A child who expresses interest in visiting a parent in the hospital should be taken seriously. Unless there are extreme logistical obstacles, or health-related reasons to postpone a visit, families should support children of all ages coming to the hospital.
If you have reservations about a child visiting, try to sort these out with other adults before talking to your child about them. Are you worried that something will upset your child? If you are the ill parent, are you reluctant to have your children see you in a compromised state? While there are some things that a child should be protected from—more on this below—most children can be supported through hospital visits in ways that make visiting more helpful than harmful.
For all but the most routine visits, it is often helpful to bring an additional supportive adult. Young children may need close supervision, distraction, or someone to go with them to the gift shop or lounge. Even older children can use an extra adult to keep them company elsewhere in the hospital or take them home if they are done visiting but the other parent wants to stay longer.
Many of the worries that parents and children have about visits can be alleviated with preparation. You or someone who has seen you very recently should explain to the child what it will be like at the hospital: the building, the hallway, the room. Is there a roommate? Is it the intensive care unit? How will Mom or Dad look? What machines will he or she be hooked up to? How different does the parent look than the last time the child saw him or her? About how long will the child stay? What are the alternatives if the child wants to step out of the room?
If a parent’s medical condition is serious, the adult facilitator should call ahead to nursing staff to determine what the child will see when entering the room. If possible, this adult should work with nursing staff to learn the patient’s schedule and plan the visit around scheduled procedures, personal grooming, and the administration of medications so that the parent is at his or her best for the visit.
The parent’s medical condition will determine what kind of visit the child may have. The supportive adult should explain to the child anything that is different than anticipated. For example, if the parent is sleepy, the adult facilitator should make sure the children understand why—pain medication, a recent procedure—and it isn’t that the parent is not happy to see the child.
Children may need a bit of warm-up time to get comfortable with the environment and their parent’s appearance. Reassurance about what they can do and what they cannot do is helpful. “It’s okay to hold Mom’s hand, or give her a kiss, but it’s not okay to bounce on the bed, hug her sore ribcage, or yell.” A child should never be forced to touch a parent if she doesn’t want to, but many can be reassured that it is alright, even if they are hesitant at first.
For prolonged hospitalizations, some children get very comfortable in the hospital and develop routines for doing homework or playing quiet games in the room or lounge. Some larger hospitals, such as Massachusetts General Hospital, have professional staff called Child Life Specialists, often borrowed from the pediatric ward, who can work with children during visits, facilitating activities and expression of feelings.
To help children feel as comfortable as possible during a visit and to facilitate the next one, support them in feeling that whatever they were able to do is alright. If they were only able to stay in the room a few minutes, an adult should acknowledge that even that brief visit meant something to the patient. If the children were wiggly and disruptive, the supportive adult can make an observation and ask if there is something he or she could do next time to make it easier. Certainly, children should receive lots of positive feedback for anything they did well: talking with the ill parent, drawing a picture, sitting quietly when they needed to, asking the nurse a question about the IV.
Afterwards, the caring adult should find out what the visit was like for the child. What was most surprising? What did she like least? Or best? Was it what she expected? Sometimes the things children notice are the things adults are least likely to notice, and their comments can provide a sense of how they are taking things in. This discussion also helps plan for the next visit, and informs what to consider when the parent comes home.
Occasionally, visits should be postponed or avoided. It can be frightening if a parent is agitated or alert but unable to recognize a child. If this is a temporary state, it is best to wait until the parent is calm or even sedated for a visit that might not involve a lot of interaction, but at least will not be scary. Children can sometimes sit with a sedated or comatose parent, hold a hand, or say a few words, and feel that their parent knows they are there. As described above, children can manage many situations if they are well prepared.
Some children say that they don’t want to visit their parent in the hospital. They need to be asked why. Younger children may be frightened of what might happen there: Mom might get a shot or they might see blood. Specific fears can be addressed directly: “Mom doesn’t have to get an injection or have a procedure during your visit. We can always step out of the room if something needs to happen that you don’t want to see.” “There are always nurses and doctors to help out if something happens.”
Older children may not want to see their parent looking very ill, or may just be uncomfortable in a hospital environment. Talking through some of these general worries can help. A child can’t be forced to visit, however. A caring adult could ask your child, without being judgmental, how she would feel if she didn’t visit, and provide alternatives to in-person visits as described below.
Sometimes a visit is just not possible. Phone calls are good alternatives, and modern technology can even allow for video, e-mail, and photo communication. Being able to send a drawing or note and receiving feedback about how much the hospitalized parent appreciated it often feels gratifying to younger children.
Many children who aren’t able to visit will ask adult visitors about how their parent is doing, and appreciate some kind of detail about the day or what their parent did at the hospital. For example, “Mom’s breathing was a bit better today, and she was able to get up and walk out in the hallway,” or “Dad had that tube taken out of his nose today, and he should be able to try eating tomorrow.” Even not-so-happy news can be delivered to keep children included: “That medicine isn’t working quite right for Dad’s infection, but the doctors are changing to another one that they think will work better.”
If the parent is very ill and not likely to survive, the other parent or another caring adult should make it possible for the child to go for a last visit. Like adults, children and especially teenagers may have things they want to say or hear before someone dies, even if the parent is unconscious.
Sometimes children refuse to go for visits when they are worried about the parent dying imminently. The supportive adult can inquire as described above about what the child is frightened about, and potentially alleviate any specific fears. Sometimes children worry that the parent will die while they are there and they don’t want to see that. It helps to talk together about how likely that would be, and create a plan to support them through that if necessary.
If it is clear that the child or teenager has thought through his decision and can articulate why he doesn’t want to visit and why he will feel best about not going, his decision should be supported even if the caring adult disagrees. Some adolescents are very clear that they don’t want to visit at the end of life, preferring to remember their parent as he or she was, and they need to feel good about their decision. See other sections for more information about end-of-life visits.