Version June 2024
| 1. Coach parents before admission not to deceive their child about the purpose and timing of hospitalization. Although the honest truth may be upsetting or startling to some children, coping with the reality of their situation now prevents uncomfortable surprises later. Children who feel "tricked" into hospitalization lose confidence in the reliability of their caregivers and therapists, and this both increases homesickness and lessens trust. |
| 2. Orientation to the unit is one key to good adjustment. When children feel as if they have some control over the novel hospital environment, they may be less fearful and homesick. Depending on the child's condition, a tour of the unit, labeled photographs of staff members, big calendars, daily schedules, and introductions to the other kids on the unit can all help children feel comfortable and oriented in their new environment. |
| 3. When possible, staff members should convey a consistent message about length of stay. Conflicting messages from adults in charge reduces children's global confidence in caregivers. Unpredictability leads to anxiety. If one staff member says, "You'll be here about two weeks," and another says, "You'll be here about three weeks," children are likely to feel distressed and homesick. |
| 4. When hospitalization follows a traumatic event in which multiple family members were involved, family members may be in different parts of the hospital or even different hospitals. This can induce homesickness and separation anxiety. When possible, staff members should help children make contact, by telephone or in person, with dispersed family members. |
| 5. A child's mental status during hospitalization can change dramatically, even in the course of a day. Often, these changes involve a distorted sense of time and a fluctuating awareness of the caregivers' presence. These factors can cause homesickness. Continue efforts to orient the child. Pictures of the family, large clocks and calendars, lights on in rooms during the day, and frequent reminders often help reorient homesick children. |
| 6. Changes and uncertainties in caregiver visitations can cause homesickness. Caregivers should be apprised of the importance of frequent, reliable contact with their children. Staff members should encourage caregivers to call and give ample warning if they are unable to make a scheduled visit. |
| 7. Sometimes hospitalized children feel left alone, and this can cause homesickness. Especially early in a hospital stay, before the child knows the staff and routine, even five minutes alone can be frightening. Try to keep children apprised of the day's schedule and give ample warning if there are going to be times when the child is left alone, however briefly. |
| 8. To ease parental separation anxiety, staff members should forewarn parents when their child will be moved to a different room. Parents are unsettled to come to visiting hours and enter their child's room, only to find it empty or occupied by a stranger. For the same reasons that children need to feel prepared for upcoming events, so do parents. |
| 9. When possible, minimize discharge uncertainty. Children have an easier time coping with homesickness when they have a fixed-length hospital stay to manage. By the same token, avoid changing a child's discharge date if at all possible. Once staff members state an exact date out loud, children (and parents) have a tendency to fixate on that date. Changing the promised date can provoke homesickness. It may be best to tell children and families that discharge dates are hard to predict and to give them a range of plausible dates. |
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