Centre for Arts and Play work
in Palliative Care
Play work with children
Play work (child life work) is a part of multidisciplinary team in many hospitals and hospices abroad. Its role is to help children and families make living with illness easier through play, the activity closest to the child's heart. Play work is carried out by a specialist, an expert in 'play and child life' (hence the terms health play specialist, play specialist or child life specialist used abroad). Play is the language of childhood. Time and opportunity for play is the right of every child. Play and artistic creation open up a space in which the child takes control in expressing, exploring, experimenting and understanding their reality without failure and with the overall goal of managing their situation as best they can.
The life experience of a child in palliative care is characterised by uncertainty, obstacles to normal development, potentially fear and loss of control. Yet providing time and opportunities for play for children with serious illness may be overlooked or considered irrelevant, especially when adult caregivers are focused on alleviating the clinical symptoms of illness. Play allows for compensation for the negative impact of the disease not only on the children themselves, but also on their siblings and the whole family.
Where does play/child life work take place?
In hospitals, a child life specialist (or health play specialist) has a role to play throughout the entire hospitalization—from the moment a child is admitted. At this stage, the specialist helps orient the child and family to the hospital environment, explains the nature of the illness in a way that is age-appropriate and understandable, and prepares the child for examinations or medical procedures using child-friendly language and play-based tools. The specialist provides distraction during painful procedures and supports recovery afterward. Their role also includes encouraging optimal development despite health-related limitations, and working with siblings and parents as they adjust to the changes brought about by the child’s illness.
In hospices, the child life specialist helps shape the daily program, collaborates with other care providers, spends time with healthy siblings, and transforms an unfamiliar setting into a space where play, joy, and meaningful development are possible. They speak with children and parents about their interests and wishes, and look for ways to fulfill these during their stay. The specialist may spend time with seriously ill children in the playroom, art or music studios, multisensory (Snoezelen) rooms, or outdoors. They also work alongside physical and occupational therapists in both dry-land and water-based activities.
Examples of hospice-based activities may include: arts and crafts, sensory play with adapted toys and materials, hydrotherapy in small pools, sensory-based reading, music-making, or organizing special events such as spring celebrations or winter holidays. The specialist can also gently support parents in creating a memory box with the child’s artwork or photographs. Their role is, simply put, to help make the hospice a welcoming space—one where there is room for play for everyone.
In home-based care, child life specialists visit families with specific goals tailored to their needs. Sometimes the focus is on sensory stimulation, other times on play itself. These sessions offer the child joyful moments while giving parents a brief moment to rest—or the inspiration to create their own play experiences with their children, supported by the specialist’s example.
Where do our Swallow’s
child life specialists fly?
Our child life specialists visit children receiving palliative care in hospitals and offer play-based activities tailored to each child’s needs and wishes. These activities are designed to improve mood, provide emotional support before and after medical procedures, encourage communication skills, offer sensory stimulation, or create meaningful family memories. They also work with siblings and parents to help make the hospital experience as supportive and minimally stressful as possible for the entire family.
Míša visits the University Hospital in Hradec Králové every week, where she provides therapeutic play interventions for children and their families. She primarily supports children with palliative needs, but also meets with children in acute conditions or those who are long-term hospitalized. She engages children through play or uses interactive theatre, depending on the goals of the intervention and the individual needs and preferences of the child and their parents. Her work includes mood-lifting activities to increase motivation for treatment, distraction techniques around medical procedures, and sensory-based games that promote healthy development. She often uses theatre as a way to foster connection between the child and family and to create joyful shared memories. She also supports siblings and caregivers to reduce emotional exhaustion and stress during hospital stays.
Růženka, our second specialist, works with children in the Department of Follow-Up Intensive Care at Hořovice Hospital. Her focus is on sensory stimulation, using music-based activities, sensory reading, and developmental play. She regularly returns to visit the same children on mechanical support, gradually expanding their play possibilities, encouraging natural playfulness, and offering emotional presence and support through play.
Currently, we are expanding our team of child life specialists so that, starting in autumn 2025, we can also offer our services to families in home-based palliative care. Together, we continue to deepen our knowledge in therapeutic play, play-based interventions, communication, and pediatric palliative care. As a team, we are also developing tailored methods and approaches that best support child life work in this unique and sensitive field.
Why we use play?
Play is the language of childhood. The time and opportunity to play is a right of every child. Through play and artistic expression, children are given a space where they can take control—expressing themselves, exploring, experimenting, and making sense of their reality without fear of failure, and with the ultimate goal of coping with their situation as best as they can.
For a child in palliative care, the experience of life is often marked by uncertainty, interruptions in normal development, fear, and a loss of control. And yet, the value of offering time and space for play is sometimes overlooked or underestimated—especially when adult caregivers are focused on relieving the child’s clinical symptoms.
But play has the power to offset the negative impact of illness—not only for the child, but also for their siblings and the entire family.