Psychological Intervention with the Dying Child

The chapter deals with psychological palliative care to pediatric patients at the end-of-life. Description of the development of children's conceptions of death and awareness of impending death is followed by the presentation of the Pediatric Psychological Palliative Care (PPPC) model, which is an approach designed to help children or adolescents and their families confronting death. The principles and implementation of PPPC are described in regard to issues such as fears of abandonment and separation, leaving the familiar and confronting the unfamiliar, punishment, pain and suffering, and death; being told the truth; protecting one's parents; guilt in regard to one's parents; loss of respect for authorities; loss of control; sadness and sorrow; anger; wish-fulfillment; hope and self-comforting; search for meaning. The last part focuses on relations with the family and the treatment team, including communication, and decision-making in regard to palliative sedation and home or hospital as place of spending the last period of life.