Palliative Care Challenges in Caring for Adolescents and Young Adults: Advance Care Planning, Spirituality and Moral Distress (007)

3.25CH  Cancer remains the most common non-accidental cause of death in childhood. In 2013, 627 children between the ages of 15 to 19 years of age died related to malignancies out of a total of 9,480 deaths in this age group (Osterman et al., 2015). Almost 10,000 young adults between 20 and 49 years of age die annually from cancer (SEER, 2016). Yet, clinicians remain reluctant to have difficult discussions with these adolescents and young adults (AYAs) (Rosenberg et al, 2016). Discussions with AYAs can be challenging, as one strives to balance AYA autonomy with their parents’ wishes (Osterman et al., 2016). Advance care planning helps define goals of care so that the AYA’s wishes can be honored throughout the disease trajectory and at end of life. Spirituality may impact discussions, decision making, and coping with the challenges of cancer for the AYA and the family.

Occasionally, the desires of the AYA may differ from those of the parents, leading to moral distress and discomfort for the nurse. Innovative tools are available to assist the nurse in eliciting the AYAs’ wishes to ensure their goals can be achieved. This workshop will utilize an interactive approach to role play common AYA clinical situations and conversations to develop strategies to engage AYAs in discussions about prognosis, hopes, worries, goals of care, treatment preferences, and spirituality. Methods of advance care planning will include interactive gaming and group discussion. The goal of this workshop is to expand the nurse’s confidence in engaging AYAs in crucial conversations, leading to improved coping throughout the trajectory of the disease and treatment using innovative tools and communication strategies.