Dealing with the Stress of a Hospitalized Family Member

A hospitalization can affect not only the patient, but family members and friends who might experience stress when a loved one goes into the hospital. Once you understand what is causing stress, you are in a better position to get help. Below are some common causes of stress experienced by the family and friends of someone who is in the hospital.

Physical and emotional reactions
Sleep can be more difficult during times of stress, and when it does occur, it often is not restful. Nutrition can suffer if families rely on fast food or vending machine snacks so they do not have to leave the patient's bedside for long. Families might also feel irritable, angry or guilty for neglecting other family members and obligations. Some get so worn out they cannot take care of the patient when he or she goes home again.

Concerns about information
Families are concerned about what is happening to their loved one in the hospital and how much information they will get. They would like to receive thorough, candid information, but they also worry about their ability to understand and cope with the information they receive.

When the patient is a child, families may worry they have not prepared their child adequately for the hospital stay and that this may add to the child's discomfort. Families feel the helplessness of losing control of the child's care and the frustration of not being able to ease the child's fear or pain.

When the patient is an adult, families worry about how to explain the situation to children in the family. In the case of serious illness or injury, they must decide whether or not a visit by the children would be appropriate.

Anxiety about discharge care
Families and friends worry that illness or injury may leave their loved one either disfigured or disabled and that they may not be able to meet his or her needs after discharge. This dilemma is especially painful when they are separated by long distances from the patient and have to make special arrangements with family and work to accommodate care.

Financial worries
Some families worry about the cost of treatment and follow-up care for rehabilitation, home care, medical equipment or physical therapy. They may need help understanding what is covered by insurance and how they will meet the remaining hospital and physician expenses. They may worry about returning to work without neglecting their loved one.

What can you do?
If you are concerned about the stress you are experiencing related to the hospitalization of a family member or a loved one, a good first step is to ask to speak to someone in Religious Ministries, Social Work, Patient Relations or a member of the health care team with whom you feel comfortable. Most families can successfully adjust to the stress by using the following tips:

Get information on the patient's condition
If your loved one has difficulty participating in his or her care, the family may designate someone to be that person's primary family contact with hospital staff.

Make sure the attending doctor and nurses know the name and phone number of the designated family contact person, who will be calling for updates about your loved one's condition.
Ask your family doctor to stay involved and to talk to the specialists treating your family member or loved one.
Ask the nursing staff to tell you about medical equipment and its purpose. Find out what the alarms or bells mean.
Some hospitals issue "patient pathways" that outline the commonly expected daily plan of care for different medical conditions. Ask if the patient is on a pathway and if you can have a copy of it.
Keep a small notebook handy so you can write down questions to ask the doctor and other caregivers.
Ask for a second opinion if you want reassurance and peace of mind that you are making the right decisions.

If you are not the primary contact between the hospital and your family, you may still want information about your loved one's condition:

Ask for any literature the hospital may have to help you understand the patient's condition and treatment. They may have a library on the unit or nearby for family and friends to use. Yale-New Haven Hospital offers a wide range of materials for patients and families
Use the Internet. There are now thousands of Web sites dedicated to distributing health care information. Your hospital is likely to have one of its own, and this is the simplest place to begin your search. Ask for a copy of YNHH's Making the Right Choice on the Web about how to find good health information on the Internet.

Prepare your child for hospitalization

If you know in advance that your child needs hospitalization, take the child on a pre-admission hospital tour.
Minimize your child's pain by asking for a pediatric pain management physician.
Ask if there is a parent-to-parent support network
Ask if a child life specialist or social worker can be assigned to your child

Prepare your child for a hospital visit

Try to answer children's questions honestly. Prepare them for what they will see, hear and experience (physical appearance of patient, equipment). Take photos with a Polaroid camera if possible, to show environment. Nursing or other support staff can help you accomplish this.
Give children choices: Do they want to visit or not? Do they want to go into the patient's room or just look from the doorway? If they don't want to visit, they may want to draw a picture or write a letter to the patient in the hospital as a way of keeping in touch
If children are left at home, call or communicate as often as possible. Reassure them, identify any temporary caregivers, and discuss any changes in routine.
Consider past experiences that could affect how your children might process this event, for example, a recent illness or death of a family member, pet or classmate. Probe for and correct any misconceptions about the patient's illness or reason for hospitalization
Watch for any changes in sleeping, eating or playing patterns and address your children's concerns as soon as possible.
After the hospital visit, set aside time to talk with your children about what they saw and how they felt.

Deal with physical and emotional reactions

Talk to other families in the hospital with similar situations.
Ask how you can help staff provide care to your loved one, perhaps by helping with meals or bathing.
Ask if you can sleep in the room with your family member/ loved one.
Eat well and get plenty of sleep (napping in a quiet room on the floor can help).
Seek help from hospital staff such as social workers, chaplains and child life specialists or patient representatives, if your needs are unmet or if you just need support.
Many hospitals have specifically trained volunteers who have experienced the same problem as your loved one. Talk to the nurse or the social worker to see if you can arrange daily visits with one of the volunteers to help reduce your anxiety as well as your loved one's.
Use the hospital's chapel and ask a chaplain or your own minister, priest or Rabbi to visit you.
Ask a good friend to organize and coordinate friends and neighbors to provide meals and babysitting for the family.
Check the Internet for appropriate web sites. For example, www.caregiver.org specializes in on-line support for families who provide care to someone who is elderly or chronically ill.

Anticipate your loved one's discharge

Review written instructions about medications, diet restrictions, limits on physical activity, and dates for follow-up appointments. Be clear about the proper use of any equipment that's needed (blood glucose monitors, oxygen, blood pressure, etc.). Do this before your family member leaves the hospital so all your questions can be answered immediately.
Find out about any signs that indicate the patient is not healing properly. Find out whom to call if these signs occur or if you have questions or unexpected situations come up after the patient has gone home.
Know the names of your loved one's medicines including dose, schedule, side effects, whether there are any food-drug interactions, and when to report any problems to the healthcare provider.
If your family member requires skilled nursing care, medical equipment at home or a companion when you return to work, the hospital can make these arrangements or recommend agencies to contact.

Find out about financial assistance

Ask your hospital if there is a list of hotels, motels or short-term rentals that offer discounts to families or friends of patients.
Ask if there are discounts on parking and food vouchers for families who have loved ones in the hospital for a long time
Two Web sites, www.phrma.org and www.themedicineprogram.com give you information about how to apply to drug companies for free medications for limited periods. Many maintenance medications for diabetes, AIDS, cancer, ulcers, high blood pressure and cholesterol are offered as part of this little known program.
Some hospitals assign a patient account representative to each patient's case. Consult with this person on all matters related to bills during and after the hospitalization.
Many insurance companies have nurses on staff who can help answer coverage questions.
Be assertive with your insurance company if you disagree with charges for your loved one's care. Do not be afraid to challenge.

Frequently requested information about Yale-New Haven Hospital

The Yale-New Haven Web site: www.ynhh.org
The Yale New Haven Call Center: (888) 700-6543
Pre-admission tours for children: (203) 688-7996
Volunteer Services: (203) 688-2297
Religious Ministries: (203) 688-2151
Social Work: (203) 688-2195
Patient Relations: (203) 688-3430

Call (203) 688-2000 or toll free (888) 700-6543 to speak with a health information coordinator or request an appointment. You can also get physician information or request an appointment on this web site.

Last revised: March 8, 2004 (cfs)