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P-67 The development and integration of a collaborative young adult palliative and end of life care service
  1. Louise Smith
  1. Claire House Children’s Hospice, Wirral, UK


Background Young adults (YA) are a unique cohort of people (Pritchard, Cuvelier, Harlos, et al. Cancer. 2011; 117(10):2323–2328). Not a child, yet still learning and developing into an adult. Therefore, they have a unique set of needs when approaching end of life (Pritchard, Cuvelier, Harlos, et al., 2011), that are not met fully by either Paediatric or Adult Palliative Care Teams alone. We explored an interdisciplinary approach to ensure all emotional, physical and practical needs are met (Cohen-Gogo, Marioni, Laurent, et al. Eur J Cancer. 2011;47(18):2735–2741).

Aims To develop a dedicated Young Adult Palliative and End of Life Care Service for young adults aged 16–25 that can work across both paediatric and adult settings, incorporating the skills of the wider collaborative team (Pritchard, Cuvelier, Harlos, et al., 2011; Cohen-Gogo, Marioni, Laurent, et al., 2011). With the aim of ensuring bespoke, young adult-centred patient care, that is family inclusive, an important finding for this cohort (Ngwenya, Kenten, Jones, et al. J Adolesc Young Adult Oncol. 2017; 6(2): 200–212).

Methods Link into the local Teenage and Young Adult Oncology service and become an integrated part of their MDT, picking up appropriate, earlier referrals. Once referral obtained, refer to existing adult services, and work alongside them to provide collaborative care to both young adults and family.

Results/referrals Eight young adults in 2020; Eleven young adults in 2021; Twelve young adults in 2022; Nine so far in 2023. Not only can we show evidence of increased number of referrals, but importantly earlier referrals. We obtained written and verbal feedback from families and professionals to evaluate value of collaboration. The feedback shows evidence of effective, supportive relationships built between the team and the young adults and their professionals.

Conclusion Both paediatric and adult teams are very skilled in end of life care, but don’t look after huge numbers of young adults, so it’s difficult to grow confidence and experience with this cohort (Pritchard, Cuvelier, Harlos, et al. 2011; Wiener, Zadeh, Wexler, et al. Pediatr Blood Cancer. 2013; 60(5):715–718). By having a dedicated young adult team collaborating with existing teams, we can provide added layers of care to ensure young adults with advanced, progressive or incurable illness, can live as well as possible until they die (Ngwenya, Kenten, Jones, et al., 2017.). Earlier referrals, allow for a longer palliative relationship, which has been shown to improve quality of life (Coltin, Rapoport, Baxter, et al. Cancer. 2021; 128(2): 326–334).

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