Herní práce s dětmi

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

Play work (child life work) is a natural part of health care 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.

In hospitals, it is most often used throughout the hospitalization - from the time of admission to explain the whole process and the specifics of the illness in a language that is appropriate to the child's age; to elucidate and prepare the child for an examination or medical intervention; to distract from pain during and after treatments; to develop and stimulate children who are hospitalized; and to support siblings and parents as they cope with the changes associated with the child's illness.

In hospices, the child life specialist completes the daily program, collaborates with other caregivers, engages with healthy siblings, and makes the unfamiliar environment a place where there is time for play, fun, joy, and development. They talk with children and parents about their wishes and activities they enjoy and looks for ways to fill them while in hospice. They engage with the sick children during free time in the playroom, art or music studio, in the snoezelen sensory room, or during walks outside. They collaborate with physiotherapists and ergotherapists in dry and water exercises. Examples of activities in the hospice include making art, playing with sensory toys and aids, working together on hydrotherapy in the pool, sensory reading, playing musical instruments, or even devising special events such as spring or Christmas celebrations. The child life specialist can also sensitively discuss with parents their wishes to create a memory box with the children's creations or photos. In short, their job is to make the hospice a welcoming place where there is plenty of space for everyone to play.

Child life specialists also come to home care with a specific assignment from the family - sometimes it's sensory stimulation, sometimes it's the play itself - through play sessions the child can have a joyful time while the parents can relax for a while or be inspired by the play specialist's work to engage in play with their children in their own way.

In the corridor of the hospital sat terrified parents with a crying baby, who they were unable to calm down for several tens of minutes. They had just been admitted, and were going through various little examinations, measurements, and answering lots of questions. The little girl was already screaming, the nurse was trying to take her pulse at the same time, but despite her massive crying, she couldn't.

I stopped by, sat down and asked, "Hi, I'm Misha and I'm a child life specialist here at the hospital. Is there anything I can try to soothe (I looked at the tag on her hand) Agatha?" Both parents immediately nodded. I pulled a wind chime out of my backpack and started to ring it in front of Agatha's eyes. In a sec, she stopped crying and watched the little beads from which the notes poured... The nurse sat behind her back and ~ without Agatha noticing ~ measured her pulse. We continued for a few more minutes, so that Agatha began to breathe calmly on her own. The parents smiled at each other and Daddy said: "We need to buy this home. It calms me down too..."

From the diary of a child life specialist

Our play specialists currently visit palliative children in hospitals and offer them activities according to their wishes and needs to help improve their mood, to care for their condition before and after medical interventions, to develop communication skills, to provide sensory stimulation or to create shared family memories. They also work with siblings and parents to make their hospital stay as stress-free and least exhausting as possible.

Michaela is a child life specialist at the General Faculty Hospital in Prague, the University Hospital Hradec Králové and the Motol University Hospital, where she offers game interventions to children and families . Primarily, she visits children with palliative needs and brings them activities according to their wishes and needs to help improve their mood before and after medical interventions, to promote healthy development, sensory stimulation and to create shared family memories. She also works with siblings and parents to make their hospital stay as stress-free and bearable as possible.

Růžena, our other child life specialist, is now volunteering at the Motol University Hospital and preparing to work in a palliative care environment. She helps children to make their stay in the hospital more comfortable by playing games, talks and sensory reading, which is her area of expertise. She works with whole families, encouraging them to spend joyful time together, collaborate and communicate in a healthy way.

Both specialists are constantly educating themselves in play work, therapeutic play and communication, and together they develop methods and practices that are best for play work in palliative care.

Where we do the play work