Physical care of the dying child is focused on comfort, using the least-invasive procedures while protecting privacy and dignity. A child with terminal illness has the same physical needs as any seriously ill child, including pain management, regular sleep and rest, nutrition, maintenance of bowel and bladder function as well as respiratory function, and skin care. Additionally, several studies have shown a high degree of symptom burden in children with terminal illness in the last few weeks of life. These symptoms include pain, dyspnea, fatigue, lack of appetite, nausea and vomiting, constipation, and changes in sleep patterns (Shaw, 2012).
Children who are dying share the same fear of pain as adults with terminal illness. Even infants feel pain. Care providers need to talk with the family about pain management before the need becomes severe. Parents are greatly concerned that their child not suffer at the end of life. When pain or other symptoms are not treated or are treated unsuccessfully in their dying child, parents are likely to experience long-term distress. For most children pain control can be achieved using standard dosing with medications such as opioids and benzodiazepines (Shaw, 2012). Families who express concerns about addiction from narcotic pain medication need to be reassured that there is no evidence to support the idea. Like adults, children may develop a tolerance to sedatives and opioid medications, so that the dosage or the choice of drugs may need to be changed.