Stories about: transitioning

Helping your child through a transition

Meaghan O’Keeffe, RN, BSN, is a mother, writer and nurse. She worked at Boston Children’s Hospital for nearly a decade, in both the Cardiac Intensive Care Unit and the Pre-op Clinic.  She is a regular contributor to Thriving.

Meaghan_OKeeffe_1A few months ago I hit a parenting rut. It was the end of February. Between the holidays, the snow days, and some sick days, we hadn’t had a solid three-day week of pre-school in almost two months. My four-year-old son, Tommy, began to have extreme meltdowns several times a day. Because it was time to leave the house. Or it was time to put a toy down. Or it was time for bed. (Or, as it seemed to me, just because.) Each moment was an intense battle and no matter what I tried, I couldn’t navigate around the rough waters. I kept hitting the rapids. I was at my wit’s end. Enough that I pulled his pre-school teacher aside one morning, and whispered, near tears, “I don’t know what to do with him.” She reassured me this was normal and gave me some tips. I made a few changes, and within a couple of weeks, it appeared we had emerged from the whirlpool.

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Time for transition? We can help.

Kitty O'Hare, MD

By Kitty O’Hare, MD, coordinator of Transition Medicine at Boston Children’s Hospital’s Martha Eliot Health Center.

The field of pediatric medicine has come a long way in the past few decades. Kids with health conditions like sickle cell disease, heart conditions, even cancer are living, full, healthy lives into adulthood.

It’s a great accomplishment, but with increased survival rates come unique challenges. In addition to treating their chronically ill patients, today’s pediatricians need to prepare them for adult life, where they will be responsible for managing their own health. But according to a recent national survey, we doctors aren’t as good at helping our patients transition into adulthood as we could be: less than half of all kids with chronic health conditions receive the services they need for a successful transition to adulthood.

Because Boston Children’s works with such a large pediatric population, most of our staff is aware of the lapses in care that can happen when a person transitions from a child care setting to one for adults. We’re also committed to lessening that gap, so we’re participating in a national initiative, funded by a federal grant through the National Health Care Transition Center, called “Got Transition?”  

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Setting the stage for medical independence

By Kitty O’Hare, MD, coordinator of Transition Medicine at Martha Eliot Health Center

I see this story play out over and over again in my clinic:

A 15-year-old comes to the office for an asthma visit. The teen is glued to their cell phone, iPad or PSP from the moment they enter the exam room. Every time the provider asks about medication use or frequency of symptoms, the parent jumps right in with a ready answer while the teen stays in their electronic universe. Even if the provider tries to engage the teen directly, only one-word answers or grunts are given. By the end of the visit it is obvious how much (or little) the parent knows about asthma, but it is less obvious how much the patient knows about their disease.

Parents are wonderful health advocates for their children. I tell parents that they know their child much better than I ever could. Parents make all kinds of decisions for their children every day, but unlike deciding on pizza vs. chicken fingers for dinner, healthcare decisions literally can be matters of life or death. So it is very hard for parents to hand over control of healthcare to their children.  But it is important for children, teens especially, to learn to take control of their health. Here is how parents can help:

Step 1: Teach children to understand their bodies.

This is a key area of child development. We teach toddlers to name their “head, shoulders, knees and toes,” but sometimes the learning stops there. As children grow, it is important to reinforce the proper names for the parts of the body as well as some basics of their function. Very few people can describe the inner workings of the cardiovascular system, but even a small child can learn that the heart pumps blood throughout the body, or that everyone has two lungs. Parents can teach children how everyday decisions affect their body, for example, that drinking milk gives you calcium and Vitamin D for strong bones and strong teeth.

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