Home Care for Children Dying of Cancer

Abstract

Hospitals have traditionally provided the setting for the treatment of children with cancer, including those in the terminal stage of their illness. However, when treatment that requires hospitalization has been discontinued and the child's cancer is still not under control, then the wisdom of continued hospitalization is questionable. If the care that is required by the patient could be provided as effectively by the parents and by nurses at home, then it would be reasonable to make a home care option available to the families who desired it. The possible advantages of such home care would be improved satisfaction of the child, better adjustment to the situation by the family, and reduced cost. It is more comforting to the child to be in familiar surroundings with the parents at hand during the terminal stages of his or her illness. Most of the specialized and expensive sive facilities provided by the hospital are no longer needed by the child. The preliminary findings from a research project dealing with home care of children with cancer are reported in this article. The feasibility and desirability of the home as an alternative to the hospital for children whose death from cancer was impending were examined. Administration of the home nursing service was at the time of the study separate from existing nursing services. Home care nurses were hired on an hourly basis and were recruited from hospitals and public health agencies. Two project staff nurses oriented the home care nurses to the special functions that they would serve, and also provided consultation and some of the actual home care.