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Abstract

Death is a reality for children and adolescents as over 53,000 children and 3,000 adolescents succumb annually to one or more chronic illnesses. Death of these precious patients may occur in the hospital, often the neonatal or pediatric intensive care units. No one is prepared for such tragic events-neither the patient, nor the family, nor hospital staff. This article considers complex issues related to the hospitalized dying adolescent and offers recommendations for the staff as hospital individuals often struggle with providing the youth a peaceful, dignified, and painless death.

Keywords: Pediatrics, adolescence, death, care

Do not stand at my grave and weep

I am not there. I do not sleep.

I am a thousand winds that blow

I am the diamond glints on snow

I am the sunlight on ripened grain

I am the gentle autumn rain

When you awake in the morning's hush

I am the soft uplifting rush

Of quiet birds in circling flight

I am the soft star that shines at night

Do not stand at my grave and cry

I am not there.I did not die.

Anonymous, Dedicated to Adele Dellenbaugh Hofmann, MD (1926-2001)

Introduction

Approximately 53,000 children and 3,000 adolescents die each year in the United States as a consequence of chronic illnesses (1, 2). Youths can die from acute causes as well. More than 14,000 youths die each year from unintentional injuries (these are mostly motor vehicle accidents). Approximately 5,000 youths die from homicide, and approximately 4,000 youths die from suicides (3).

Death is perhaps the most difficult aspect of human existence for all to face. Humans tend to ignore and/or deny the inevitability of their own mortality. As life ebbs away from youth despite the best that health care professionals (HCPs) can do, HCPs must confront the uncomfortable reality of their patient's mortality and share uncomfortable emotions with the teenager and family-including grief, helplessness, loss, anger, and others (4). It is a most bitter and poignant concept that a youth is dying at a point when many decades of living should be ahead.

The literature on theories and methods for conceptualizing issues that are related to death and dying is controversial. One of the most well-known theorists and advocates for addressing the needs of the dying...

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