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Without thoughtful preparation, your kid's visit to the hospital has the potential to morph into a traumatic experience. Yet some upfront legwork on the part of Mom and Dad can ease a child's anxiety and also set the stage for his or her positive future dealings with the medical world.
"Parents are the No. 1 comforting agent for the kids," says
TIPS
1. Don't wait until a test or procedure is necessary. Because it's impossible to predict when a child--or his sibling, parent, or grandparent, for that matter--might need medical care, parents should proactively set kids' perceptions of hospitals, medicine, nurses, and doctors, says
"Talk positively about healthcare and healthcare encounters," she explains. "For example, when a blaring ambulance speeds down the street, you might comment to a young child, 'There go our helpers, helping people get better.'" And if you've had a negative medical experience yourself? "Keep all that conversation out of earshot of a child," she says. Such talk could stoke a lifetime of anxiety about health or medical professionals.
2. Find out about additional resources. Great care does not start and end with the doctors and nurses. Depending on the hospital, parents and pediatric patients stand to benefit from ancillary services, often centralized in a family resource center, which can include a library of medical information and staff to help with research and assistance with accommodations for families of out-of-town patients. And particularly if you're going to a children's hospital, parents can expect a cadre of specially trained experts to help smooth a visit.
Child-life specialists are experts in child development and trained to help young patients cope--be it with a serious chronic illness or a one-time test--through play, distraction, and education. They are skilled in winning the trust of young patients, in part because they don't wield needles. They can be called upon to teach a youngster what to expect during a CT scan, maybe using a Barbie doll and a toy scanner. Or they might be recruited to help distract a teenager from the discomfort of a large catheter being inserted, perhaps by guiding the teen to imagine and describe a place that relaxes them, like their favorite hiking spot or family beach.
3. Give your child advance warning. Too often, parents bring their child to the hospital for a scheduled surgery without telling him or her anything in advance.
"That type of approach should be avoided at all costs," says Clark. "It really puts (the care team) in an awkward and terrible position." He suspects that parents just want to protect their child. But not arming young patients with age-appropriate information can backfire, as what they imagine is happening may be far worse than what really is.
4. Show your child what can be expected. If your child is facing surgery, take advantage of an operating room tour, if available. Familiarizing a child with the bright lights and hulking machines can demystify the place, as can letting kids hold or play with the breathing mask that will be put over their nose and mouth to deliver anesthesia drugs. Putting on the sterile garb, hats, and masks can also make the preop experience feel less foreign and frightening.
Kids may get nervous that all the instruments will be used on them (which they won't).
Sometimes, online hospital tours are an option when live ones are not. Such virtual tours may be available for more than just the OR, too, including the workings of an MRI scanner, which can be loud and anxiety-provoking. At the very least, says Bauers, a child-life specialist will be able to coach a parent over the phone on ways to explain to your child what will happen during the hospital visit.
5. Be honest, but don't belabor the facts. Factual information and age-appropriate responses to kids' questions are the best route. This holds true even when the questions are tough to handle. If your daughter has cancer, for example, and watched an older relative go through chemo, she might wonder if her hair will fall out.
"You don't skirt (their question), and you definitely don't say no," Klayman says, "If we lie to them, their trust will go down." They may even ask if they're going to die. Be truthful and positive, says Klayman. "We don't expect you to go in and die--there are so many different types of cancer and so many types of good medications," she suggests saying. And if your child asks a question you don't know how to answer, "say, 'Let's write that down,'" suggests Klayman, and follow up with the doctor to learn the answer.
6. Use language carefully. Adults use some pretty confusing medical language. Without explanation, the baffling jargon can send children on a trajectory of anxiety and fear that will extinguish your efforts to help them feel brave and confident. For example, when explaining how surgery will go, it's wise to avoid the phrase "put to sleep." They may know a dog that was "put to sleep," never to wake up again. But don't avoid using words kids will hear over and over from nurses and doctors. Just explain what the words mean. If they have a tumor that needs removing, use the word tumor, says Klayman, explaining, "'The doctor found something growing (in your back) that doesn't usually grow there, and he's going to take it out.'" Keep it simple and straightforward.
A few hospital items may need a special explanation, says Bauers, such as a "CAT scan," which doesn't have anything to do with the furry animal but will help take pictures of the child's insides, or an IV, which sounds like a plant but is actually a way to give important medicines. Also, when a child hears the word stretcher, it may serve you well to explain that it refers to a way of moving patients around and has nothing to do with stretching--or hurting--the child, says Bauers.
7. Find out if you can accompany your child into the OR for surgery. You won't want to be present for the procedure--nor will you be allowed to be--but quite a few hospitals will let parents stay with their child through the early stages of anesthesia as a calming presence. Clark asks parents ahead of time how they expect their child to behave when rolled on the gurney to the OR. This allows him to anticipate if a nervous child might require some sedating medications by mouth before starting the anesthesia and also to discuss whether or not parental presence is a good idea.
While a confident teen might scoff at needing his mother, in the moment he might really value and be soothed by her presence. Indeed, "the trend over time (has been) to have parents present for more and more circumstances," explains Clark. "In ICUs (intensive care units), it's common to have parents present in all phases of care."
A parent's ability to stay composed while accompanying a son or daughter into the operating room should be looked at ahead of time. Clark suggests parents ask themselves, "Will my presence make this series of events better?" There is no wrong answer--unless it's a dishonest one. Mom and Dad need not feel guilty if being with their child going into the OR feels overwhelming, says Bauers. Oftentimes, a child-life specialist can jump in and offer the necessary comfort.
8. Ask how your child's pain will be handled. One of the most stressful things for parents to cope with is the concern that their kid will experience pain. If the child wants to know, "Will it hurt?" don't minimize the possibility that it might, says Clark. Downplaying the reality will only make the child distrustful when discomfort does arise. Clark notes that anesthesia has a growing number of tools to treat postoperative pain, from oral and IV medications to techniques that block the nerves around a surgical incision. Ask ahead of time how much pain a given procedure typically causes and how the team plans to manage it.
9. Prepare your child by practicing. When a nurse needs to start an IV and a kid is anxious, recruiting relaxation techniques like deep breathing is far easier if the parents have practiced with the child at home. And using a toy medical kit or reading children's books about hospital procedures, which can be found with other resources on the
10. Offer something positive to look forward to. It could be a visit to Grandma and Grandpa once a hospital stay is over, or simply a trip to
11. Cut yourself a break. Feeling stressed or emotional when handing your child over to a medical team is absolutely normal. Clark often witnesses parents' teary departures from the OR once their child has drifted off. And know that if you cry in front of your kids, that's OK, too, says Klayman. Acknowledge your feelings to them, and explain to your daughter that you wish she could be at soccer practice with friends, which you know she loves, instead of coming into the hospital. But explain that your tears just mean you're "letting sadness out," she suggests.
And for the good of your child, take care of yourself. "The literature tells us that a big factor that affects the child is the stress level of the parent," says Klayman. This, too, means advance planning, like arranging for friends and family to visit and give you a breather. It also means becoming informed about your child's medical situation and gaining a sense of empowerment about handling it.
