How Do We Talk To Our Children?: Using Child Life To Support the Children of Seriously Ill Adult Inpatients (789)

Abstract

1.Understand the role of child life in supporting the children of seriously ill adult patients.2.List resources available to support the children of seriously ill adult patients.3.Understand how to integrate child life into an existing inpatient palliative care service. Families with children struggle with how to talk about and cope with a parent’s life-threatening illness, yet open communication can reduce anxiety, depression, and other psychobehavioral problems in these children before and after their parent’s death. Clinicians of many disciplines who are trained in adult medicine may not be prepared to address these issues. Child life specialists traditionally fill this role in inpatient pediatric wards but are rarely used in adult settings. We reviewed the literature on the role of child life specialists in the care of children of adults with serious illness and report our experience with developing a consultation service to provide this support. Results. Although extensive data support child life interventions in the pediatric setting, no studies report the impact of child life specialists in the care of children of adults with serious illness. At our academic medical center a child life specialist met with the families of over 90 inpatient parents with serious illness, facilitating communication with and providing support for their children to improve coping, processing, and self-expression in a developmentally appropriate manner. Support and education were also provided to the staff caring for these patients. Barriers to setting up a similar program include lack of access to child life services, institutional separation between pediatric and adult services, and resistance to a new role in the palliative care team. Medical centers without access to child life services can still develop resources to help clinicians and families. Child life specialists are uniquely prepared to address the acute needs of children in families with a hospitalized seriously ill parent. Institutions with access to child life specialists should consider employing them in the adult setting. More research is needed to evaluate the clinical impact of such services.