If children feel that they need to, and the unit allows it, you can take them to visit the patient. A visit may help them understand the situation more clearly, ease fears created by their imagination and prepare for what comes after intensive care, whatever the outcome. Preparing for the possibility of death is an important part of a healthy grieving process. Understanding the seriousness of the situation can also prepare them for a long period of rehabilitation, severe fatigue or lasting effects in their loved one, making the transition less abrupt.
It is important to discuss the visit with the healthcare team beforehand. The child should be prepared for what they will see, both to reduce the shock and to make the visit a genuinely helpful experience.
ICU psychologists can be an invaluable source of support when planning these visits and helping children express how they feel.
Bear in mind that disruption to family life can sometimes affect a child’s eating, potentially leading to nutritional deficiencies, or disturb their sleep and usual bedtime habits. It may help to allow some temporary flexibility—for example, letting them sleep in a parent’s bed even if this is not normally permitted.
Remember to tell the family’s paediatrician about the situation so that they can help you watch for any difficulties among the other children in the family.
Here are a few ways to help children cope with this difficult experience:
– Explain the situation using words the child can understand. Be honest while offering reassurance where you genuinely can;– Try to maintain their usual daily routines as much as possible;– Let the nursery, childminder, school and/or after-school activities know that someone close to the child is in intensive care;– It may be important for the child to have a trusted adult outside the immediate family to talk to, so that they can express themselves without feeling that they are adding to their parents’ stress or sadness;– Give the child space to talk or draw about what they understand and how they feel. This gives you an opportunity to clarify or correct anything they may have misunderstood;– As with adults, support from a trained professional, such as a psychologist, may be helpful if the child is finding the situation difficult to cope with.
Recognising signs of stress or psychological distress in a child:
Children commonly express stress or psychological distress in three ways:
What can you do?
Further information:
Recognising signs of stress or psychological distress in a child
Recognising acute stress in a child and how to help
Talking to a child about post-traumatic stress