Newborn to 18 Months
Your very young child will take their cues from you. When you breathe and relax, they will too.
A soft comforting voice, soft music, lullaby sounds and a gentle touch are helpful and soothing during uncomfortable medical tests or exams. Favorite toys or diversional items that distract or amuse can greatly decrease the sense of wait time or discomfort. Toys that are active and light up can be very helpful. Read to me board books also soothe and help while you wait for treatments.
Toddlers (18 mo to 3 yrs)
- Young children have a different sense of time than we do. Wait until 1-2 days before admission to talk to your toddler.
- Keep explanations brief and language simple.
- Reassure your child that you will be with him whenever possible.
- Bring familiar items from home (e.g., blankets, stuffed animals, sippy cups, music).
- Allow your child to choose his/her favorite things to bring to the hospital (this will give the child a sense of control).
- Be patient with your toddler (it is not uncommon for young children to regress and become fussy or clingy). Crying is a natural coping response at this age.
- A pretend doctor’s kit and a teddy bear provide good play experiences for children to rehearse things like “take a listen”. “Going to the doctor” story books can be read to your child. Start a few days before a hospital visit.
Preschoolers (3 to 5 years)
- Provide simple but honest explanations for medical events. “The doctor wants to help make the pain in your tummy go away, so she needs to take a quick listen.” Blowing bubbles or pinwheels help with relaxation and distraction. Singing a song or telling a story help with calming and wait times.
- A pretend doctor’s kit and a teddy bear provide good play experiences for children to rehearse things like “take a listen” or “make a quick a poke”. “Going to the doctor” story books can be read to your child as much as a week before.
- If your visit is planned, talk to your preschooler 3-5 days before a hospital stay (it is important to give them enough time to process the information, but not too much time to allow for misconceptions to develop)
- For unplanned visits to the ER, use simple terms and concrete explanations without too many details, such as “I think the doctors in the ER can help you feel better.”
- Keeping a bag packed with a few diversional special toys that you can grab on your way out, can be very helpful in waiting rooms.
- Use words for body parts, and functions that are familiar to your child.
- During difficult or uncomfortable procedures, young children often imagine they are being punished for something they did wrong. Tell your child that it is no one’s fault when we get sick or need the doctor or hospital.
- Simple rewards for cooperation such as holding still during blood tests can help him/her feel accomplished and teach coping skills. Never punish a child for not cooperating. Find something to praise. “You held still for five seconds! Good job!”
School Age (5 to 12 years)
- Find diversional activities that combine fun with challenge, such as “Find it” games (finditgames.com), pop-up books, glitter wands, music with headphones, iPad/iPhone/tablet games.
- Keeping a bag packed with a few diversional special toys that you can quickly grab on your way out, can be very helpful in the waiting room.
- Talk to your child openly, honestly and in simple terms (children at this age are more likely to maintain a trusting relationship if they feel included in the experience and part of the decision-making process)
- Have an understanding about anesthesia, pain, change in appearance, etc., to prepare for questions your child may have.
- Explain to your child why the procedure, surgery, or hospitalization is necessary. Discuss fears or concerns.
- Provide an opportunity to ask questions and express how he/she is feeling (e.g., what questions do you have about the hospital? What are you wondering about with your procedure?)
- Talk with your child about ways to share his upcoming hospital stay with friends.
- Teach deep breathing/relaxation in advance. Using a pinwheel or party blower can help. Explain that athletes use breathing techniques to do things faster and better.
- Answer questions honestly. Use good websites to explain how the body works or what a procedure is. If medical interventions are routine for your child, help them experiment in advance when blood work or procedures are expected, to decide what coping techniques work best for them.
- Encourage expression and validate feelings.
Adolescents (12 and up)
- Encourage a teen’s participation in their health care. Encourage questions and taking part in decision making.
- Teach deep breathing in advance. Explain that athletes use breathing techniques to do things faster and better. Provide access to good education about how the body works and medical treatment.
- Some teens experience intense emotions that might seem like emotional regression. They might cry like a baby in your arms or insist on things they know are not an option, like asking, "to go home." They might throw a tantrum, curse, or say things they don't really mean. A calm soothing attitude and voice can help to de-escalate difficult feelings.
- Always tell the truth about what is happening and ask them if they want to be included in conversations with medical staff. Ask them their permission to discuss sensitive topics with staff, but remind them that some information is essential and then ask them to choose who speaks first, the teen patient or you. Give choices about everything no matter how small and give back some sense of control.
- For older teens, it may help to be honest about your own feelings of fear, grief and worry. It will help with communication and building of trust. Just be careful not to make them feel like you are asking them to comfort you. This could be very important because older kids might be afraid to tell you about a new symptom because they don't want to upset you.
- Adolescents may tell you they don’t need your help, but they do. Remain available for support and to encourage expression and validate feelings.
- Talk with your child's school to develop a plan for making up missed assignments (ask to speak with our hospital school teacher. Depending on your district, patients hospitalized for more than a week or two weeks, or with frequent hospitalizations, can get credit for hospital instruction. Teens can also take proctored exams while hospitalized.)
- During a hospitalization, when possible, allow a teen to bring technology that will help them stay connected to peers and activities they enjoy.
Your kids will look to you for reassurance and information.
- Tell the truth! Your child needs to trust the information you give them. Never say that a procedure won’t hurt when it will. Never tell a child they are going to grandma’s house when they are going to the hospital.
- Use soft language. If a needle stick is involved, call it a quick pinch or ask a child life specialist to prepare for an IV.
- Contact the child life program. Child Life Specialists are trained to help your child understand hospitalization at their own developmental level.
- Ask first. A good place to begin the discussion is by asking children what they know about coming to the hospital. Their answers can help you to correct misconceptions and identify specific fears.
- Use all 5 senses. Children need to know how things may feel, smell, sound and look.
- Tell kids where you are. Reassure your child that a family member will be there or when they will return.
- Provide choices whenever possible. Some hospital stays are planned. Encourage your child to help pack for the hospital. Bringing a few personal items, such as a cherished blanket or stuffed animal.
- Emergency Hospital Visits. Ask kids to participate in preparing your emergency bag for the ER.
- Orient yourself to the flow of a hospital day, including staffing shifts, rounding times, medication times and visitor policies for friends and relatives (remember parents/caregivers are not considered visitors, you are an essential part of the care team).
- Designate one person or use Caring Bridge software to send out news updates.
- Remember age and development when explaining things to children: Children of different ages have differing capacity to understand timeframe, stressful events, and abstract concepts like illness and hospitalization.