Hailey Tran
When it comes to discharging your child from the hospital, there are several factors to consider. In most cases, parents or legal guardians are responsible for making medical decisions on behalf of their children, including requesting discharge against medical advice (DAMA). However, the hospital can seek a court order to keep a child in their care if they believe it is in the child's best interests. To ensure a smooth transition, it is essential to plan for your child's discharge, especially if they have undergone psychiatric hospitalization. This includes understanding any prescribed medications, treatments, and activity limitations required for your child's recovery.
| Characteristics | Values |
|---|---|
| Who can request discharge | Parents or legal guardian |
| When can discharge be requested | Anytime, but the hospital can override the request if it believes the child is unsafe to go home |
| What happens when discharge is requested | Hospitals can request parents to sign a DAMA form, but this is not a legal requirement. Hospitals can also go to court to obtain an order to keep a child in the hospital |
| Planning for discharge | Understand any treatments, medicines, and activity limits that need to be followed at home. Discuss any concerns the child may have about returning home |
| Medication | Ask the medication’s purpose, dosage, delivery, special considerations, and side effects. Ask for prescriptions for medicines or other therapies |
| School | Involve the school nurse, psychologist, social worker, or other medical staff to help ease the child's return to school |
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What You'll Learn
Understand your child's medication and treatment plan
Understanding your child's medication and treatment plan is crucial for ensuring their well-being after they return home from the hospital. Here are some essential considerations and steps to take:
Medication Management:
- Obtain a Comprehensive List: Ensure you have a detailed list of all the medications your child is taking, including new prescriptions, existing prescriptions, over-the-counter medicines, vitamins, and supplements. This list will help you manage their medication effectively and avoid any potential conflicts or adverse interactions.
- Understand Medication Instructions: Know exactly how and when to administer each medication. Ask the care team or pharmacist about any specific instructions or precautions. Understand the reasons for each medication, the expected benefits, and any potential side effects.
- Medication Safety: If your child's medication needs to be locked away or carefully monitored, ensure you have the necessary arrangements in place. This is especially important for psychiatric medications, where managing access is crucial.
- Follow-up on Prescriptions: Confirm with the pharmacy that they have received new prescription orders, and make a plan to get them filled and picked up promptly.
Treatment Plan:
- Discharge Summary: Prior to discharge, you should receive a detailed summary outlining your child's hospital stay, including procedures, treatments, and medications administered. This summary will help you understand the course of treatment your child received during their hospitalisation.
- Follow-up Care: Work closely with the healthcare team to establish a follow-up care plan. This may include instructions for personal care, doctor's appointments, physical therapy, or any other ongoing treatments or interventions. Ensure you understand the schedule for follow-up appointments and adhere to it diligently.
- Prevent Relapse: Discuss proactive steps with your doctor to minimise the risk of a relapse of the symptoms that led to hospitalisation. Design a safety plan that addresses potential challenges and practice it with your child before discharge.
- Transition to Outpatient Care: Recognise that inpatient stays are primarily for stabilisation, and ongoing outpatient care is typically necessary for long-term management. Ensure you have a plan for outpatient care and a designated doctor or healthcare provider to continue your child's treatment journey.
- Educate Yourself and Your Child: Hospitals often provide counselling and education sessions to help parents and caregivers understand discharge plans, treatment regimens, and home care procedures. Participate actively in these sessions and ask questions to clarify any uncertainties.
Remember, understanding your child's medication and treatment plan is a collaborative process involving you, your child (depending on their age and capacity), the healthcare team, and other support services. Don't hesitate to seek clarification or additional information whenever needed.
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Recognise your child's feelings about being discharged
Recognising your child's feelings about being discharged from the hospital is an important part of the process. Firstly, it is important to acknowledge that your child might be experiencing a range of emotions, from happiness and relief to anxiety and embarrassment. These feelings are normal and to be expected. It is crucial to create a safe and non-judgmental space for your child to express their feelings. Encourage them to share their thoughts and emotions through talking, drawing, writing, or other creative outlets.
