Hospitalization Causes Stress Understanding your child’s developmental stage along with his/her chronological age, personality, previous experiences, diagnosis and amount of pain or discomfort is very important when your child is hospitalized.
Hospitalization causes stress. When a child is stressed, he or she may tend to regress, or act younger/less mature in his or her behavior. This behavior is normal and you should expect to see it with your child. It is important to understand this behavior and plan to support your child as he or she is at the moment, not how you would expect your child to behave in another situation.
Understanding the needs of children at different stages may be helpful to you in giving support to your child during this hospitalization. The following stages are briefly described by behavior characteristics.
Infants It is important for a baby to have his/her needs met in a timely manner. This allows the infant to develop a strong sense of trust. While your child is hospitalized, we make every effort to provide a consistent group of caregivers and work with you to meet your child’s crucial needs to ensure that bonding with you develops as normally as possible.
Toddlers This is the "me do it" stage. Toddlers spend their days trying to achieve independence. "No" is their favorite word. But "no" does not always mean "no" – it can mean "yes, but I want it my way." Sometimes "no" means "not right now" or "I’m afraid and I don’t understand."
Toddlers have vivid imaginations, and this imagination can be used to help them through uncomfortable procedures and experiences. But this imaginative thinking can also make them more fearful of the unknown because of what they invent in their own minds. Therefore, you need to tell them exactly what will happen to them, if it will hurt and how long it will take. Always be honest with a toddler.
Although they fight for independence, separation from their parents can be very frightening. Toddlers need reassurance that this separation is temporary. We encourage you to stay with your child whenever possible, but when you can’t remain, be honest by saying why and when you are leaving and when you will return.
Preschoolers Preschoolers are learning that they live in an exciting world as they begin to move out into their own environments. Children of this age are experimenting with their own powers of control. They are able to verbalize their needs and want to be involved in what is happening to them.
Like the toddler, these children are still magical thinkers. Preschoolers are keenly aware of their bodies and they fear hurtful procedures. They need to know, in simple terms, what is going to happen and how it will happen. Preschoolers need reassurance that their illness and hospitalization are not their fault, that they did nothing wrong.
Like the toddler, they fear being left by their parents. We invite you to stay with your child, but if you must leave, we ask you to be honest with your child as to when you are coming back. Keep in mind that preschoolers’ abilities to reason are limited, their thinking remains "me centered," and their problem-solving abilities are basic. We work with you during your child’s hospitalization to help you give your child the language he or she needs to understand procedures and to communicate individual needs to the medical staff.
School Age Children at this age love to learn and they want to be independent. They work hard at learning about their world and how to be successful in it. They are eager to learn from adults other than their parents. Positive reinforcement is important at this age, as well as the need to emphasize individual strengths.
School-age children want and need to know about their illness and how they can take care of themselves. These children are better able to cope with separation from family; however, they need to know time frames for when someone will visit or if you are able to stay.
School-age children can understand simple explanations of procedures that will help them to cope
and cooperate. This understanding of events and procedures is key to helping them with their fear.
They like to have as much control of their environment as possible.
School-age children need constant reinforcement that they are doing a good job and that they are succeeding in their efforts. Parents must believe in their child’s ability for self-care. Joint teaching sessions at this age are very useful for getting the child to follow home routines that might be needed after discharge.
Adolescents These emerging adults are determining who they are and their place in the world. Adolescents are focusing on where they fit into their peer group. Authority is often viewed with skepticism. The adolescent seeks greater independence, individuality and self-reliance.
Adolescents must be able to manage their own illness and have a good understanding of the disease process. Adolescents need to maintain contact with their friends and be involved in decision making during hospitalization, and may be concerned with keeping on track with school work. Parents must work with their adolescent to promote partnerships in the treatment plan and keep the lines of communication open.