Care-by-parent before a child is discharged from hospital

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Learn how "care-by-parent" prepares you to care for a child with complex needs when they are discharged from hospital.

Key points

  • Care-by-parent allows the main caregivers of a child with complex medical needs to care for their child independently before the child is discharged from hospital.
  • The care-by-parent period takes place over 12 to 48 hours, including overnights, in a single patient room.
  • Caregivers must be fully trained in their child's personal and medical care and have all the medication and working equipment they need before care-by-parent can start.
  • Nursing staff will not monitor the child as closely during the care-by-parent period, but they are available if caregivers need help or have questions.

If your child has a complex medical condition that requires treatment in hospital for a period of time, your child's health-care team will include a period of "care-by-parent" in your child's discharge plan.

Care-by-parent involves a child's primary caregivers providing all personal and medical care for a child independently within the hospital before the child is discharged.

The goal of care-by-parent is to allow a child's caregivers to:

  • practise the skills that they have learned
  • feel confident in their abilities to care for their child independently at home.

How long must I provide care-by-parent?

The length of time depends on your child's medical needs. Care-by-parent often takes place over 12 to 48 hours, including overnights. You and your child's health-care team will discuss the exact timeframe for your child.

When will I be ready to do care-by-parent?

You and your child's health-care team will discuss when exactly care-by-parent will start.

In general, however, you and your child must meet the following conditions before you can be considered ready for care-by-parent.

  • Your child must be medically stable for discharge home.
  • You must have been taught all aspects of care for your child and attended classes to better understand your child's care and any equipment you will need. Classes may be provided within your child's hospital or by organizations recognized by the hospital.
  • You must show the health-care team that you are confident in caring for your child independently. This includes demonstrating the skills required to care for your child, which include identifying and responding to emergency and "what if" situations.
  • You must have all the medications that you will need from the hospital pharmacy for the complete care-by-parent period.
  • You must obtain and understand how to use all the equipment you will need to care for your child.
  • You must make sure any equipment is tested by the hospital's medical engineering department.
  • If your child needs to go home with an artificial airway, you must have completed CPR training.

When your care-by-parent period is confirmed, you can write it here.

My care-by-parent period will run from: __________________ to ___________________.

Where is care-by-parent performed?

Care-by-parent is performed in a single patient room in the hospital. Your room will be assigned to you in advance and you will have time to set up all your equipment before the care-by-parent period starts.

What is in the care-by-parent room?

Besides the equipment you need, there will be a bed or crib for your child and a daybed for you. Each room also has a private bathroom and a phone.

The hospital will provide you with bed linens. Disposable supplies (such as diapers, suction catheters or feeding bags) can also be supplied.

You are welcome to bring your own pillows, blankets and any other supplies from home. You may also bring your own food and store it in the unit fridge with a label indicating your name or your child's name.

What can I expect from my child's health-care team during care-by-parent?

Nursing staff will not monitor your child as closely as they did before the care-by-parent period.

You can normally expect the following level of involvement.

  • Just before the care-by-parent period, your child's nurse will check your child's vital signs (their temperature, heart rate, blood pressure and breathing) to make sure your child is stable.
  • You and your child's nurse will review what is expected of you and the health-care team.
  • Your child's nurse will show you the nurse call and emergency button in your room in case you need help.
  • Your nurse will be available to answer questions and help you care for your child only if you request assistance.

How do I get help if I need it during the care-by-parent period?

If you ever need help during the care-by-parent period, do not hesitate to ask your child's nurse.

If you have any questions or non-urgent concerns, use the nurse call button in the room. Your child's health-care team will encourage independence during care-by-parent, but it is important to get all your questions answered before your child goes home.

If your child develops breathing problems, or if any other type of emergency develops, immediately press the emergency button in your room. Since your nurse is no longer monitoring your child as much as before, you are responsible for watching your child and getting help as soon as you need it.

May I take my child out of the room?

Yes, you may take your child out of the room. Always tell the nurse on duty or the unit clerk when your child is leaving the room and make sure you also take any portable equipment that you need.

What should I do if I must leave the care-by-parent room?

Your child must be supervised at all times. Never leave your child alone in the room.

If you have an emergency where both caregivers must leave, please bring your child back to their nurse. You may also take your child with you, but make sure you have all the portable equipment you need before going anywhere.

May I have visitors in the room?

Care-by-parent is meant to be a learning experience for the people who will be caring for your child at home. Anyone who will be caring for the child is welcome, but the hospital is unlikely to encourage many visitors, as they can be distracting.

Who can I talk to about my child's care?

You will likely be working closely with the following people on your child's healthcare team to prepare for care-by-parent.

  • Primary care nurse
  • Transitional care co-ordinator
  • Doctor
  • Charge nurse
  • Unit nurse educator
  • Social worker (depending on your family's needs)
  • Respiratory therapist (depending on your child's condition)

Please do not hesitate to ask any of these people for help in preparing for care-by-parent. The care-by-parent experience is meant to build your confidence to make sure you are ready to bring your child home and care for their needs. Your child's health-care team is here to help you succeed at home.

Last updated: August 11th 2014