NAVIGATING THE HOSPITAL: Maintaining a Connection

The period of time following your child’s adoption is critical for developing and maintaining connection and attachment.  Once home, your goal is to create an environment that is safe and conducive for healing. You and your child are beginning to learn about one another and forming a relationship. In your role as a parent, you are striving to be a secure base for your child and show them you are their protector, their confidant, and someone who is there to love and care for them.

During this critical period of building attachment and connection, your child may need to have a medical procedure and/or be admitted to the hospital. You may have some fears or concerns about how to continue the process of building and maintaining a connection with your child while in the hospital, particularly if they will be there for an extended period of time. As mentioned in the Connecting Point “Understanding Your Child and supporting them in the Hospital,” children can experience regression in their development and relationships by a hospitalization. So, do not feel defeated if your connection or relationship with your child regresses during this time. Below are tips to maintaining attachment during your child’s hospitalization.

Inform healthcare providers: Upon admission to the hospital, let the members of your healthcare team, your child life specialist, and your social worker know that you are in a critical period of developing attachment with your child. You may even need to educate the staff on why this period is crucial for you and your child. Understanding the importance of the attachment period will help them work with you to maintain this goal during the hospital stay.

Maintain consistency: You have most likely begun developing routines and family rituals,  a stay at the hospital, particularly an extended stay, can interrupt these routines or rituals. During your child’s hospital stay, try to continue as many of your home routines as possible. This is not only helpful in maintaining connection with your child but can also provide a sense of normalcy and consistency for your children not in the hospital. If you and your child read a story and sing a song every night before they go to sleep, try and continue this while in the hospital, along with other routines and traditions you may do in your home. This will normalize the hospital for your child and make the transition back to home a little easier. If you have questions about how to continue routines or family rituals while in the hospital, ask your nurse, child life specialist or anyone on your child’s multidisciplinary team how you can incorporate them into the hospital stay.

Bring familiar or comfort items: If your child has any comfort items such as a blanket, stuffed animal or any other item that may be important or comforting to them make sure to bring it with you to the hospital. A comfort item could also be something that the child has brought with them from their previous home or orphanage that provides them with a sense of comfort or security.  Many hospitals allow children to keep a comfort item with them during a surgery or procedure. This can provide a sense of familiarity to your child when they may not know what is happening or cannot see a familiar face. If one parent is unable to be at the hospital consistently, a comfort item could also be something of yours that stays with the child. For example, dad’s t-shirt, mom’s scarf or bracelet or something else they would identify as important to you, this item could symbolize your presence and help them feel secure even when you cannot be there.

Advocate and ask about parent involvement:  During this critical time of bonding and connection for you and your child, you want to be involved as much as possible in your child’s care. Ask your nurse and other members of your child’s care team how you can be involved. If your child is in an isolation or critical care unit and can only have limited contact, make sure to ask when you can see them and hold them. Don’t be afraid of sounding like a broken record by asking often. Some hospitals have strict policies about who can accompany a child to the operating room for a procedure, while others have a more flexible policy. If your child must have a procedure or surgery where you cannot be present, ask if there are any options for going back with your child or how long you can be with your child prior to their procedure. Discuss with your medical team the possibility of being present in the room when your child wakes from the procedure so that you are the first face they see.  Another way to be involved in your child’s care is to ask about comfort positions. A comfort position is when a parent or caregiver is able to hold a child in a certain position that is comforting to them and makes them feel safe and secure during an IV start or other procedures are done when the child is not sedated.

While in the hospital it is likely that different departments will need to conduct lab work and tests.  You can advocate for your child by asking staff if they can minimize the sticks and pricks your child will receive.  Request that multiple tests be done on lab work when possible to reduce the amount of invasive procedures.

Accept help from friends and family while also limiting visitation: Spending all day, every day, at the hospital with your child for an extended amount of time can become physically, emotionally and spiritually draining. For everyone’s well-being it will be key to make sure you are taking care of yourself.   Be sure to tag team with your spouse so that you can take time to go home, shower, take a quick nap or whatever will help you refresh and relax. During this critical bonding period, it may be necessary to limit visitation with friends and extended family to ensure that your parent-child connection is maintained. While you may need to limit visitation, this does not mean to not accept help or support from your friends and family. If friends or family offer to bring you a meal to the hospital, or offers to pick up your other children from school, take them up on their offers. Doing so can help relieve some of the stress or pressure you may be feeling. On that same note, do not be afraid to ask for help if you need it. Allowing others to help you during this time is not a weakness.

Games and Activities for Hospital Stay: Most children’s hospitals have a playroom available with a large stock of games, toys and activities. Ask if this available for your child. If a child life specialist is on staff ask them for activities that are specific to your child’s needs, development, or any medical restrictions. Below are a few games and activities that could be fun for your child while in the hospital.  Proverbs 17: 22 reminds us, “A joyful heart is good medicine…”

• Bring some of your child’s favorite games and toys with you to the hospital. Card games, small travel games or puzzles your family enjoys are good options. This could be a great opportunity for maintaining a family connection.
• Create an “About Me” poster to hang up in their room. On the poster they can write or draw some of their favorite things such as, their favorite food, favorite movie, favorite toy, favorite color, etc. They can also include information about their siblings, pets, and any other fun facts about themselves they would like the hospital staff to know. This personalizes your child’s hospital room and provides your child’s caretakers with fun facts to assist in building rapport with your child. This also helps if there is a language barrier or if your child is shy to build a connection with their medical care team, without requiring them to verbalize this information.
• If your child has limited mobility, cotton ball soccer can be a fun game. To play this game, you need your child’s rolling tray, cotton balls, two cups and straws (items that can be found in the hospital room). To play, each player blows the cotton ball using their straw to get the cotton ball into their respective goal (the cup) to score.
• Hospital room/unit scavenger hunt can be a great activity for helping a child become more comfortable with the hospital environment. Ask your child’s nurse or child life specialist for assistance with this activity. Together, create a list of hospital supplies, equipment, and people that your child must find and check off the list. This can be especially helpful if your child is overly anxious about their surroundings or if they will be staying at the hospital for a longer period of time.
• If your child becomes overwhelmed, it could be helpful to create a shield of strength. To make a shield of strength start by cutting out the shape of a shield or have your child do this. Then, talk with your child about what makes them feel strong and have them draw or  write it on the shield. Some examples may be their family, friends, church, God, etc. This could be a great time to talk with your child about how God is always with us and gives us the strength we need to get through difficult experiences.  Joshua 1:9 reminds us “Be strong and courageous do not be afraid or discouraged, for the Lord your God is with you wherever you go.”  Create a shield of strength for yourself and show your child what encourages you and gives you strength. After making the shields you could put them up in your child’s hospital room in a prominent spot and encourage your child to review it when they become discouraged or overwhelmed.

Conclusion:

By following these tips, it is possible during a hospital stay to build and maintain attachment with your child.  Hospital stays can provide intensive time to meet your child’s needs, giving them the nurture they may have missed in the orphanage.  If you make the most of your time by providing comfort, advocating for them with the medical team, maintaining a consistent routine, and spending time in play, then you will likely see attachment grow in spite of the difficult circumstance. Many parents have reported that while they wished their child did not have to experience medical procedures, they felt in some ways, the hospital stay accelerated attachment with their child.

 

Developed by:  Charlie Ann Bishop, CCLS