When a Child Is Hospitalized: How Do You "Make It All Better?"

For children who need to be hospitalized, the event can be confusing or even frightening. Whether the child requires a short hospital stay because of a virus, or is undergoing surgery or treatment for a more serious condition, a parent who is well informed and takes the time to prepare the child can help the hospitalization go smoothly.

Heather Toth, MD, Medical College of Wisconsin Assistant Professor of Medicine/Pediatrics, practices at Children's Hospital of Wisconsin. She says that parents should give the child details and explanations about an upcoming hospitalization as soon as possible. "The best advice is to keep the lines of communication open," she says.

"Children have a good sense of what's going on; they have good intuition. I recommend letting the child know what's happening right away." Withholding information might give the child time to imagine worse things than the truth, and develop a fear of what's going to happen.

Telling the Child
Parents can begin by telling the child about the condition he or she is experiencing, and what's going to happen in the hospital. "Depending on the child's age," says Dr. Toth, "you can go into greater or lesser detail. Gear your language to their age - for young children, the more simple language, the better."

Children under the age of two understand only what is happening at that moment, while children between two and seven can understand more about their conditions and the treatments needed. Children older than seven can often understand more complex explanations, and should be encouraged to ask questions of the parents and hospital staff.

For children of any age, "Reassure them that they'll be kept as comfortable as possible, and that everyone is looking out for their best interest," says Dr. Toth. The child might even feel that the illness is his or her fault, or that somehow he or she caused the illness. Make it clear that this is not the case.

Preparations for the hospital stay can begin early, too, says Dr. Toth. "Start packing a bag with the child, and be sure to include some comfort items from home, like a pillow, a blanket, or a toy." Pictures of family members, pets, or classmates can also help a child feel more at home in the hospital.

Dr. Toth recommends using the wide variety of resources available to teach children about hospitalization. "There are lots of books out there and information on the Internet, but parents should also be aware that not all the information on the Internet is reliable. If they have questions, their physician should be able to direct them to a reputable resource," says Dr. Toth.

Children usually feel more at ease if they know that parents will be allowed to stay with them throughout their hospitalization. "Parents are encouraged to help bathe and feed their child while they're in the hospital, if they want to," says Dr. Toth. This helps bring a sense of normalcy to both parent and child.

In addition, the child should know a little about the hospital staff, and meet his or her physician ahead of time. In addition to the child's physician, Dr. Toth says, "Children's Hospital has some wonderful resources like Child Life Specialists, who come to see the child and talk with families."

Children's Hospital staff use interactive play to help children learn about their hospital stay. "We have dolls that children may use to role-play different aspects of a care provider's exam or treatment. For example, there are dolls that a child may use to listen to heart sounds and dolls that demonstrate how an IV is started," says Dr. Toth. These things can help a child feel more secure about the upcoming hospitalization.

Talking with Providers
Before the hospitalization even begins, it's important to communicate effectively with the child's physician and nursing staff, says Dr. Toth. "Ask lots of questions," she says. Prepare a list of questions to take with you, so you can write down or tape record the answers to your questions, as well as other pertinent information. Be sure to bring not only your own questions, but also your child's questions and those of his or her siblings.

A list of questions to ask the physician and staff might include:

• How long will my child be in the hospital?
• Can I stay with my child overnight?
• What are the treatment options for my child?
• Will I need any special equipment when my child comes home?
• How long will it be before my child begins to feel better?
• When will my child be able to go back to school?
• Are multiple treatments needed?
• What are the possible side effects of the treatment and/or medication, and what can be done about them?
• Who should I ask about financial issues?

"If there's a support person who can be with the parent - a grandparent, friend, or significant other - that's often helpful as well," says Dr. Toth. That way, in addition to emotional support, two or more people are hearing the information.

Once the child is in the hospital, parents can begin by making sure the hospital staff knows everything about the child, including what medications and dietary supplements the child is taking, any allergies the child has, and physical statistics such as the child's height and weight.

Medical errors can be a cause for concern, so it's especially important that parents communicate with hospital staff at every stage of the child's hospitalization and subsequent care. "Don't be afraid to be the child's advocate," says Dr. Toth.

Medication needs to be carefully monitored. Parents should double-check that the medicines the child receives are exactly what the physician prescribed, and that the dosage matches the prescription. Parents must also be certain that they completely understand all instructions for administering the medicine, such as how often the child should take it, whether any dietary restrictions are called for, and if any side effects might occur.

Ask why each test or procedure is being done, and when test results will be available. If your child is having surgery, make sure that you, your child's physician, and the surgeon all understand and agree exactly what will be done. It's perfectly acceptable to seek a second opinion from another physician as well.

Caring for the Caregiver
It's very important for parents and other caregivers to take good care of themselves as well as their child. "Sometimes we see parents and other caregivers who get worn down, especially during prolonged hospital stays," says Dr. Toth. "We tell parents to take lots of breaks. When the child is sleeping, the parent should sleep too." She recommends that parents go home and shower, reconnect with friends and family, and refamiliarize themselves with things at home whenever they can. "The caregiver needs to be healthy and happy to be a good caregiver," she emphasizes.

With proper preparation and the involvement of family and friends, a child's hospitalization can be made easier for all concerned. "Stay calm," Dr. Toth recommends. "Take care of yourself, and keep the lines of communication open between the child, the physician, and yourself." Taking these steps will help ensure a more comfortable hospital stay for both child and parent.

P. J. Early
HealthLink Contributing Writer

This article includes information from the US Department of Health and Human Services and the National Cancer Institute.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.