Chapter 7

Child With a Chronic Health Problem

 Chronic Illness

• Interferes with ADL’s for more than 3

months a year or
• Causes hospitalization for more than 1
month in a year

• Respite care:
– Care of ill child so caregiver may have rest
– Daily or overnight, few available
 Stages for caregivers
• Overprotection:
• Protect child at all costs, avoiding discipline
• Rejection:
• Distance themselves emotionally, provide physical
care; continually discipline, scold
• Denial:
• Condition does not exist, encourage child to
overcompensate for any disability
• Gradual acceptance:
• Common sense approach, helping to set realistic
goals
Children often perceive illness as
a punishment
• RX:
• Encourage independence
• Strain on caregiver
• Caregiver must have time away
• Strain on siblings
• Set quality time for other siblings
• Allow other children to vent
 Siblings of child with chronic
illness
• Sibling rivalry – resentment
• Stigma, especially if child has physical
disfigurement or apparent deficit
• Anger, hostility
• Reaction depends on family’s ability to
cope with stress
• Must spend quality time with healthy
children
 Nursing role
• Encourage family to express their feelings
• Assist family in adjusting to child’s condition
• Encourage optimal growth / development
• Prevent social isolation and promote self care
• Explain all procedures, be honest
• Aid caregiver in accepting condition
• Grief, denial, guilt
• Be a good listener
• Offer names of support groups