SPECIALIST
PPC
COMMUNITY- COMMUNITY
BASED HEALTH Local Care Coordination TERTIARY &
CARE SECONDARY
ACUTE CARE
CHILD
FAMILY
PRIMARY OTHER
HEALTH AGENCIES/
CARE ORGANISATIONS
History
• 2008:
Rachel House
• 2009-2010:
Pediatric Palliative
Care Training
• 2009:
Pediatric Palliative
Care in “Dharmais”
Cancer Hospital
21 April 2009
April 2009 June 2009
November 2009
June 2009
“Dharmais” Palliative Care Unit
Adult Pediatric
Palliative Care Palliative Care
Unit Unit
How it’s run…
Patients
Primary
Physician
FRIENDLY WARD
NO PAIN NO SCARED
APROACH
PSYCHOLOGICAL SOCIAL
Pain Management
Pain Killer
Morphine
Amitriptyline
Codein
Paracetamol
How it’s run…
Patients
Primary
Physician
status
family
promotion
car health spirituality
Sick person’s world
Work
family
health
spirituality
Dying person’s world
work, house, car, finances
family spirituality
medical issues
End of Life Care
• Never give up
• Accept the reality
How the practice in Indonesia?
“Amit, amit…..”
“I want it maximal…”
FAMILY
What is your dream ?
What is your dream ?
A, boy, 8 year old
Neuroblastoma in the suprarenal
stage IV
(metastases to the liver)
Chemo resistant
Educate the Caregiver
Try to fulfill his dream
What else?
Distribution of Pediatric Palliative Patients in
“Dharmais Cancer Hospital that
Referred to Rachel House 2009
Hospice Home Care
Sex
Boy 2 1
Girl 2 4
Referral
RSKD 4 5
Age (year)
0-4 0 1
5-9 1 0
10-14 2 3
15-18 1 1
Hospice Home Care
Diagnosis
Embrional Carcinoma 1
Ovarium Cancer 1
Ewing Sarcoma 1
Osteosarcoma 1
Nasopharingeal Cancer 1
LMNH 1
Rhabdomyosarcoma 1
Meduloblastoma 1
Mixopapillary Ependimoma 1
Place of Death
Hospice 2
RSKD 1
Home 5
Pediatric Palliative Care 2010
Month End of Live Pain
Care Management
January 1
February 2
March 1 1
April 2
May 2
Juni
Juli
Agustus
September 1
Distribution of Pediatric Palliative Patients in
“Dharmais Cancer Hospital 2010