ERIC Number: ED321437
Record Type: RIE
Publication Date: 1989-Dec
Psychological Issues in Pediatric Home Care.
Kohrman, Arthur F.
The popularity of home care for chronically ill or technology-dependent children has moved professionals into unfamiliar settings. Factors responsible for the relatively sudden surge of effort to place children with complex needs at home include costs, individualism and autonomy, changing views of medicine and its institutions, limits of medical technology, and growth of technical capability. The movement carries many imperatives for behavior and attitude changes in adapting to the public nature of the care, the need for families to assume risks usually assumed by hospital staff, and the need for professionals to dissociate the management of risk from their direct control. Bringing home the medically complex child may create problems which must be anticipated by candidate families, such as loss of privacy, terror concerning the patient's survival, role confusion, exhaustion, endlessness, and guilt. Participation of caretakers from outside the immediate household requires establishment of criteria for training and clear negotiation of the terms of the arrangement. Psychological concerns of professionals who participate in home-care planning include belief in the hospital as the best locus of care and the nature of professional responsibility. The plan for discharge should consider the: adequacy of funds, screening and supervising of paid and volunteer caregivers, best use of home space, respite care, and other issues. Includes 11 references. (JDD)
Descriptors: Caregivers, Children, Chronic Illness, Deinstitutionalization (of Disabled), Family Caregivers, Family Involvement, Home Programs, Long Term Care, Medical Services, Physician Patient Relationship, Psychological Needs, Psychological Patterns, Special Health Problems, Therapeutic Environment
Publication Type: Reports - Descriptive; Speeches/Meeting Papers
Education Level: N/A
Authoring Institution: N/A
Note: Paper presented at the Conference of the National Center for Clinical Infant Programs (Washington, DC, December 1-3, 1989).