Jalmsell et al. conducted a retrospective study surveying bereaved parents to determine symptoms at EOL for children with cancer. Thirty-five percent of children in this study died from a brain tumor. Fatigue was reported as being the most debilitating symptom impacting on well-being in the last month of life. Fatigue is multifactorial, unrelieved by rest, and not related to quality of sleep. Children with BT experienced less pain and more diffi culties related to bulbar weakness, impaired mobility, and constipation compared to children with leukemia/lymphoma. Loss of appetite and weight loss were not prominent symptoms of children with BT as compared to children with other malignant disease. Pritchard et al. identified in their study that bereaved parents reported changes in the child’s behavior and appearance at EOL as being of great concern.