P.353 Multidisciplinary management of cognitively challenging patients across the transplant journey: a case example
Monday May 06, 2019 from 17:00 to 18:00
Exhibit-Poster Area
Presenter

Angela Williams, Canada

Nurse Practitioner

Transplant and Regenerative Medicine Centre

Hospital for Sick Children

Abstract

Multidisciplinary management of cognitively challenging patients across the transplant journey: a case example

Angela Williams1, Anna Gold2, Kathy Martin Martin1, Miriam Granger4, Jane Darch5, Michelle Peralta3, Elizabeth Dale1.

1Transplant and Regenerative Medicine, Hospital for Sick Children, Toronto, ON, Canada; 2Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada; 3Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada; 4Department of Social Work , Hospital for Sick Children, Toronto, ON, Canada; 5Department of Child Life, Hospital for Sick Children, Toronto, ON, Canada

Introduction: The transplant journey can be physically and emotionally overwhelming for a child, and elicit a range of feelings and behaviours. These challenges can be amplified in the cognitively challenged patient as they are often faced with multiple procedures, uncertainty, and fear, but may lack the ability to effectively communicate their needs and control their behaviours.

Methods: We aim to describe our centre’s experience using a multidisciplinary approach model in supporting a patient with Autism Spectrum Disorder (ASD) through the transplant journey. The team includes Psychology, Child Life, Consultation-Liaison Psychiatry, Nursing, and Social Work.

Results: P.G. 14 year old girl with end stage renal failure requiring hemodialysis who subsequently received a kidney transplant. Associated with her diagnosis of ASD and cognitive delay, P.G’s ability to cope with a range of activities involving loud noises, anxiety due to prolonged waiting, medication administrations, and ability to attend hospital visits etc. were compromised. Given these challenges the expertise of a multidisciplinary team of Neuropsychology, Child Life, Consultation-Liaison Psychiatry, Nursing, and Social Work was engaged in order to prepare and support P.G and her family from dialysis through to transplant, and beyond. Each professional role provided unique but inter-relating interventions and strategies in managing P.G’s behaviour. Each team member completed an assessment unique to their professional background which in turn helped to shape the overall plan of care. With the implemented strategies and ongoing support from the team, P.G and family are now able to effectively cope with the demands of follow-up care and medical regimes.

Conclusion: A multidisciplinary approach is crucial in the success of the medical and psychosocial outcome of patients with complex developmental needs. Through this case illustration, we will highlight our centre’s approach in preparing and supporting these patients across the transplant trajectory applying the contribution of each multidisciplinary team member.


© 2021 IPTA 2019