The most appropriate time is as soon as possible after the patient has been diagnosed with terminal cancer, when the parents have consented, and when a referral to the service has been made by a doctor.
Yes, especially when it is the wish of both the patient and the parents and it has been fully-discussed with attending medical professionals. It is also important to ensure that a full assessment has been made and that the necessary arrangements are completed before the patient is moved home. Once at home, palliative home care nurses will visit the patient at home as needed to support the parents and advise them on taking care of their sick child.
Death is a natural process and can occur at any time. If we are able to prepare for it well, life becomes more meaningful. Parents naturally find it difficult and distressing to explain the facts to their sick child, but if we can find the right way to talk to a child about his impending death it will help that child to fulfill his wishes. These may include arranging the details of their own funerals and giving instructions on how to distribute their belongings among friends and relatives before they pass away. While this may seem hard, parents can find appropriate ways to talk to their sick child with the help of professional counsellors and medical staff. This allows for ventilation of emotions and helps to relieve pressure, both for the parents and for the child. In fact, it is surprising just how much strength children can display in facing their own death.
Some parents are hesitant to give analgesics to their sick child because they are afraid of the possibility of addiction and/or the side effects of the drugs. If the dosage of opioid class analgesics such as morphine is adjusted gradually according to the doctor’s prescription, the sick child will not become addicted to the analgesic. Importantly, when the pain is relieved, the quality of the child’s life will be improved.