Pediatric Advanced Care Team (PACT)

The IWK Health Centre Pediatric Advanced Care Team (PACT) is a consultative service dedicated to optimizing the wellbeing of infants, children, youth and expectant parents in the Maritimes who are facing life limiting or life-threatening conditions.  PACT focuses on the prevention and relief of symptoms and provides an additional layer of family-centered supports throughout the illness experience, whether on to a cure or into bereavement.  

PACT works alongside primary health care teams and community providers to enhance quality of life, ensure continuity of care, and support children and families to make and advocate for care decisions that best reflect their unique values and preferences.  

As the Division of Palliative Medicine at IWK, PACT is also involved in research, education, policy, and advocacy with the goal of providing the highest quality, evidence-based pediatric advanced care, complex care and palliative care to Maritime children and families.  

What we do

We are a team of health professionals focused on improving quality of life for infants, children, youth and expectant parents facing life-limiting or life-threatening conditions.  Our palliative approach to care is typically delivered alongside, not instead, of disease directed treatments.  Our aims are to optimize the management of symptoms and to provide an extra layer of support to families facing uncertainty and challenges so they might still live their best lives. 

In Nova Scotia, pediatric palliative care is provided by the IWK Division of Palliative Medicine’s Pediatric Advanced Care Team [PACT] in collaboration with other IWK services and community providers.  

Quality of Living

Quality of life—the mix of comfort, joy, inclusion, social interaction, etc. that constitute wellbeing—is unique for every child and family.  The palliative approach to care optimizes quality of life by understanding a child and family’s goals and values, collaboratively making care decisions that reflect those goals and values, ensuring clear and open communication, and managing symptoms.  Because care plans and symptom management strategies often change over time according to the child’s condition, response to treatment, or illness trajectory, the palliative approach is a dynamic and ongoing process.

Active symptom management

Active symptom management means anticipating and preventing symptoms, when possible, and responding early and effectively when symptoms arise.  The goal of symptom management is to help the child to live as comfortably and as fully as possible.  

Decision Making Support

Families of children with serious illness are often called upon to master complicated medical information and to make difficult decisions, sometimes with incomplete information and/or much uncertainty.  IWK PACT works to ensure that families have as full and accurate an understanding as possible and to support them in making decisions that best reflect their values and preferences.

End of Life Care

For adult patients, palliative care is often synonymous with end-of-life care but this not true for pediatric patients.  In pediatrics, palliative care is typically offered alongside cure-directed treatments and palliative services are open to patients with life-limiting or lift-threatening illnesses, whether their life is expected to be measured in days or decades. When we know that a child is going to die from their illness, pediatric palliative care is the service with expertise in caring for children at end of life.  IWK PACT works with local care providers, community palliative care teams, and hospices, to ensure that children and families have the care they need in the location that best meets their family’s goals and preferences.  

Grief and Bereavement Services

Grief is a human condition, experienced by humans of all ages, including the very young. Grieving often begins well before the death of the child, sometimes with the diagnosis of a life-limiting condition and continues in anticipation of the loss. Grief is often felt, too, by the diagnosed child, grieving the loss of their own future. Pediatric palliative care and their collaborators can support patients and families (including siblings) before death with memory making and legacy building.  

Bereavement supports are the continuation of care provided to families who experience the loss of a baby, child or youth. That loss has a ripple effect, with grief spreading outward through the many circles of care—parents and siblings, extended family members, schools, communities, etc.  IWK PACT and many other groups in the Maritimes provinces are working to ensure equitable access to bereavement care and to the range of resources are reflective of the many ways that children and adults grieve.