The Current Status of Pediatric Palliative Care at Home – The Israeli Perspective

Every year approximately 450–500 new pediatric patients are diagnosed with various types of cancer in Israel, and approximately 90–100 of these children succumb to their disease every year. Although the number of childhood deaths each year may seem small, the emotional, social, and financial impacts are extraordinary. Pediatric palliative care (PPC) in Israel exists and functions on three levels: hospital, community, and hospice. All these three levels of PPC are connected to and dependent on each other and deliver their services to pediatric oncology patients who spend most of their time at home after being regarded as incurable. In Israel, an absolute majority of children with chronic and life-limiting conditions, including cancer, die in hospital. The reasons for this are several and reflect medical, psychosocial, and organizational aspects characteristic of the last phase of life of pediatric oncology patients in the country. The relative scarcity of both human and material resources for providing highly professional and comprehensive pediatric palliative care at the community level, as well as an underdeveloped pediatric hospice network, further complicates the current situation. For the improved development of PPC at the homes of children with advanced and progressive cancer, many improvements in such fields as continuous professional education and creation of financial mechanisms directed at stimulation and reimbursement policy in the field should be considered and implemented.