title: Specialized home palliative care for adults and children: differences and similarities.
abstract: OBJECTIVE
  To compare the provision of specialized home palliative care (SHPC) by the adult and pediatric SHPC teams at the Munich University Hospital.
  
  
  METHODS
  All patients treated by one of the SHPC teams and their primary caregivers were eligible for the prospective nonrandomized survey. We analyzed the demographics, the underlying diseases, duration and impact of SHPC on symptom control and quality of life (QOL) as well as the caregivers' burden and QOL.
  
  
  RESULTS
  Between April 2011 and June 2012, 100 adult and 43 pediatric patients were treated consecutively; 60 adults (median age, 67.5 years; 55% male) and 40 children (median age, 6 years, 57% male) were included in the study. Oncologic diseases were dominant only in the adult cohort (87 versus 25%, p<0.001). The median period of care was higher in the pediatric sample (11.8 versus 4.3 weeks; NS). Ninety-five percent of adult and 45% of pediatric patients died by the end of the study (p<0.001), 75% and 90% of them at home, respectively. The numbers of significant others directly affected by the patient's disease was higher in children (mean 3.4 versus 1.2; p<0.001). The QOL of adult patients and children (p<0.05 for both), as well as of their primary caregivers (p<0.001 for both) improved during SHPC, while the caregivers' burden was lowered (p<0.001 for both).
  
  
  CONCLUSIONS
  Our results show important differences in several clinically relevant parameters between adults and children receiving SHPC. This should assist in the development of age-group specific SHPC concepts that effectively address the specific needs of each patient population.
authors.affiliation: 1 Pediatric Palliative Care Service, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-University , Munich, Germany .
authors.forename: Gesa
authors.initials: G
authors.lastname: Groh
authors.forename: Berend
authors.initials: B
authors.lastname: Feddersen
authors.forename: Monika
authors.initials: M
authors.lastname: Führer
authors.forename: Gian Domenico
authors.initials: GD
authors.lastname: Borasio
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005858:Germany; D006699:Home Care Services; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D011788:Quality of Life; D013038:Specialization; D011795:Surveys and Questionnaires; D055815:Young Adult