Why You Should Prepare Your Child for Healthcare Experiences

Updated: Nov 29, 2018



"In the absence of information, we jump to the worst conclusions." -Myra Kassim


Sadly, too often parents are not honest with their children during healthcare experiences. Especially when parents know their child will experience pain, they are more inclined to withhold information from their child.


Aren't I Protecting My Child?


Parents who aren't transparent often have the intent to shield their child from discomfort and anxiety. Parents feel they are actually protecting their children by not telling them the truth about what will happen. However, this is a disastrous approach and one that doesn't set children up for success.


With this method, rather than this decreasing their children's anxiety, this causes children to feel far more anxious! This is backed by research and I have included it for you later on in this post.


PREPARATION

When kids have to endure painful and traumatic medical experiences, we can significantly decrease the fearful anticipation and the trauma associated, all while increasing their coping skills by implementing psychological preparation.


"Psychological preparation involves the communication of accurate, developmentally appropriate information in advance of an experience. Information that includes the reasons for a threatening or painful procedure, the anticipated sequence of events and the sensations that accompany the experience." (Psychosocial Care of Children in Hospitals, Gaynard et. al, 1998).

We can psychologically prepare kids for:

procedures

surgery

a hospital stay

a check-up

an ER visit

etc.

Basically EVERY medical intervention.



Educating and preparing your child is the greatest tool

you have as a parent during your child's medical experiences!



As Child Life Specialists, we do everything in our power to be proactive in helping kids through their medical experiences. In this fast-paced environment that is a tricky task! Most other healthcare workers are generally reactive. They try to help your child get better after they are sick or injured. We, on the other hand, want to prevent any psychological stress or trauma that could happen during stressful medical situations, and preparation is our best avenue to do so.


You would prepare your child for her first day of school, right? Would you feel guilty if you dropped your child off without any explanation as to why she is there, if or what time you will be back, what she can do there, and who those other humans are that are there?


You prepare your child for her:

New baby brother or sister

First day of daycare

Playdates

Babysitters

Etc.


You do these things because you want your child to be as prepared

as possible to give you the best possible outcome.


It comes almost as second nature to prepare our children for new experiences like school. But the truth is many parents don't talk to their children about what to expect with healthcare experiences. Or, they don't tell them enough details about what their kids are about to experience.


Why?


It all comes down to one reason. We aren't telling them due to:



FEAR



We are afraid that our kids will lose it.

We are afraid of our own unknown.

We are afraid we won't have answers to their questions.

We are afraid based on our children's response to past experiences.


Our minds run a marathon before we can even catch up:


"How will my child do?... Well I don't do well with needles, so he certainly won't do well!.. My kid is going to hate that!.. He can't do that awake, he'll have to be put to sleep... I'm claustrophobic in those things so he can't do it."


Why are we determining our children's successes and failures

before giving them a chance to succeed or fail?



We often project our own fears onto our children.


How are we setting them up for the future if we are already telling them they can't do it, or if we are asking for an alternate way so our child doesn't have to do it the "hard" way?



WHY ARE WE AFRAID?

So why are we afraid to tell our kids what's actually going on?


There are many reasons we feel we can't break the news.

These may be based on past experiences with our children or simply on our prediction of how they will react.


Here are just a few of the most common reasons I've found most parents don't want to be honest with their kids:



1. We believe our child will become more anxious, upset, or fearful.

2. We feel our child isn't able to emotionally deal with the truth (maybe a new diagnosis or prognosis).

3. We feel our child is too young to understand or comprehend anyway.


Well guess what?


What I'm about to tell you may not sit well with you, so hear me out and stay with me!


It's all a lie!


Research has backed the benefits of preparing children for their medical experiences time and time again!


Again, one of the most important things you can do is

be honest and educate your child about her healthcare.


Children deserve to know what's going on with their health just as much as adults do! They have a right to be respected.


It's imperative that you are honest when you educate your child. While your language should be what we call "minimally threatening" and "developmentally-appropriate," beware of sugar-coating. This doesn't give your child a clear, realistic idea of what's to come.


Now, let's dive into these fears of ours and talk about why they are all lies.



1. We believe our child will become more anxious, upset, or fearful.


When talking about educating and preparing your child for her medical experiences, you may be thinking,


"Not my child! She would absolutely do worse! You obviously don't know my child!"

Maybe she will do worse. Maybe she will fight, cry, kick and scream more than if you had surprised her. Maybe she will make it harder on you and medical staff. But isn't that better than sneak-attacking something completely threatening, terrifying, and confusing on her? After that horrible surprise, she's sure to be more upset with you.


What's even more important is that after educating your child she can rest assured of one thing (in an environment that is entirely unpredictable and threatening).


She can....


TRUST YOU!

By educating your child, you've maintained your child's trust!