Your child might also be worried about readjusting to life outside the hospital. They may have concerns about returning to school or social situations, especially if they have been away for a long time or if their peers are unaware of the reasons for their hospitalisation. It is important to maintain open communication with your child and their friends' parents, teachers, and other important figures in their life. This can help ease their worries and ensure that their support network understands their needs during this transition.
Additionally, your child might have concerns about their health and wellbeing after being discharged. They may fear a return of their illness or infection, or they may be anxious about managing their condition at home. It is important to address these concerns by providing clear and honest explanations about their diagnosis, treatment, and hospitalisation. Reassure your child that they are not responsible for their diagnosis and that their healthcare team will continue to support them after discharge.
Furthermore, recognise that your child might be anxious about the level of supervision and parental expectations at home. They may have gotten used to the structure and rules of the hospital environment, and transitioning back to previous levels of independence can be challenging. It is important to communicate openly with your child about your expectations and to work together to establish a routine that provides structure while also allowing for gradual increases in independence.
Finally, remember that your child's feelings about being discharged may evolve over time. They may experience setbacks or new challenges, and it is important to remain patient and understanding throughout this transition. Regularly check in with your child and encourage them to share any concerns or difficulties they may be experiencing. By recognising and addressing your child's feelings, you can help make their transition from the hospital back home a smoother and less stressful experience.
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Plan for your child's return to school
Planning for your child's return to school after a hospital discharge can be a challenging process, but there are several steps you can take to make the transition smoother. Here is a plan to help guide you through this process:
Understand Your Child's Feelings and Concerns
Recognize and address your child's feelings about being discharged from the hospital and returning to school. Discuss any fears or concerns they may have, such as the fear of rejection or not fitting in with their peers. Encourage open communication and assure them that it's normal to feel anxious about this transition.
Inform the School and Seek Support
It is essential to maintain open communication with the school staff, including teachers, guidance counselors, and the school nurse. Inform them about your child's long absence and any medical or emotional needs they may have following the hospitalization. You can request a meeting with the relevant staff members to discuss the necessary accommodations and support for your child's return.
Develop an Academic Plan
Work with your child's teachers and counselors to develop an academic plan that suits your child's needs. Depending on their situation, they may benefit from a reduced schedule, flexible due dates for assignments, or tutoring assistance. If your child has ongoing medical complexities, they may be eligible for an Individualized Education Program (IEP) or a 504 Plan, which provides customized goals, learning strategies, and physical accommodations.
Facilitate Social Reintegration
Encourage your child to reconnect with their friends and peers before or after returning to school. This can help ease their transition and address any concerns about fitting in. Arrange for social time during their initial return, such as including recess or lunch periods, to promote social interaction and emotional well-being.
Medication Management
If your child requires medication during school hours, collaborate with the school nurse or relevant staff to manage their medication schedule. Ensure that the school is aware of any side effects and provide them with the necessary information to support your child's medical needs.
Monitor and Follow Up
Stay in close communication with the school and your child to monitor their adjustment. Regularly check in with your child to see how they are feeling and coping with the transition. Work with their healthcare team to identify any potential issues and follow up with the school to ensure that the support plan is effective.
Remember, each child's needs are unique, so tailor this plan to fit your child's specific circumstances. Don't hesitate to seek additional support from healthcare professionals, social workers, or therapists if needed.
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Create a safe space for your child at home
Creating a safe space for your child at home after hospital discharge involves several considerations and steps. Firstly, it is important to understand that your child might still be processing their hospitalization and the associated emotions. They may feel anxious, embarrassed, or worried about their welfare. It is crucial to provide emotional support and help them navigate their feelings. Maintain open and honest communication with your child, and assure them that it's normal to experience a range of emotions during this transition.
