The Therapeutic Relationship

Zachary is a 5-year-old boy admitted to the pediatric unit with dehydration. His parents work in a small town 90 miles from the hospital, and you are planning his Child Life services as well as looking at his discharge needs. Describe the role and impact of family-centered care in the planning of Zachary's services.

First response:

Megan Keogh

When looking at Zachary's situation both medically and socially it is clear that family-centered care is the best approach to use when planning Zachary's child life services and considering his discharge plan. Family-centered care is defined as, "an approach to healthcare that is based on mutually beneficial partnerships between patients, families, and healthcare professionals" (Thompson, 2009). I feel this is especially important to utilize because of the distance that Zachary's family must travel to and from the hospital, due to the location of their jobs. This distance may create a communication barrier between the parents and the healthcare professionals caring for Zachary, because they may be unable to visit the hospital every day. Using family-centered care the child life specialist will be able to reach out to Zachary's parents via phone or email; finding out what communication form works best for them when they cannot be there in person, to discuss Zachary's well-being, mood, and give them time to express any concerns they may have for the CCLS. The CCLS should also work with the family to decide what Zachary's plan while he is in the hospital will look like. They may have useful suggestions that the specialist can use to determine what interventions will work best for their son.

"Fostering collaborative dialogue with families, promoting communication throughout the experience, and continuously acknowledging the family as an integral part of the healthcare team are strong foundations in quality child life programs" (Thompson,2009). Some interventions that I might suggest for Zachary would be games and activities with slight or gradual physical activity such as WII games or Charades to begin to rebuild his physical strength and endurance after his dehydration. I would also suggest providing caregiver education for the parents as part of Zachary's discharge plan. I feel that the child life specialist should provide the parents with information on dehydration that will inform them on ways to keep Zachary hydrated and healthy, as well as provide information about what exactly dehydration is and signs and symptoms that may be associated with it. This is a great form of support for the parents and a simple way to provide them with resources that will benefit their family. "Family/caregiver education programs are used as part of comprehensive client care, particularly in facilities caring for children and elderly persons, these interventions use a variety of materials (e.g. print, video) to inform caregivers about illness and disabilities" (Shank & Coyle, 2002). Family-centered care incorporates all of these care ideas and will serve Zachary and his family's needs during his hospital stay.

Shank, J., & Coyle, C. (2002).Therapeutic recreation in health promotion and rehabilitation (1st ed., Vol. 1). State College, PA: Venture Publishing.

Thompson, R. H. (2009). The handbook of child life: A guide for pediatric psychosocial care.

Second response:

lashari degraffenreid

When providing any services, it isessential that child life specialists communicate with and collaborate with the child and family in order to create a care plan that best meets the child and family's identified needs and priorities. The child life assessment process requiresinformation from three sources: the healthcare team, the family and the child(Thompson, R. H. (2009). By speaking with the parents of Zachary I will see what his daily needs are and will let the family know that if they have any questions or concerns about Zachary medications, procedures, and/or hospitalization that they acan let me know and I will address their concerns with the appropriate people. Once I speak with the doctor and nurse and I will proceed with my planning of Zachary's services. Hospitalization impacts the whole family and can be a stressful, traumatic time for everyone. Brothers and sisters often need special attention (childrensnational.org).

Being that the hospital is 90 miles from his parent's, I will communicate with the parents inregards to see if there are other siblings and try to make a plan on when they will be at the hospital and see if I can sit in with Zachary to keep him company and do some medical play or other child life services with him while the parents attended to the other siblings. Going over any procedures Zachary may have that day and answering any questions that eiether Zachary or his parents may have. Family-centered care requires trust and respect, including respect for each family's values, beliefs, and religious and cultural background. We value families' knowledge of their children, acknowledge their authority as decision-makers and respect their choices.

References

Thompson, R. H. (2009). The Handbook of Child Life : A Guide for Pediatric Psychosocial Care. Springfield, Ill: Charles C Thomas.

http://childrensnational.org/choose-childrens/deciding-on-care/support-for-families/child-life