Your child now has confidence that if another procedure is coming her way, you're going to let her know about it.


If you hadn't educated your child, after the experience she would be in fight or flight mode, completely on edge, and wondering what would happen next. The alarm in her body would be going off and she might wonder if there's more to come. What's most upsetting is that she now understands she can't look to you for help since you lied to her by allowing this to be sprung on her, so she's likely trying to read the cues of medical staff to know what's coming next.


Is this the outcome you wanted?


Research Suggests Otherwise

Your child may initially display more negative behaviors because you prepared her; however, you may not realize that she will likely cope more effectively during the procedure and she will have lower anxiety for future medical experiences.


Research supports positive effects of preparation.


How do they measure that?

By monitoring pulse-rates, among many other variables!


Children's pulse rates are lower during procedures when they were prepared vs. kids who aren't prepared.

(Wolfer & Visintainer, 1975)


Isn't that amazing?! How can you argue that?


Check out some more benefits of psychological preparation:


"In addition to helping children know what to expect, preparation can actually increases their confidence and ability to cope with an impending health care event. To the extent that preparation leads to more effective coping with a specific health care event. It can also lead to increased confidence and competence that generalizes to other similar situations. When children are systematically and successfully prepared throughout their health care experience, they are more likely to experience an overall reduction in emotional distress, and increased confidence in their ability to cope with stressful situations. In theory, this would, in turn, contribute to medical recovery and help prevent later developmental disturbances or adjustment problems." (Psychosocial Care of Children in Hospitals, Gaynard et. al, 1998).

- During invasive medical procedures, children who were prepared were more cooperative than children who weren't prepared (Zelikovsky, Rodrigue, Gidycz, & Davis, 2000).

- Psychological preparation reduced distress and enhanced coping (Wolfer, Gaynard, Goldberger, Laidley, & Thompson, 1988).

- Preparation reduced anxiety in children prior to surgery (Hatava, Olsson, & Lagerkranser, 2000).


These are just a few of several studies that have been conducted on the effects of preparation. Preparation is widely recognized among researchers as an intervention that significantly decrease children's emotional distress and increase their coping skills.


Children do much better when they are prepared and know what to expect, just like adults! When we prepare our kids, we set them up for success.


Because truly, "in the absence of information, we jump to the worst conclusions" and kids do too!


Don't allow your child's brain to jump to awful conclusions and assumptions about what may happen to her (which is very typical for many fantasies to arise, especially in preschoolers' minds!). Teach her what to expect so she doesn't have unnecessary fear and anticipatory anxiety!

Don't let that secure attachment you two have go to waste. Maintain your child's trust during these difficult times. Remember my post Your Child Looks to You where I talk about how our children look to us to know how to respond to new experiences? It's imperative that you are the adult modeling the communication you want in your relationship with your child. Keep that communication strong and your child will be less anxious, fearful, and upset because you educated her!


Anxiety is a Factor

If your child is very anxious, that does play a factor. However, you are still going to educate your child. Your timeline might look different than other kids her age, but you need to still tell her. For example, teenagers can be prepared for procedures and surgery several days to weeks before, however, if your child is very anxious you may choose to tell her only a couple days before so that her entire week doesn't go to waste since she will worry about it so much.


Beware though!


The percentage of kids who fall into this category is not huge. Just because your child is afraid of needles, doesn't necessarily mean your child is needle-phobic and highly anxious around all medical procedures! Most kids are very afraid of needles. There's a small percentage that are actually needle-phobic. If this is your child, she's likely falling into this category, where her anxiety is something you need to carefully consider.


Regardless of when you tell your child, you are still telling your child! Even if it's right before the poke happens, you tell her it's going to happen.


In Child Life there are


NO surprises!


This doesn't mean there aren't going to be unexpected plans in patients' healthcare, obviously I don't determine that. But it does mean that whatever the plan of care becomes is shared with the child so she can psychologically prepare for it.


Also important to note:

Research suggests that children who are very anxious still cope more effectively when they are prepared. (Meeting Children's Psychosocial Needs Across the Health-Care Continuum, Rollins, Bolig, Mahan, 2005).


Keep your child informed with what you know along the way and she will experience less emotional upset, she will be less fearful and anxious. All of this leads to better coping!



2. We feel our child isn't able to emotionally deal with the truth (maybe a new diagnosis or prognosis).


Sadly, sometimes procedures in medicine lead to another or to a new diagnosis.


If you lie to your child about the test or procedure, then what will you say when they need surgery or an admission? Are you going to continue the lie? When does it end? I hope it doesn't end when she wakes up in the ICU wondering how she got there from the lie you told her about going to a "routine check-up." (As crazy as that sounds, it happens!)


If you're wondering....

How much do I tell my child?


Good question. Hold that thought! It will be answered in my next post on preparation.