Before your child returns home, it is advisable to consult their psychiatrist or treating doctors to understand any specific rules or guidelines that need to be followed. For instance, can they be left alone for short periods? Are they allowed to visit friends' houses? Understanding these parameters will help you create a structured and safe environment for your child.
Additionally, you can make practical adjustments to your home environment to enhance your child's safety and comfort. This includes removing any potential hazards, such as clutter, rugs, or cords that could cause tripping. Ensure adequate lighting in the house and consider installing handrails or grab bars if needed. If your child requires any medical equipment, medications, or supplies, ensure you have them readily available at home.
Creating a safe space also involves providing emotional support and helping your child reintegrate into their daily routine. Give them time and space to adjust, and involve their friends and peers in a way that makes them feel accepted and understood. Remember that setbacks or challenges are normal during this transition, so remain patient and seek support from your child's treatment team or other professional resources if needed.
Lastly, it is beneficial to maintain regular contact with your child's outpatient team and follow their recommendations for therapy, psychiatry appointments, or medication adjustments. Keeping a journal or log of your child's progress, emotions, and any noticeable changes can be incredibly helpful for both you and the doctors, providing an objective measure of their progress and any areas of concern.
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Know your rights and the hospital's rights
When it comes to discharging your child from the hospital, it's important to understand both your rights as a parent or guardian and the hospital's rights and responsibilities in providing care. Here are some key points to consider:
Your Rights as a Parent or Guardian:
- In most cases, parents or legal guardians have the right to request a discharge for their child, even if it goes against medical advice (DAMA). This is because caregivers have the right to decline treatment for their child.
- You have the right to be involved in the discharge planning process. Hospitals typically start planning for discharge as soon as your child is admitted, and you should be included in these discussions.
- You can request information about your child's medication, including purpose, dosage, delivery, special considerations, and side effects. Ensure you understand the treatment plan you need to provide for your child at home, including any medications, activities limitations, and instructions for wound care or hygiene.
- If you disagree with the hospital's recommendations or believe your child is ready for discharge, you can try to explain your situation and perspective. However, the hospital may still override your decision if they believe it is in the best interests of the child.
The Hospital's Rights and Responsibilities:
- Hospitals have a duty to protect children and provide medically appropriate care. If they believe that discharging a child would pose a risk to their safety or health, they can take steps to prevent this, including seeking a court order to keep the child in the hospital.
- Medical professionals are responsible for making decisions in the best interests of the child. If they believe that discharging a child would be unsafe or detrimental to their health, they can advise against it and even go to court to obtain an order to keep the child in the hospital.
- Hospitals typically require parents or caregivers to sign a DAMA form when discharging a child against medical advice. This form documents that the family has chosen to decline further recommended care, and it waives the hospital's responsibility for any complications arising from the early discharge.
- In some cases, such as when a child is in the custody of law enforcement, the hospital may require authorization from the responsible correctional facility for discharge.
It's important to remember that while you have the right to request a discharge for your child, the hospital also has a responsibility to ensure the child's well-being. Open communication and collaboration between parents and medical professionals are essential to ensuring a safe and appropriate discharge.
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Frequently asked questions
The process will vary depending on the type of hospital and treatment your child has received. In general, you should expect to review your child's medication with the care provider, receive prescriptions, and discuss any home care requirements. If you are discharging your child against medical advice (DAMA), you may be asked to sign a form stating that you are leaving before the physician-recommended endpoint.
In most cases, only a parent or legal guardian has the right to request a discharge for their child. However, doctors can go to court to obtain an order to keep a child in hospital if they believe it is in the child's best interest. This may result in the child being forced to stay in hospital.
It's important to identify the next steps and make arrangements to help your child transition smoothly. You should discuss any concerns about your child's mental health with their doctor and work with them to create a safety plan to avoid relapse. It's also a good idea to inform your child's school about their absence and involve staff such as the nurse or psychologist, who may be able to provide additional support.
You can ask your child's care provider for prescriptions for any required medications or other therapies. These can usually be filled at a hospital pharmacy or a pharmacy of your choice.
