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Play work with children in hospitals, hospices and in home care

Play work (child life) is the name of a profession that is a natural and self-evident part of health care in many foreign hospitals and hospices. Its task is to help children and families make life with the disease easier, through play, which is the closest activity to children. Play work is performed by a play specialist / child life specialist, an expert in "play and child life" (that is why the terms health play specialist, play specialist or child life specialist are used abroad). Play is the language of childhood. Time and opportunity to play is the right of every child. Both play and artistic creation open up a space in which the child takes control in expressing, exploring, experimenting and understanding his reality without fail and with the overall goal of managing his situation as best as possible.

The life experience of a child in palliative care is characterized by uncertainty, obstacles to normal development, possible fear and loss of control. And yet, providing play time and opportunities for children with serious illness may be overlooked or considered unimportant, especially when adult caregivers are focused on alleviating the clinical symptoms of the illness. The game makes it possible to compensate for the negative impact of the disease not only on the children themselves, but also on their siblings and the entire family.

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In hospitals, it is most often used during the entire period of hospitalization - from the admission of the child into care to the explanation of the hospitalization process and the specifics of the disease in language appropriate to the child's age; to explain and prepare the child for an examination or medical procedure; to distract from pain during and after procedures; to the development and stimulation of children in whom hospitalization and in supporting siblings and parents during coping with the changes associated with the child's illness.

In hospices, the play specialist completes the daily program, cooperates with other caregivers, attends to healthy siblings and turns an unfamiliar environment into a place where there is time for play, fun, joy and development. She talks to children and parents about their wishes and activities they like and finds ways to fulfill them during their hospice stay. She attends to sick children during free time in the playroom, art or music studio, in the snoezelen sensory room or while walking outside. He works with physiotherapists and occupational therapists during exercises on dry land and in water. Examples of activities in the hospice can be, for example, creating art, playing with sensory toys and aids, collaborating in hydrotherapy in the pool, sensory reading, playing musical instruments, or perhaps inventing special events such as spring or Christmas celebrations. The game specialist can also sensitively discuss with parents their wish to create a memory box with children's creations or photos. In short, his task is to make the hospice a pleasant place in which there is enough space for everyone to play.

Play specialists go to home care with a specific task for the family - sometimes it is about sensory stimulation, sometimes about play as such - thanks to the play sessions, the child can have a joyful time, while the parents can relax for a while or be inspired by the work of the play specialist for their own play with children.

I sat by the little patient's bed and watched her make hills and puddles in the sandbox. I wanted to lead the game to the end, but she sensed it, so she tried to drag out the story we were creating together. She took the seagull puppet in her hand and sat it on the hill. Then she flew with him as far as she could reach from the crib and landed above the pool. The seagull leaned into her. She began to speak: “Not yet, the day is not over yet. It's not night. It's not dark. It's not night yet. Because first the seagull must... must... must tell about what he experienced...", she paused, took the seagull and placed it on the sand. "She has to tell about it..." she trailed off. She couldn't finish the sentence.
"Do you want to say out loud who the seagull would tell about his adventure?" She nodded her head and remained silent. I continued, "You want to say it out loud, but you can't." I looked at her and smiled to encourage her. She picked up the seagull and flew it over the hill. During the flight, she just whispered, “Grandma. I would like to call my grandmother.” Then she landed right in my palm with a seagull. Mom took the phone and together they called grandma. We waved and I went.

From the child life specialist's diary

Our specialists currently visit palliative children in hospitals and offer them, according to their wishes and needs, activities that help to improve their mood, to take care of their condition before and after medical procedures, to develop communication skills, to provide sensory stimulation or perhaps to create common family memories. They also work with siblings and parents to make the hospital stay as stressful and exhausting as possible.

Child Life Specialist Míša will go to the General Faculty Hospital in Prague , FN Hradec Králové , and from autumn 2024 she is also going to FN Motol , where she offers game interventions to children and families . She primarily visits children with palliative needs and brings them activities according to their wishes and needs that help improve their mood before and after medical procedures, support healthy development, sensory stimulation and create shared family memories. She also works with siblings and parents to make the hospital stay as stressful and exhausting as possible.

Růženka, our second child life specialist, now comes as a volunteer to FN Motol and is preparing to work in a palliative care environment. She helps children enjoy their stay in the hospital by playing games, talking and sensory reading, which is her specialty. He works with entire families, to whom he brings incentives for spending time together joyfully, cooperation and healthy communication.

Both specialists are educated in the areas of play work, play therapy and communication, and together they develop methods and procedures that are best for play work in palliative care.

Where we provide the play work

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