Parental advice: Preparing your child for a stay in hospital (part 2)

by NicciLouise

In the last article (dated 11th March 2013) I looked at the importance of preparing yourself and your child for that soul consuming hospital visit. I also looked at what to say to your child and when depending on how old they are.

But, who can help you? What words should you use and what games can be played? Let’s start with books!

by Deborah Hautzig, Dan Elliot and Joseph Mathieu (2-6 years)

by Deborah Hautzig, Dan Elliot and Joseph Mathieu (2-6 years)

‘A visit to the Sesame Street hospital’ [1] is rather dated as it was published in 1985, however, I have included it here because it is pitched towards children as young as two. In fact you can feel reassured that most character books, or books about animals that you find are more likely to be pitched at younger children. Young children show more interest in toys than other children. Having happily played alongside other children as a toddler they may not play cooperatively together at all until they are nearing four years old [2]. As they enjoy looking at things that are familiar, and will become distracted or bored with things that are not, it is best to stick to known characters, animals or books about teddies.

This can also be the case with older children such as those on the autistic spectrum. In fact in these cases it can help to make a picture book yourself [3] using an actual book as reference to help you. This way you can use his or her favourite character such as ‘Thomas the tank engine’, or even use objects such as stamps or logos. Whatever your child is most interested in. This may seem like you are encouraging an obsession that you have been trying to move away from, or regressing in progress achieved, but it is important to have your child’s focus to be able to share new information.

For all children with a low attention span due to age or development in that area ensure you make the book reading experience a happy one, that sensory distractions are kept to a minimum such as loud music and that you read in a calm manner and at a good interval in the day [3]. For example not when your child is excited and wants to run about! Then put the book away and get it out again a few hours later and repeat the process.

by Fred Rogers (3-8 years)

by Anna Civardi (3-8 years)

‘Going to Hospital’ [4] is a good book, as ‘Usborne First experiences’ books usually are, and it is pitched towards children that are between the ages of 3 and 8 years old. However, it only tells the story of a basic hospital visit.

If your child is likely to have x-rays because of having a cardiac or chest problem or due to broken bones then ‘Jessica’s x-ray’ [5] could be more appropriate. It is pitched to the six to ten years age group.

by Pat Zanta and Clare Dobson (age 6-10 years)

by Pat Zanta and Clare Dobson (age 6-10 years)

This book contains miniature pictures of real x-rays. However, I don’t find it particularly colourful inside.

An example of a page inside 'Jessica's Xray'

An example of a page inside ‘Jessica’s Xray’ [5]

For children with delayed language that are already using symbols you can download pictures from the internet to make basic storyboards from websites such as http://www.do2learn.com . However, as is with all free things there is a catch! These pictures are usually in black and white, so I recommend colouring them in to make the transition in their minds from life to pictures easier. They also don’t focus on unusual events such as hospital visits, so you can find your self drawing your own symbols or buying them from http://www.winslow-press.co.uk or http://www.pecs-unitedkingdom.com. The PECS system is the same symbols that are used in most UK special schools, but check with your child’s school first to ensure you don’t confuse them with different symbols for the same thing.

When thinking of preparing your child with books an important option to consider is the offer of assistance from the play specialist connected to the ward that your child will actually be going to! They can often be met at the pre-operative visit or appointment as an outpatient. Once they have bonded with your child in some way they can show them their photo story book. These are specific to the type of operation, or procedure your child is going to have and show regular photographs of a smiling child from entry into the hospital up to their departure.

If you want to look at them first you can, but be aware that they can seem daunting and may put you off wanting to involve your child. Even a wire attached with a plaster to the foot of a child to measure oxygen levels can be seen as a threat if it is not known what it is there for, or whether it is trying to hurt them. The staff have been trained to use the books in a way that is truthful, but that uses non threatening wording. They also cover parts of the photos and reveal each section as they talk about it. Children I have cared for actually sometimes wake up happy when they realise they are ‘doing better than John’ as they require smaller plasters or less monitoring. This in turn surprises and pleases their obviously anxious parents.

At home you may have a plastic doctors set and a teddy, or dolls that you have been able to bandage up, together with your child in play, with toilet roll and this is a brilliant way to prepare your child. It doesn’t really matter if they use the toys in the correct way as long as they look similar to the real thing and they are able to handle them and become accustomed to them. You may even feel you can buy plastic syringes or bandages from the chemist to use as toys. Syringes are particularly useful and always used to give medication in hospital, even if that medication is being taken by mouth.

The play specialists also have toys to do role play with the children and these are specially adapted to have missing limbs, be in wheel chairs, have central lines, feeding tubes, cannulas in their hands, eye patches, relevant plasters.. whatever your child is having done they should have a toy that matches!

Going into hospital for any reason is never ideal and any experience you have of being an adult in hospital will vary a great deal from what your child will experience. They will be cared for by nurses in bright uniforms, or even with polo shirts, and be able to play computer games, hang out in the play room and go to the hospital school where the teachers liase with their usual teachers to ensure they keep up to date with even GCSE exams. There will be sad times, but with children these are kept to the minimum with distraction and a low threshold on giving medication, and they are rarely remembered. The last thing doctors and nurses want is for your child to become fearful and hospital phobic as it only makes them harder patients to treat in the future. If they are about to do a procedure and you think the play specialist should be there to support your child then ask them to wait and if at all possible they will.

At the end of your stay you may find yourself being one of those parents pulling a child away that’s calling out ‘I don’t want to go home..’ I have seen it before, and experienced it myself! Anyone would think we keep them in a box under the bed..

Don’t forget to follow ‘Honey, I’m lost with the kids!’ to ensure you don’t miss future articles including ‘Distraction techniques and how they work to ease your child’s pain.’

References

1) Hautzig, D., Elliot, D., & Mathieu, J. (1985). A visit to the sesame street hospital.

2) Tassoni, P. (2008). Practical EYFS Handbook. London: Heinemann.

3) J, M. (2008). Playing, Laughing and Learning with children on the autism spectrum. London: Jessica Kingsley Pubishers.

4) Civardi, A. (2005). Going to hospital. Usbourne Publishing Ltd.

5) Zonta, P. a. Jessica’s x-rays.

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