But until then here's a bit about it:


Educating your child about her healthcare doesn't mean you tell her everything you know about her diagnosis and you don't give her every individual's experience you know who has that diagnosis including your aunt's friend's brother's cousin. Educating your child isn't about scaring and creating more anxiety in her.


It's about meeting children where they are, teaching them what they need

to know to succeed, answering their questions, and helping them

grow and develop and cope from there.



If you're facing a new diagnosis or prognosis, you will not be able to maintain that lie for very long and when your child does find out, she's going to be even more upset with you. Give her the information one bit at a time, allowing her to process the information and answering the questions she asks with honesty, even if that means giving more information than you planned on sharing. She likely can handle a lot more than you initially believe.


Preparation isn't the same for all children. How much information you give, when, and how you give that information depends on the individual child and her developmental level. If you have more than one child you likely understand that each child has very different needs and you will need to consider the child to know how to prepare that individual child. Again, more info on this to come on my next post.



3. We feel our child is too young to understand or comprehend anyway.


There's actually much more you can teach your child than you might think! Just because your child is young doesn't mean you can't prepare her. Yes, with very young children preparation looks very different! It is highly play-based and you will give less information than older children.


Personally, I begin telling my children that a vaccine is coming their way around 15-months-old. At that age, they are able to understand much of what we say, and while my 15-month-old may not understand my simple preparation statement of "this is going to feel like a quick pinch" right before that poke comes, this does begin to help give her that vocabulary so in future situations she will know what that means. Additionally, playing with a doctor kit with your child at this age allows them to play out and learn about her experiences at the doctors office in a comfortable and natural way. This is preparing her for her future doctor visits.


I just took my son for his 18-month check-up and I wish I would have filmed his response when we entered the exam room! It was clear to me that he remembered it, even though it had been 3 months since we were last there! He knew what was going to happen there and he was already feeling scared. He was clinging to me, climbing up me, and not letting me put him down on the exam bed until I sat with him. Children remember and are learning much about their surroundings far earlier than you may recognize.


While you can give simple statements before procedures to children ages 15-months to 2-years-old, at about 2 - 2 1/2 years-old, your child can benefit from much more than a statement. Here's an example:


My daughter was just over 2-years-old when she had surgery to have ear tubes placed. This is how I prepared her for this experience! The first thing I did was add an anesthesia mask to her toy doctor kit. (I had intentionally taken it home from a breathing treatment she had at a previous doctor's visit.) A few days leading up to her surgery I intentionally played with her doctor kit with her and we used the anesthesia mask on her dolls, stuffed animals, and on each other. We talked about how it helps them to breath and how it's soft like a pillow. Then the night before her surgery, I prepared for going to the hospital. I told her that I was going accompany her to the hospital. We talked about how there would be lots of doctors there and that the doctor was going to help her ears get better. We discussed how the doctor would check her ears, eyes, nose, and mouth just like she does when we go for a check-up. I told her she would put on some silly hospital pajamas, drink some medicine and then take a nap. I told her when she woke up from her nap I would be there. On the morning of her surgery, we played with the anesthesia mask again, this time with the mask in the pre-operative exam room.

I hope this example gives you an idea of how much you can prepare your child for at such a young age. My daughter didn't bat an eye over this day and never talked about it again. If you are calm, your child is more likely to be calm!


Just because your child is a toddler doesn't mean she doesn't need education too.


In fact, toddlers and preschoolers are more at risk for psychological upset because of medical experiences. So it's even more crucial that you prepare toddlers for surgery, procedures, and other healthcare experiences!



PREPARE, PREPARE, PREPARE!

Most of the time, our fear gets in the way of our ability to help our children in these situations.


I just took pacifiers away from my 18-month-old and I'm laughing about the fact that as parents we often work ourselves up over these things! I was so worried to take it away because I thought it was going to be a disaster. Want to know what happened? He never noticed!


This is an example of how we often address our kids' healthcare events.

We worry so much about how they will respond that we fail to realize what they really need is some communication to settle their worries.


What they really need is clarity and honesty so they have time to process that information, create a coping plan, and then cope effectively.


What they need is their questions addressed and their voices heard.


What they need is to keep some of their control, by taking advantage of the choices they do have, and they need you to give those choices to them.


They need your respect, trust, and support as they climb these huge mountains of trials for their little tiny bodies and souls.


They can only do that if you allow them to! The only way you will find your child coping effectively is if you prepare and educate her using developmentally-appropriate and minimally-threatening language, tailored to her, and intentionally planned by you. You can do this! We'll talk about how in my next post on preparation.


Thanks for reading! Please give me your feedback! Have I convinced you that it's vital to keep your kids informed? What questions do you have about educating your kids about their healthcare? Are you more willing to educate your child in the future? Give me all your thoughts so I can help answer these questions in my future posts!


xo

| Kara |





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