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I haven\u2019t worked with many adolescents and young adults (AYA, roughly teens to twenties).\xa0 But when I have, I find that they\u2019re often some of the hardest patients to care for.\xa0 Why?\xa0 We talk about why it\u2019s so hard with Abby Rosenberg (chief of PC at DFCI and Boston Childrens), Nick Purol (clinical social worker at DFCI and Boston Childrens), Daniel Eison (pediatric PC doc and co-host of PediPal).\xa0 We are grateful to Andrea Thach (PC doc at Sutter East Bay) for bringing this topic to our attention and for asking questions as a guest host.\xa0 Here are just a few of the explanations for why it\u2019s so hard:

• They are closer in age to some of us (younger clinicians).\xa0 Countertransference hits hard.

• There\u2019s an in-between space between adolescence and adulthood - and there\u2019s something that we identify with in that in-between space, tugging at our heart strings

• Everyone has been a teenager.\xa0 Everyone has lived through their early 20s.\xa0 Every member of the interdisciplinary team.\xa0 Adolescence and young adulthood is a romanticized time of life in our culture.\xa0 We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are - and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they\u2019re not invulnerable.

We talk about these issues and more - what resources to leverage, how to cope as a team.\xa0 We in geriatrics and adult palliative care clinicians have so much to learn from our colleagues in pediatrics - and though many of these lessons are specific to adolescents and young adults - many of the lessons are valuable for the care of patients in older life stages.

Links to resources for working with AYA, from Nick Purol):

The Courageous Parents Network has a wealth of information/resources/videos/articles on many overlapping issues and topics related to caring for children/adolescents/young adults with serious illness (from both the provider and clinician perspective): https://courageousparentsnetwork.org

Courageous Parents Network

Empowering parents caring for children with serious illness through video, shared community, professional guidance, and palliative care. You are Not Alone.

courageousparentsnetwork.org

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Voicing My Choices is a wonderful tool for discussing goals/wishes and introducing advance directives in the context of serious illness. It's based off 5 Wishes and validated for AYA through direct feedback from the population:\xa0https://store.fivewishes.org/ShopLocal/en/p/VC-MASTER-000/voicing-my-choices

The Oxford Textbook of Palliative Social Work has several chapters relating to working with AYA (either due to family illness or their own), with many psychosocial clinicians in our field contributing:\xa0https://www.amazon.com/Oxford-Textbook-Palliative-Social-Work/dp/0197537855

Same is true for the Interdisciplinary Pediatric Palliative Care Textbook:\xa0https://www.amazon.com/Interdisciplinary-Pediatric-Palliative-Joanne-Wolfe/dp/0190090014/ref=sr_1_1?crid=33YG2UAKDZ8DO&keywords=interdisciplinary+pediatric+palliative+care&qid=1682288312&s=books&sprefix=interdisciplinary+pediatric+palliative+car%2Cstripbooks%2C101&sr=1-1&asin=0190090014&revisionId=&format=4&depth=1

-@AlexSmithMD