Beyond pediatrics
Caring for children & grandchildren of adult hospice
patients
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.
Objectives
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Background
CHNE services and referral process
Patient interventions
Caregiver interventions
Interventions for children and
grandchildren
• After the death of a patient
Presentation title, date, 2
background
• Edgewood College graduate
• Internship completed at The Children’s
Hospital of Philadelphia
• Certified Child Life Specialist
• Interest in end of life, crisis and
bereavement
• Pediatric ICU experience
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Child life at community
hospice
• Serving seven inpatient
centers
• Five counties
• Patient population
• Consults for children and
grandchildren of adult
patients
• Consults for
developmentally delayed
adult hospice patients
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Consult process
• Over 50 psychosocial
specialists (PSP)
• PSP to make consult
– Over phone
– Online
• Initial assessment by
CCLS
• Visit frequency
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Patient Experience
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.
Supporting the patient’s wishes
• CCLS assessment of
patient’s wishes (for their
children)
• PSP collaboration
• Bucket list
• Legacy Items
• Video recordings/life
review
• Music playlists
• Card & letter writing
• Scrapbooking
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Supporting the patient’s wishes
Music Playlists
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Card & Letter Writing
scrapbooking
• Written messages from
patient on
photos/postcards
• Therapeutic value for
patient and family
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Video Recordings & Life reviews
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Educating the caregiver
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.
Caregiver
Education
• CCLS assessment with
parent/caregiver
• Address
concerns/questions
• Developmentally
appropriate
education/language
• Bereavement
resources
Presentation title, date, 12
Child life interventions
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.
Child Life interventions for children
& Grandchildren
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Invisible strings
Paper strip necklace/bracelet
Keepsake wind chime
Feelings heart coloring sheet
“All About My Loved One”
“Me and My Loved One” beach ball game
“Boom Boom Balloon” game
Memory boxes and memory jars, picture frames
Pillowcase decoration/blanket making
Scream boxes
“Way! No Way!” game
Paper memory quilt
Dream catchers
Presentation title, date, 14
Inpatient interventions
• 7 inpatient centers
• Covering 5 different counties
• Patients transferred to inpatient
centers for pain management/end
of life care
Presentation title, date, 15
Inpatient interventions
• Inpatient center
preparation
• “All About My Loved
One” poster
• Room decorating
• Matching
pillowcases
• Blanket making
• Matching removable
tattoos/messages
• Bracelet/necklace
making
Presentation title, date, 16
Invisible Strings
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All about my loved one Beach
ball game
• Normative open-ended
statements:
• Therapeutic open-ended
statements:
– When I think about my
loved one being sick, it
makes me…
– One memory I have of my
loved one is…
– One thing I am worried
about is…
– One question I have about
my
Presentation
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date, 18 one who is sick
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Paper strip necklace
• Cut paper into ½’’ strips
• Have child write messages to their
loved one on each strip
• Roll strips of paper up and tape
• String paper strips of string
• Encourages sense of privacy and
trust
Presentation title, date, 19
Keepsake windchime
• Allow child (and patient) to
gather small belongings that
have meaning to child and
patient
• String on several pieces of string
• Allows opportunity for
therapeutic conversation about
items
• Gives opportunity for both child
and patient to create keepsake
together
Presentation title, date, 20
Forget me not flower pots
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“way! No way!” game
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People die in many different ways (discuss ways people die)
Everything that is alive dies some day
My thoughts or feelings can make someone die
Most people live a long time before they die
Some people choose to be buried after they die, while others choose to be
cremated (good opportunity to discuss cremation)
Sleeping is the same as being dead
People feel pain/hurt after they die
It’s my fault that my loved one died
It’s okay to cry/be sad
Sometimes I feel mad that my loved one is sick
Sometimes I worry that I might die too
Even though my loved one died (or is sick), I can still be happy/have fun
Presentation title, date, 22
Boom boom balloon
• Allows opportunity for
discussion about coping
with stress
– “What makes you pop?”
– “How can we keep
ourselves from popping?”
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Paper quilt
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Patient keepsakes
Presentation title, date, 25
Child life & music Therapy
Presentation title, date, 26
Child life & music therapy
Presentation title, date, 27
After the death of a patient
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.
Support for grieving
children
• Funeral support
Maximum 2
closure visits
• Therapeutic
activities
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Balloon Release
• Memory Gardens
• Message in a
bottle
• Memory jars
• Cremation
remains
• CHNE
Presentation title, date, 29
Bereavement
Questions?
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.
Thank you!
Amanda Thiel
BS, CCLS
Voice Mail: (904)407-6965
Cell: (904)445-9942
athiel@communityhospice.com
© 2014 Community Hospice of Northeast Florida, Inc. All rights reserved.