and research about these barriers and their impacts are necessary to support seriously ill children and their families.
Journal of Palliative Medicine, 2007
To determine how palliative and end-of-life care can best be incorporated into the training of pe... more To determine how palliative and end-of-life care can best be incorporated into the training of pediatric residents. From 2001 to 2002, we surveyed 246 directors and 235 residents of pediatric residency programs. We elicited responses regarding (1) perceived relevance of pediatric palliative care, (2) residents' exposure to palliative medicine, (3) competency of faculty and matriculating residents in palliative care, (4) core palliative medicine competencies, and (5) the best teaching/learning format for palliative care. Fifty-five directors (22.4%) and 98 residents (42.0%) responded. More than three quarters of directors (78.1%) agreed with the statement that palliative care as a competency is "somewhat" to "very" important. Approximately one third (32.7%) agreed with the statement that their residents were not clinically exposed to end-of-life care; 99.0% of the residents indicated participation in such care. Almost one third of directors (27.3%) indicated that they had no faculty available to teach palliative care. Only 38.2% agreed with the statement that matriculating residents are competent in palliative medicine while many residents indicated having limited or no training in core palliative care competencies. For palliative care principles to be better incorporated into pediatric practice, they must be incorporated into residency education, optimally through informal teaching and during rounds. Finding ways to teach residents palliative medicine during clinical "teachable moments" and standardizing didactic curricula should become a priority in palliative and end-of-life care education.
nhpco.org
... Not-so-helpful approaches to support are discussed and alternative adult responses are offere... more ... Not-so-helpful approaches to support are discussed and alternative adult responses are offered on ... Ann-Patrice Foley, LMSW Pediatric Social Worker Angela Hospice Livonia, MI [email protected] ... protective of the parents and sensitive to their loss, often transition ...
Author(s): Torkildson, Christy | Advisor(s): Chapman, Susan A; Harrington, Charlene | Abstract: M... more Author(s): Torkildson, Christy | Advisor(s): Chapman, Susan A; Harrington, Charlene | Abstract: Medically fragile children, defined as children with life-threatening or life-limiting conditions who require consistent care and medical technology to support or enhance quality of life, have been found to have extensive needs for home and community based services. There is little information on Medicaid home and community-based (HCBS) waivers for medically fragile children in the literature. This study provides a needed foundation to understand the trends and difficulties in developing Medicaid Home and Community-Based 1915c Waivers for medically fragile children. Methods: Utilizing an adaptation of Anderson’s Behavioral Theory, a secondary descriptive analysis was conducted of secondary data from states for the period of 1999 to 2009 and policy survey data of state officials for 2010 to 2011. Additionally, an in-depth case study of the Medi-Cal HCBS 1915c Waiver Partners for Children i...
Pediatric Clinics of North America, 2007
The medical practitioner in the community is in a unique position to assist children and their fa... more The medical practitioner in the community is in a unique position to assist children and their families from the time of diagnosis with a life-threatening condition through to the end of life. The purpose of this article is to inform medical practitioners who care for children with complex, chronic, and life-limiting conditions about pediatric palliative care in the community. It is intended as a guide to improve understanding about (1) the misconceptions and barriers surrounding the provision of care in the community for children with chronic, complex, and life-limiting conditions; (2) the availability of services for care in the community; (3) challenges concerning out-of hospital do-not-attempt-resuscitation orders for children; and (4) reimbursement issues that impact the provision of care.
Uploads
Papers by Christy Torkildson