Beyond pediatrics Caring for children & grandchildren of adult hospice patients © 2014 Community Hospice of Northeast Florida, Inc. All rights reserved. Objectives • • • • • 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 Presentation title, date, 3 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 Presentation title, date, 4 Consult process • Over 50 psychosocial specialists (PSP) • PSP to make consult – Over phone – Online • Initial assessment by CCLS • Visit frequency Presentation title, date, 5 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 Presentation title, date, 7 Supporting the patient’s wishes Music Playlists Presentation title, date, 8 Card & Letter Writing scrapbooking • Written messages from patient on photos/postcards • Therapeutic value for patient and family Presentation title, date, 9 Video Recordings & Life reviews Presentation title, date, 10 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 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 Presentation title, date, 17 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 title,loved date, 18 one who is sick is… 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 Presentation title, date, 21 “way! No way!” game • • • • • • • • • • • • 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?” Presentation title, date, 23 Paper quilt Presentation title, date, 24 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 • 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.