Supporting children and young people after a traumatic hospital admission

Being in hospital can be a difficult and sometimes scary experience, both for parents and children/young people. Some experiences can feel particularly traumatic and you may worry about how your child will cope following this. This  page from Great Ormond Street Hospital (GOSH) explains what to expect and give suggestions for how you can help.Traumatic experiences could include:

• Delirium
• Nightmares
• Stays on intensive care 
• Witnessing significant events of other patients (arrests/chest closures)
• Procedures (however big or small)
• Hearing significant news
• Periods of unconsciousness
• Physical changes to the child’s body
• Separation from parents/family

These are some examples and not all children will experience these as traumatic.

• • Subtle changes in a child’s behaviour
• Distress or changes in mood
• Nightmares
• Memories or pictures of the event unexpectedly popping to mind
• Feeling as if it is happening again
• Playing or drawing about the event repeatedly
• Not wanting to talk or think about the event
• Avoiding reminders of the event
• Getting angry or upset more easily
• Difficulty with concentration
• Difficulty with sleep
• Being more jumpy or alert to danger
• Being more clingy to parents/carers
• Physical feelings such as tummy ache or headache
• Temporary loss of abilities including feeding and toileting
• Problems at school

These reactions can be normal following a difficult experience, as the child is trying to make sense of what has happened. These often resolve over time with and without the need for additional support.

These ideas won’t always work every time with every child or young person, but they can help sometimes so are worth trying.

You could develop a calendar/timetable of the days with hospital/non-hospital activities in them (hospital school, occupational therapy, physiotherapy, play, free time and meal times). Members your child’s team could assist you with this.

It can be hard to maintain usual boundaries, especially when your child is unwell in hospital, but do this where possible. Boundaries can help a child feel secure and safe. It can be difficult to parent in front of others, particularly if your child is behaving in a way you do not agree with, however staff are keen to support you. If there are important things about your child and how they best respond to others, share these with your child’s medical team.

Talking helps the child process and understand the events that took place. It can also help correct any imagined or misunderstood events. This is helpful for children of all ages, even if your child is very young.

Show your child you are available and able to talk to them about what has happened. Continue to talk about the event after discharge.

Talk to them about the experience in an age appropriate and open way, and answer any questions honestly. You might want to try helping them label and talk about different feelings they might have or be experiencing. Often showing our own feelings helps children understand their own, so don’t feel you always need to hide your emotions.

It is appropriate to provide reassurance and comfort to your child after something difficult has happened. Try to remember what else has soothed or helped your child feel safe in the past and use these too.

It is really important you care for yourself through the experience. Make sure you are eating, drinking and sleeping enough and giving yourself any time you might need to process your own experiences. If you are finding it difficult to think about or talk about what has happened, seek support from another adult before speaking about it with your child.