|In modern society, we expect children to outlive their parents. However, 53â000 children in the United States die every year from trauma, lethal congenital conditions, extreme prematurity, heritable disorders, or acquired illness. The causes of death in children are substantially different from the causes of death in adults; thus, palliative care guidelines that are appropriate for adults are often inappropriate for children. For children living with life-threatening or terminal conditions, medical professionals are obligated to ensure that medical technology is used only when the benefits for the child outweigh the burdens. Child palliative care includes the control of pain and other symptoms and addresses the psychological, social, or spiritual problems of children living with life-threatening or terminal conditions. Adolescents and young adults (AYA) face some unique challenges in living with life limiting illness. Due to advances in medical treatment many AYAs have grown up through childhood with their illness, and despite needing ongoing treatment are no longer children. Others have been diagnosed with a life limiting illness as adolescents or young adults just as they are undergoing significant changes to physical, emotions and social autonomy. These unique physical, psychosocial and spiritual needs require nurses to have proactive and appropriate knowledge and skills. Adolescents are transitioning into adulthood and independence, and this ongoing development has an impact on caring. Many of these adolescents are now reaching adulthood and require support in transitioning to adult services.