7 Questions You Should Ask Yourself Before Working with Pediatric Palliative Care Patients

May 27, 2022

As much as I can see the positive impact massage and touch therapy has, working in pediatric palliative care is not the career path for every massage therapist or healthcare provider.

If working with this population is something you are considering professionally, there are some questions you need to ask yourself before jumping in.

Why do I want to work with medically fragile children?

Examine your motivations for becoming a therapist who specializes in pediatric palliative care massage.

Pediatric palliative care strives to provide comfort and support to young patients and their families, and pediatric massage therapists typically focus on making the transition from life to death more comfortable. 

When children live with a life-threatening illness, they often undergo painful procedures and experience numerous types of pain as symptoms of their diagnosis. Each year, tragically, children in palliative care die without receiving the pain management they need.

With this in mind, many healthcare providers want to use touch therapy to help provide pain relief and increase comfort for children.

Despite their fears, concerns, or the unknown, many therapists internally encourage themselves to start working with this population. Often applying a save the day “Superhero” idea of hopping into this practice and fixing things. As much as you have the best intentions, this is a terrible approach. Have you considered what it takes to work effectively with pediatric patients and their families?

Do I have the training and background to do this work?

As a massage therapist providing therapeutic care to medically fragile children or in palliative or hospice care, a touch therapy session can take on a very different purpose than treating a typically developing child.

Massage and touch therapy for pediatric palliative clients and patients should be performed by a professionally trained provider who has undertaken specific training in working safely with palliative care clients. The healthcare provider will adapt their techniques to suit the child’s current state of health and any presenting symptoms to achieve the desired outcome.

In many situations, the majority of touch the child has received recently has been uninvited poking and prodding, painful clinical touch, or lack of positive touch.

The most gentle touch therapy can be best during these times. A trained therapist knows to adjust tactile techniques to be much lighter in pressure and more slowly paced.

What is my self-care plan?

A hectic pace and a demanding schedule can mean self-care goes to the bottom of the priority list for many healthcare providers. The palliative massage practitioner must be concerned with the safety and well-being of the client or practice and prioritize their own.

Consider the direction to apply your oxygen mask first when on an airplane; before we can help anyone else, we must first help ourselves.

These considerations are necessary for your emotional health;

Monitor your emotional health for signs of stress. 

Maintain a healthy balance in your life by recognizing your limitations and strengths.

Develop strategies for dealing with grief and loss.

Self-care is crucial for pediatric massage therapists and healthcare professionals at greater risk for burnout and compassion fatigue. Each practitioner may have a different way of coping. When you develop and follow specific strategies, it will increase resilience and, at the same time, reduce the physical and emotional impact of stress.

Do I have a good support system?

Generally speaking, it is vital to have supportive people in your life. However, when working in pediatric palliative care, a healthy support system is crucial, especially during times of grief.

A support system comprises the people you trust, who help you and comfort you. These are the people who take care of you or provide emotional support, wisdom, and strength when you need it. Surround yourself with a circle of encouraging, caring, and compassionate people.

During grief, you can become overwhelmed, confused, or exhausted. It can help to have someone to talk to and share your thoughts with during these times.

What makes me afraid to work with children and families in this healthcare situation?

Many therapists and healthcare providers feel professionally qualified to provide touch therapy interventions in general but may not know how to adjust techniques and approaches for medically fragile children.

Many pediatric patients have numerous medical lines or equipment, and practitioners may express concern that they will not know what to do in these situations.

Some practitioners are not all worried or afraid of this concept, but rather, they have fear about how to speak with children who are nearing end-of-life. Healthcare providers also express worries about handling difficult questions from children.

Healthcare providers and pediatric massage therapists must consider responding to the child when they ask specific questions such as, “When will I Get better?” or “What will happen to me when I die?”

Do I understand the code of ethics involved in working in pediatric palliative care?

One of the essential differences between a pediatric palliative massage therapy practitioner and any other touch therapy practitioner is the necessity of facing your attitudes, fears, and beliefs around death and dying.

Working with dying children forces the palliative massage practitioner to confront these issues directly, regardless of whether they are disturbing or upsetting. Every professional who provides pediatric palliative care must know their limitations and be able to assist clients and patients in confronting their fears of the death of dying while creating a safe and non-judgmental environment.

What are my plans for maintaining professional boundaries?

When working in these specific emotionally charged situations, we must constantly remind ourselves of our professional boundaries.

Some acceptable activities to perform during a pediatric palliative touch therapy session include making adjustments in pressure, positioning and pillowing, responding to requests for personal items, taking a break, or even listening to specific music choices.

We must consider the situation as a whole and every part that makes up the session.

If you consider providing touch therapy for pediatric palliative care patients, you must first slow down. Take the time to become genuinely informed on the practice of pediatric massage, but also to ensure you are best suited for this important professional responsibility.