Life in the Hospital Lane – Back to Hospital, Again

You and your child have mastered and come through the other end of a lenghty hospital stay before, you can do it again.

There has been some ‘normality’ for 5 weeks. The family are all together, at home, with minimal appointments and checkups. School routines have resumed, the pets have gladly settled with your presence in the house again. The washing pile has subsided, meals are regular and eaten together at the table. You’ve even scheduled a date night with your partner this coming weekend! Then later that evening, a turn in health, the familiar road back to hospital is taken and you almost wish you hadn’t gotten too comfortable.

Re-admittance to the hospital is challenging, and it can be heartbreaking, especially when it comes hot on the heels of a lengthy stay you thought you’d seen the end of. When it comes to dealing with disappointment and sadness, it can be challenging for parents, and challenging for the child. Parents seem to struggle with helping their children navigate the very real emotions that crop up when it’s ‘back to hospital we go’. The most difficult period of re-admission usually lies near the beginning of the experience, when children, often unexpectedly and unwillingly, have to encounter these feelings of disappointment and sometimes feelings of fear about what is to come. The procedures and treatments, all of the hospital ‘things’ they had thought they were finished with, are brought to mind again. Being confined to a hospital bed or being away from school and friends can seem like an unending state of imprisonment to children, regardless of the length of stay. There are several steps parents can take to assist their child with coping. The disruptions and the situation the child would love to wish away need a parent ‘s love and understanding, along with a commitment to support and care through the duration of this, and further hospital stays.

Firstly, acknowledge and validate your child’s emotions. Feeling sad, disappointed, or even angry is a natural response to an unexpected hospital re-admission. Acknowledge their emotions and let them know that it's okay to feel upset, scared, or frustrated about the situation. As a parent, make sure to give your child the space to express these emotions without judgment or criticism. Encourage your child to talk about how they feel. Assure them that you understand how they’re feeling and that you’re there to listen to them. Be a good listener, put away anything that will distract you in that moment, and provide your child with your full attention. They will pick up if you are distracted or organising other things mentally while ‘listening’. Sometimes simply talking through the re-admission with your child can help alleviate any anxiety or negative feelings towards the challenging situation.

Once you have heard your child's thoughts and sought how they’re feeling - provide reassurance and support. They need to know they are not alone. As a parent, you can demonstrate your support by being there for them. You can hold their hand, hug them, ask if there’s anything they need. Let them know that they can rely on you for comfort and reassurance. Being discharged from the hospital is often a big relief, but re-admission can be a difficult and emotional experience. Re-admission registers in your child’s mind that something has gone wrong. This conjures up feelings of discouragement, sadness, and even anxiety. Children, due to their limited maturity and life experience, may struggle to comprehend

the true cause of their re-admission, and might instead interpret it as a punishment for something they have done, or something they have failed at in their personal care. It's important to emphasise that re-admission is not a failure. There are ways to cope with these negative feelings. It is also important to recognise that children, just like adults, have different coping mechanisms. Some children may want to talk more, while others may prefer to be alone in their thoughts and play or do someting creative as a distraction. Respect how they cope and try not to force something that’s not your child’s usual response to coping.

Provide information and keep your child in the loop. It’s tempting to close yourself off and turn off the communication and questions towards the medical professionals as a way of dealing with disappointment. But it’s crucial to have a good understanding of the situation, ask your care team to explain what has happened and why your child has been re-admitted. Ask questions around timeframes. Be careful not to take these time frames as absolutes however, as it is very tough mentally to deal with a set date of discharge being extended beyond what you’d pinned your hopes on. Keep your child involved in a way that they can understand, depending on their age. Use clear and simple language and avoid overwhelming them further with complex medical details. Assure them that re-admission is necessary to help them get better. Reassure them of their safety: Let the child know that the hospital is a place where doctors and nurses work to make sure they're well taken care of. Assure them that the medical professionals are doing everything they can to help them feel better. Discuss the steps that will be taken to manage the health condition and minimise future re-admission.

A further step in assisting your child through a re-admission to hospital, is to maintain a routine. Going back to hospital after settling at home again is disruptive to say the least and can lead to feelings of confusion and anxiety. Try to maintain as much as possible any pieces of your child’s daily routine while in the hospital. This can include keeping regular mealtimes, regular sleep times, engaging in activities that they enjoy, and staying connected with friends and family members. Involve your child in decisions around their routine, dependant on their age and capabilities. Let them have a say in small decisions such as choosing which clothes to wear or which book to read. Hospital stays, and especially re-admission, can often feel like a loss of control. Giving your child some ownership and decisions to make can help them feel more in control. Empowering them with some control can help alleviate feelings of helplessness.

Stay by their side. Be present (when and where possible) and offer your support while they face this uncertain ‘set-back’. Spend time doing things they enjoy, activities, reading books, playing games together. It not only passes time but provides your child with a sense of security and comfort. It has a stabilising effect on what they may see as a very unpredictable world. It can be really difficult to put aside your own plans and disrupted timetable. But resist the temptation to voice your own difficulties when your child is in hearing range. They can take it onboard as being the one to blame for your own disruptions. Instead, try and take the time to turn the experience into a positive - time together with your child enjoying a movie, playing a board game, or working on that craft you hadn’t quite finished during the last hospital stay.

It’s only natural to experience a range of emotions, and not just the patient (your child) but feeling a whole array of frustration, disappointment, and even anger yourself. Allow yourself to feel these emotions and take time to process them. Talk with your partner or to a trusted friend or family member about how you’re feeling, and how you’re coping. Friends may assume that since you’ve dealt with hospital stays before, you are well prepared and able to cope. But a whole new set of emotions can emerge due to a re-admission. Take care of yourself and implement all the things you learnt in regard to support mechanisms and asking for help during other times in hospital. Connect with support resources, ask hospital staff about groups, networks, or counsellors if you are struggling. These professionals are experienced in dealing with the sort of feelings and emotions you have.

Finally, focus on the temporary nature of a re-admission. You and your child have mastered and come through the other end of a lengthy hospital stay before, you can do it again. Reassure your child that re-admission is temporary and that they will be able to go home again once they have received the necessary care and treatment. Let them know that their health is a priority. Even though re-admission may seem like a setback, the care they are getting while in hospital is necessary and for their benefit It really is the means to getting out again!