Practical information to help you transition your family
from the Pediatric Intensive Care Unit (PICU) to home.
"These feelings are normal; and it is important to
"Most children can and do return to their typical day-to-day lives, but there may be a few bumps along the way."
"Post-Traumatic Stress Symptoms are common among children and families of children who have been extremely ill. Most of the time, these symptoms are part of the normal process of dealing with a traumatic event for both adults and children."
"Kids can get better at dealing with stressful situations as well as work on making friendships and relationships with both peers and adults."
If you feel that anyone in your family is having trouble coping after your child has been in the PICU, reach out to your healthcare provider, counselor or spiritual or religious leader for help and support.
Taking care of yourself is taking care of your family
Caring for a very ill child is a very stressful experience for the entire family. Taking care of yourself and your emotional needs during and after this stressful time will help your whole family adjust to life again after the hospital.
It is normal to feel anxious about your children’s health after they have been released from the Pediatric Intensive Care Unit (PICU). You may feel concerned that you are unable to take care of your children’s health needs without assistance or that your child may become very ill again. These feelings are normal; and it is important to remember that you are not alone. Many parents and families have dealt with the serious illness of a child at some point.
Things You Can Do To Take Care of Yourself:
Places to look for help:
Helping your children transition home
Many families wonder what life will be like after their children leave the hospital. Most children can and do return to their typical day-to-day lives, but there may be a few bumps along the way.
Below are some things you can do as a parent to help your family transition from a critical illness. Make sure you consult with your child’s healthcare provider before following any of these guidelines. Some children may need adjustments to their normal routines for a while after hospitalization, and that is ok. Your healthcare provider should be able to help you decide which activities are ok and what you need to adjust or hold off on for a while.
General Tips for Transitioning the Family after a Critical Illness:
Changes You May Notice In Your Child After a Stay in the PICU
You may notice some of the changes below in your child after they return home from the PICU. These changes should lessen and go away with time. If they persist for a long time, or do not get better, contact your child’s healthcare provider, school counselor, or family doctor. If you feel that any member of your family is having trouble coping after the PICU, reach out to your support network, spiritual leader, or family healthcare provider.
There hasn’t been much study of emotional stress among children who have been in the PICU. What we do know from other studies is that children who have suffered serious illnesses like heart problems, serious injuries, organ transplants, or cancer may experience Post-Traumatic Stress Symptoms (PTSS). Post-Traumatic Stress Symptoms are common among children and families of children who have been extremely ill. Most of the time, these symptoms are part of the normal process of dealing with a traumatic event for both adults and children. Typically these symptoms will lessen and go away in time. If your child or anyone in your family experiences these symptoms for a prolonged period of time, if they do not get better with time, if they are experiencing many of the following symptoms simultaneously, or if you have general concerns about any family member’s ability to cope, seek help from your pediatrician, family healthcare provider and/or a licensed therapist.
Post-Traumatic Stress Symptoms:
For more information on Post Traumatic Stress Symptoms in children who have been very sick please visit the Children’s Hospital of Philadelphia’s Center for Pediatric Traumatic Stress website here.
Developmental Changes (Acting Younger):
Being in the intensive care unit of the hospital can be a frightening time for a child. When kids go through a very stressful period, they often deal with it by regressing in their behavioral and emotional development. Children may want to stop following normal routines that they have started. For example, infants who have spent a long time in the PICU may want to be held more often than usual. Toddlers may start having temper tantrums, or ask to use a bottle instead of eating on their own. Preschoolers who have started speaking in full sentences may go back to “baby-talk”, or no longer be toilet-trained. School-age children sometimes cry more than usual after a stay in the PICU, and teenagers can sometimes want to be with their parents more than usual. These are just a few of the ways that staying in the PICU can change the way a child’s behavior and temperament. Once the child has returned to his or her typical routine for a while, the changes often resolve. However, depending on the type of illness and procedures a child had, there may be lasting effects of the sickness.
What we do know from research on other hospitalizations is that the stress caused by being very sick in the hospital and being hooked up to a lot of machines can lead to behavioral changes in kids. It is very common for children to feel stressed out and scared in the hospital, and this may affect them after going home. Kids may feel helpless, anxious, afraid, or sad. Sometimes they may act withdrawn or want to be alone more than usual, or they may cling to parents and not want to be separated. Kids may change their sleeping habits or become pickier eaters. Younger children may feel guilty about being sick, or think they did something wrong to cause it. Older kids may act angry and worry about how they will fit in at school or with their friends after being in the hospital. Teens may also act mean toward their parents and jealous of their brothers or sisters. We hope you will consider participating in future studies to help us understand how critical illness may affect children’s mental health, and what we can do to make the transition from the PICU to home easier for the entire family.
Siblings of Very Ill Children
Seeing a brother or sister hooked up to machines and IVs can be quite scary for a child or teen. Siblings may experience anxiety and high stress levels because of the change in their parent’s roles (when the doctor becomes their brother or sister’s primary care taker, instead of mom and dad) and fear for their brother or sister. Children often worry about their sibling’s health, and are afraid about their own health and safety. Kids may feel detached from the sick child, guilty, and alone. They may think that they are not important to the family. Older children sometimes feel the need to assume more responsibilities. Some siblings of sick children may become depressed, and may feel resentment towards the sick sibling. However, the experience of having a brother or sister in the PICU can be an opportunity for growth for these children, too. Kids can get better at dealing with stressful situations as well as work on making friendships and relationships with both peers and adults. The emotional impact of having a sibling in the hospital, like many other aspects of staying in the PICU, is still not fully understood. Further research into this topic is needed.
Here are some tips from The Children’s Hospital of Philadelphia on helping your children cope with their sibling’s critical illness: