title: How do we talk to the children? Child life consultation to support the children of seriously ill adult inpatients.
abstract: BACKGROUND
  Families with young children often struggle to talk about and cope with a parent's life-threatening illness and potential death. Adult interdisciplinary palliative medicine teams often feel unprepared to facilitate the open communication with these children that has been shown to reduce anxiety, depression, and other behavioral problems. In pediatric settings, child life specialists routinely provide this support to hospitalized children as well as their siblings and parents. Although these services are the standard of care in pediatrics, no research reports their use in the care of children of adults with serious illness.
  
  
  OBJECTIVE
  Our aim is to describe a pilot child life consultation service for the children of seriously ill adult inpatients.
  
  
  METHODS
  We summarize the support needs of these children, their families, and the medical staff caring for them and report our experience with developing a child life consultation service to meet these needs.
  
  
  METHODS
  Our service assists seriously ill adult inpatients and their families in a university medical center.
  
  
  RESULTS
  Informal feedback from families and staff was uniformly positive. During consultations, family and child coping mechanisms were assessed and supported. Interventions were chosen to enhance the children's processing and self-expression and to facilitate family communication.
  
  
  CONCLUSIONS
  All hospitals should consider providing broad-based in-service training enabling their staff to improve the support they offer to the children of seriously ill parents. Medical centers with access to child life services should consider developing a child life consultation service to further enhance this support. More research is needed to evaluate both the short- and long-term clinical impact of these interventions.
authors.affiliation: Newton-Wellesley Hospital, Newton, Massachusetts 02445, USA. cam@thesutters.com
authors.forename: Camilla
authors.initials: C
authors.lastname: Sutter
authors.forename: Thomas
authors.initials: T
authors.lastname: Reid
mesh_terms: D000046:Academic Medical Centers; D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003142:Communication; D016638:Critical Illness; D006801:Humans; D010166:Palliative Care; D010865:Pilot Projects; D024382:Professional Role; D012944:Social Support; D013038:Specialization; D014481:United States